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Sample records for achieved 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. PMID:26438747

  2. 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.

  3. 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

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

    PubMed

    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

  5. 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. PMID:27274598

  6. Priority-setting for achieving universal health coverage

    PubMed Central

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

    2016-01-01

    Abstract 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. PMID:27274598

  7. 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.

  8. 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. PMID:26355053

  9. 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.

  10. 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

    2012-10-01

    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. PMID

  11. 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

    2012-10-01

    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.

  12. 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

    2011-03-01

    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. PMID:21269682

  13. 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

    2011-03-01

    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.

  14. Health care financing in Nigeria: Implications for achieving universal health coverage.

    PubMed

    Uzochukwu, B S C; Ughasoro, M D; Etiaba, E; Okwuosa, C; Envuladu, E; Onwujekwe, O E

    2015-01-01

    The way a country finances its health care system is a critical determinant for reaching universal health coverage (UHC). This is so because it determines whether the health services that are available are affordable to those that need them. In Nigeria, the health sector is financed through different sources and mechanisms. The difference in the proportionate contribution from these stated sources determine the extent to which such health sector will go in achieving successful health care financing system. Unfortunately, in Nigeria, achieving the correct blend of these sources remains a challenge. This review draws on relevant literature to provide an overview and the state of health care financing in Nigeria, including policies in place to enhance healthcare financing. We searched PubMed, Medline, The Cochrane Library, Popline, Science Direct and WHO Library Database with search terms that included, but were not restricted to health care financing Nigeria, public health financing, financing health and financing policies. Further publications were identified from references cited in relevant articles and reports. We reviewed only papers published in English. No date restrictions were placed on searches. It notes that health care in Nigeria is financed through different sources including but not limited to tax revenue, out-of-pocket payments (OOPs), donor funding, and health insurance (social and community). In the face of achieving UHC, achieving successful health care financing system continues to be a challenge in Nigeria and concludes that to achieve universal coverage using health financing as the strategy, there is a dire need to review the system of financing health and ensure that resources are used more efficiently while at the same time removing financial barriers to access by shifting focus from OOPs to other hidden resources. There is also need to give presidential assent to the national health bill and its prompt implementation when signed into law.

  15. Health care financing in Nigeria: Implications for achieving universal health coverage.

    PubMed

    Uzochukwu, B S C; Ughasoro, M D; Etiaba, E; Okwuosa, C; Envuladu, E; Onwujekwe, O E

    2015-01-01

    The way a country finances its health care system is a critical determinant for reaching universal health coverage (UHC). This is so because it determines whether the health services that are available are affordable to those that need them. In Nigeria, the health sector is financed through different sources and mechanisms. The difference in the proportionate contribution from these stated sources determine the extent to which such health sector will go in achieving successful health care financing system. Unfortunately, in Nigeria, achieving the correct blend of these sources remains a challenge. This review draws on relevant literature to provide an overview and the state of health care financing in Nigeria, including policies in place to enhance healthcare financing. We searched PubMed, Medline, The Cochrane Library, Popline, Science Direct and WHO Library Database with search terms that included, but were not restricted to health care financing Nigeria, public health financing, financing health and financing policies. Further publications were identified from references cited in relevant articles and reports. We reviewed only papers published in English. No date restrictions were placed on searches. It notes that health care in Nigeria is financed through different sources including but not limited to tax revenue, out-of-pocket payments (OOPs), donor funding, and health insurance (social and community). In the face of achieving UHC, achieving successful health care financing system continues to be a challenge in Nigeria and concludes that to achieve universal coverage using health financing as the strategy, there is a dire need to review the system of financing health and ensure that resources are used more efficiently while at the same time removing financial barriers to access by shifting focus from OOPs to other hidden resources. There is also need to give presidential assent to the national health bill and its prompt implementation when signed into law

  16. 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

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

    PubMed Central

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

    2015-01-01

    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

  18. Building blocks for reform: achieving universal coverage with private and public group health insurance.

    PubMed

    Schoen, Cathy; Davis, Karen; Collins, Sara R

    2008-01-01

    This paper presents a framework for universal health insurance that builds on the current U.S. mixed private-public system by expanding group coverage through private markets and publicly sponsored insurance. This Building Blocks approach includes a new national insurance "connector" that offers small businesses and individuals a structured choice of a Medicare-like public option and private plans. Other features include an individual mandate, required employer contributions, Medicaid/State Children's Health Insurance Program (SCHIP) expansion, and tax credits to assure affordability. The paper estimates coverage and costs, and assesses the approach. Our findings indicate that the framework could reach near-universal coverage with little net increase in national health spending. PMID:18474952

  19. Equity of the premium of the Ghanaian national health insurance scheme and the implications for achieving universal coverage

    PubMed Central

    2013-01-01

    The Ghanaian National Health Insurance Scheme (NHIS) was introduced to provide access to adequate health care regardless of ability to pay. By law the NHIS is mandatory but because the informal sector has to make premium payment before they are enrolled, the authorities are unable to enforce mandatory nature of the scheme. The ultimate goal of the Scheme then is to provide all residents with access to adequate health care at affordable cost. In other words, the Scheme intends to achieve universal coverage. An important factor for the achievement of universal coverage is that revenue collection be equitable. The purpose of this study is to examine the vertical and horizontal equity of the premium collection of the Scheme. The Kakwani index method as well as graphical analysis was used to study the vertical equity. Horizontal inequity was measured through the effect of the premium on redistribution of ability to pay of members. The extent to which the premium could cause catastrophic expenditure was also examined. The results showed that revenue collection was both vertically and horizontally inequitable. The horizontal inequity had a greater effect on redistribution of ability to pay than vertical inequity. The computation of catastrophic expenditure showed that a small minority of the poor were likely to incur catastrophic expenditure from paying the premium a situation that could impede the achievement of universal coverage. The study provides recommendations to improve the inequitable system of premium payment to help achieve universal coverage. PMID:23294982

  20. Managing the public-private mix to achieve universal health coverage.

    PubMed

    McPake, Barbara; Hanson, Kara

    2016-08-01

    The private sector has a large and growing role in health systems in low-income and middle-income countries. The goal of universal health coverage provides a renewed focus on taking a system perspective in designing policies to manage the private sector. This perspective requires choosing policies that will contribute to the performance of the system as a whole, rather than of any sector individually. Here we draw and extrapolate main messages from the papers in this Series and additional sources to inform policy and research agendas in the context of global and country level efforts to secure universal health coverage in low-income and middle-income countries. Recognising that private providers are highly heterogeneous in terms of their size, objectives, and quality, we explore the types of policy that might respond appropriately to the challenges and opportunities created by four stylised private provider types: the low-quality, underqualified sector that serves poor people in many countries; not-for-profit providers that operate on a range of scales; formally registered small-to-medium private practices; and the corporate commercial hospital sector, which is growing rapidly and about which little is known. PMID:27358252

  1. Managing the public-private mix to achieve universal health coverage.

    PubMed

    McPake, Barbara; Hanson, Kara

    2016-08-01

    The private sector has a large and growing role in health systems in low-income and middle-income countries. The goal of universal health coverage provides a renewed focus on taking a system perspective in designing policies to manage the private sector. This perspective requires choosing policies that will contribute to the performance of the system as a whole, rather than of any sector individually. Here we draw and extrapolate main messages from the papers in this Series and additional sources to inform policy and research agendas in the context of global and country level efforts to secure universal health coverage in low-income and middle-income countries. Recognising that private providers are highly heterogeneous in terms of their size, objectives, and quality, we explore the types of policy that might respond appropriately to the challenges and opportunities created by four stylised private provider types: the low-quality, underqualified sector that serves poor people in many countries; not-for-profit providers that operate on a range of scales; formally registered small-to-medium private practices; and the corporate commercial hospital sector, which is growing rapidly and about which little is known.

  2. Great expectations for the World Health Organization: a Framework Convention on Global Health to achieve universal health coverage.

    PubMed

    Ooms, G; Marten, R; Waris, A; Hammonds, R; Mulumba, M; Friedman, E A

    2014-02-01

    Establishing a reform agenda for the World Health Organization (WHO) requires understanding its role within the wider global health system and the purposes of that wider global health system. In this paper, the focus is on one particular purpose: achieving universal health coverage (UHC). The intention is to describe why achieving UHC requires something like a Framework Convention on Global Health (FCGH) that have been proposed elsewhere,(1) why WHO is in a unique position to usher in an FCGH, and what specific reforms would help enable WHO to assume this role.

  3. 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

  4. 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. PMID:27145707

  5. Achieving Universal Health Coverage by Focusing on Primary Care in Japan: Lessons for Low- and Middle-Income Countries

    PubMed Central

    Ikegami, Naoki

    2016-01-01

    When the Japanese government adopted Western medicine in the late nineteenth century, it left intact the infrastructure of primary care by giving licenses to the existing practitioners and by initially setting the hurdle for entry into medical school low. Public financing of hospitals was kept minimal so that almost all of their revenue came from patient charges. When social health insurance (SHI) was introduced in 1927, benefits were focused on primary care services delivered by physicians in clinics, and not on hospital services. This was reflected in the development and subsequent revisions of the fee schedule. The policy decisions which have helped to retain primary care services might provide lessons for achieving universal health coverage in low- and middle-income countries (LMICs). PMID:27239877

  6. Achieving Universal Health Coverage by Focusing on Primary Care in Japan: Lessons for Low- and Middle-Income Countries.

    PubMed

    Ikegami, Naoki

    2016-01-01

    When the Japanese government adopted Western medicine in the late nineteenth century, it left intact the infrastructure of primary care by giving licenses to the existing practitioners and by initially setting the hurdle for entry into medical school low. Public financing of hospitals was kept minimal so that almost all of their revenue came from patient charges. When social health insurance (SHI) was introduced in 1927, benefits were focused on primary care services delivered by physicians in clinics, and not on hospital services. This was reflected in the development and subsequent revisions of the fee schedule. The policy decisions which have helped to retain primary care services might provide lessons for achieving universal health coverage in low- and middle-income countries (LMICs). PMID:27239877

  7. 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

  8. 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

  9. 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

  10. Toward universal coverage in Massachusetts.

    PubMed

    Blumberg, Linda J; Holahan, John; Weil, Alan; Clemans-Cope, Lisa; Buettgens, Matthew; Blavin, Fredric; Zuckerman, Stephen

    2006-01-01

    This paper presents several options designed to help the Commonwealth of Massachusetts move to universal health insurance coverage. The alternatives all build upon a common base that includes an expansion of the Medicaid program, income-related tax credits, a purchasing pool, and government-sponsored reinsurance. These measures in themselves would not yield universal coverage, nor would an employer mandate by itself. We show that an individual mandate, and an employer mandate combined with an individual mandate, both would yield universal coverage with a relatively small increase in government costs relative to state gross domestic product and current health spending. The cost of an employer mandate--with a "pay or play" design--is sensitive to the payroll tax rate and base, the number and kind of exemptions, and whether workers whose employers "pay" receive discounts when they purchase health insurance. The development of these alternatives and their analyses contributed to the eventual health care compromise that emerged in Massachusetts in April 2006. PMID:17004641

  11. 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

  12. 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. PMID:26180991

  13. 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

  14. 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

    2015-01-01

    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

  15. 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

    2015-01-01

    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.

  16. Monitoring Intervention Coverage in the Context of Universal Health Coverage

    PubMed Central

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

    2014-01-01

    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

  17. 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

  18. 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

    2013-07-01

    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

  19. [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. PMID:26235780

  20. 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.

  1. 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.

  2. 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

  3. 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. PMID:24347710

  4. 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

  5. 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?

  6. [Universal coverage of health services in Mexico].

    PubMed

    2013-01-01

    The reforms made in recent years to the Mexican Health System have reduced inequities in the health care of the population, but have been insufficient to solve all the problems of the MHS. In order to make the right to health protection established in the Constitution a reality for every citizen, Mexico must warrant effective universal access to health services. This paper outlines a long-term reform for the consolidation of a health system that is akin to international standards and which may establish the structural conditions to reduce coverage inequity. This reform is based on a "structured pluralism" intended to avoid both a monopoly exercised within the public sector and fragmentation in the private sector, and to prevent falling into the extremes of authoritarian procedures or an absence of regulation. This involves the replacement of the present vertical integration and segregation of social groups by a horizontal organization with separation of duties. This also entails legal and fiscal reforms, the reinforcement of the MHS, the reorganization of health institutions, and the formulation of regulatory, technical and financial instruments to operationalize the proposed scheme with the objective of rendering the human right to health fully effective for the Mexican people.

  7. [Universal coverage of health services in Mexico].

    PubMed

    2013-01-01

    The reforms made in recent years to the Mexican Health System have reduced inequities in the health care of the population, but have been insufficient to solve all the problems of the MHS. In order to make the right to health protection established in the Constitution a reality for every citizen, Mexico must warrant effective universal access to health services. This paper outlines a long-term reform for the consolidation of a health system that is akin to international standards and which may establish the structural conditions to reduce coverage inequity. This reform is based on a "structured pluralism" intended to avoid both a monopoly exercised within the public sector and fragmentation in the private sector, and to prevent falling into the extremes of authoritarian procedures or an absence of regulation. This involves the replacement of the present vertical integration and segregation of social groups by a horizontal organization with separation of duties. This also entails legal and fiscal reforms, the reinforcement of the MHS, the reorganization of health institutions, and the formulation of regulatory, technical and financial instruments to operationalize the proposed scheme with the objective of rendering the human right to health fully effective for the Mexican people. PMID:24570037

  8. 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.

  9. Universal coverage for children: alternatives, key issues, and political opportunities.

    PubMed

    Berman, Stephen

    2007-01-01

    This paper describes four alternatives for expanding childhood insurance coverage, discusses key health policy issues, and assesses the political possibilities for enacting universal coverage. Alternatives are (1) a single federal child health program for all children; (2) a hybrid federal child health program (replacing Medicaid and the State Children's Health Insurance Program [SCHIP]), combined with employer coverage; (3) a new federal wraparound program for the uninsured (that keeps the existing Medicaid program); and (4) expansion of SCHIP. Key policy issues include the type of universal coverage, use of competing commercial health plans, financing, employer and individual mandates, and the definition of benefits.

  10. 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

  11. Financing universal coverage in Malaysia: a case study.

    PubMed

    Chua, Hong Teck; Cheah, Julius Chee Ho

    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 preventive

  12. 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

  13. Financing universal coverage in Malaysia: a case study.

    PubMed

    Chua, Hong Teck; Cheah, Julius Chee Ho

    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 preventive

  14. 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.

  15. 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.

  16. 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

  17. Endorsement of universal health coverage financial principles in Burkina Faso.

    PubMed

    Agier, Isabelle; Ly, Antarou; Kadio, Kadidiatou; Kouanda, Seni; Ridde, Valéry

    2016-02-01

    In West Africa, health system funding rarely involves cross-subsidization among population segments. In some countries, a few community-based or professional health insurance programs are present, but coverage is very low. The financial principles underlying universal health coverage (UHC) sustainability and solidarity are threefold: 1) anticipation of potential health risks; 2) risk sharing and; 3) socio-economic status solidarity. In Burkina Faso, where decision-makers are favorable to national health insurance, we measured endorsement of these principles and discerned which management configurations would achieve the greatest adherence. We used a sequential exploratory design. In a qualitative step (9 interviews, 12 focus groups), we adapted an instrument proposed by Goudge et al. (2012) to the local context and addressed desirability bias. Then, in a quantitative step (1255 respondents from the general population), we measured endorsement. Thematic analysis (qualitative) and logistic regressions (quantitative) were used. High levels of endorsement were found for each principle. Actual practices showed that anticipation and risk sharing were not only intentions. Preferences were given to solidarity between socio-economic status (SES) levels and progressivity. Although respondents seemed to prefer the national level for implementation, their current solidarity practices were mainly focused on close family. Thus, contribution levels should be set so that the entire family benefits from healthcare. Some critical conditions must be met to make UHC financial principles a reality through health insurance in Burkina Faso: trust, fair and mandatory contributions, and education. PMID:26803656

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

    PubMed

    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

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

    PubMed

    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.

  20. 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

  1. Universal health coverage in Rwanda: dream or reality

    PubMed Central

    Nyandekwe, Médard; Nzayirambaho, Manassé; Baptiste Kakoma, Jean

    2014-01-01

    Introduction Universal Health Coverage (UHC) has been a global concern for a long time and even more nowadays. While a number of publications are almost unanimous that Rwanda is not far from UHC, very few have focused on its financial sustainability and on its extreme external financial dependency. The objectives of this study are: (i) To assess Rwanda UHC based mainly on Community-Based Health Insurance (CBHI) from 2000 to 2012; (ii) to inform policy makers about observed gaps for a better way forward. Methods A retrospective (2000-2012) SWOT analysis was applied to six metrics as key indicators of UHC achievement related to WHO definition, i.e. (i) health insurance and access to care, (ii) equity, (iii) package of services, (iv) rights-based approach, (v) quality of health care, (vi) financial-risk protection, and (vii) CBHI self-financing capacity (SFC) was added by the authors. Results The first metric with 96,15% of overall health insurance coverage and 1.07 visit per capita per year versus 1 visit recommended by WHO, the second with 24,8% indigent people subsidized versus 24,1% living in extreme poverty, the third, the fourth, and the fifth metrics excellently performing, the sixth with 10.80% versus ≤40% as limit acceptable of catastrophic health spending level and lastly the CBHI SFC i.e. proper cost recovery estimated at 82.55% in 2011/2012, Rwanda UHC achievements are objectively convincing. Conclusion Rwanda UHC is not a dream but a reality if we consider all convincing results issued of the seven metrics. PMID:25170376

  2. 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

  3. Cell Phone Coverage Area: Helping Students Achieve in Mathematics

    ERIC Educational Resources Information Center

    Zbiek, Rose Mary; Reed, Shari Ann; Boone, Tracy

    2007-01-01

    Cell phone coverage areas arouse students' curiosity in a lesson that engages students with area as a measure that relates to, but is different from, linear measure. Each distinct set of activities (stations) blends concepts and skills to align with and transcend state standards. In reflecting on the lesson planning and implementation, we…

  4. Changes in Achievement Motivation among University Freshmen

    ERIC Educational Resources Information Center

    Dresel, Markus; Grassinger, Robert

    2013-01-01

    Changes in achievement motivation over the first semester of university studies were examined with N = 229 freshmen, who were surveyed twice in the present study. Students' academic self-concepts, achievement goals, and subjective values were chosen as theoretically central components of achievement motivation. The results indicated significant…

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

    PubMed

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

    2015-04-01

    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. PMID:25458734

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

    PubMed

    Qin, Ningning; Zheng, Xin; Tian, Guiyun

    2015-08-11

    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.

  7. 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

  8. Syrian refugees in Lebanon: the search for universal health coverage.

    PubMed

    Blanchet, Karl; Fouad, Fouad M; Pherali, Tejendra

    2016-01-01

    The crisis in Syria has forced more than 4 million people to find refuge outside Syria. In Lebanon, in 2015, the refugee population represented 30 % of the total population. International health assistance has been provided to refugee populations in Lebanon. However, the current humanitarian system has also contributed to increase fragmentation of the Lebanese health system. Ensuring universal health coverage to vulnerable Lebanese, Syrian and Palestinian refugees will require in Lebanon to redistribute the key functions and responsibilities of the Ministry of Health and its partners to generate more coherence and efficiency. PMID:27252775

  9. [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.

  10. 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.

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

    PubMed

    Patel, Vikram

    2016-07-01

    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.

  12. 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

  13. Can a universal coverage system temper the underwriting cycle?

    PubMed

    Gabel, J R; Jensen, G A

    1992-01-01

    The health insurance industry has experienced a pronounced six-year cycle of earnings for nearly three decades--three years of profits followed by three years of losses. This profitability cycle triggers a turbulent pricing cycle. After reviewing three schools of thought about the causes of the cycle, in this article we examine new evidence to determine the probable impact on the cycle of a private-public, universal coverage, national health plan. We find no evidence of a cycle in the pricing and use of health care services. Since 1985, the relationship between the overall economy and health insurance trends has weakened. We conclude that the root causes of the cycle are essentially internal to the insurance industry, and, therefore, national health care reform will have little impact on the underwriting cycle.

  14. 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

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

    PubMed

    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

  16. 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

  17. 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.

  18. Implications of dual practice for universal health coverage

    PubMed Central

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

    2016-01-01

    Abstract 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. PMID:26908963

  19. 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.

  20. 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.

  1. 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. PMID:26195606

  2. Investing in health systems for universal health coverage in Africa

    PubMed Central

    2014-01-01

    Background This study focused on the 47 Member States of the World Health Organization (WHO) African Region. The specific objectives were to prepare a synthesis on the situation of health systems¿ components, to analyse the correlation between the interventions related to the health Millennium Development Goals (MDGs) and some health systems¿ components and to provide overview of four major thrusts for progress towards universal health coverage (UHC). Methods The WHO health systems framework and the health-related MDGs were the frame of reference. The data for selected indicators were obtained from the WHO World Health Statistics 2014 and the Global Health Observatory. Results African Region¿s average densities of physicians, nursing and midwifery personnel, dentistry personnel, pharmaceutical personnel, and psychiatrists of 2.6, 12, 0.5, 0.9 and 0.05 per 10 000 population were about five-fold, two-fold, five-fold, five-fold and six-fold lower than global averages. Fifty-six percent of the reporting countries had fewer than 11 health posts per 100 000 population, 88% had fewer than 11 health centres per 100 000 population, 82% had fewer than one district hospital per 100 000 population, 74% had fewer than 0.2 provincial hospitals per 100 000 population, and 79% had fewer than 0.2 tertiary hospitals per 100 000 population. Some 83% of the countries had less than one MRI per one million people and 95% had fewer than one radiotherapy unit per million population. Forty-six percent of the countries had not adopted the recommendation of the International Taskforce on Innovative Financing to spend at least US$ 44 per person per year on health. Some of these gaps in health system components were found to be correlated to coverage gaps in interventions for maternal health (MDG 5), child health (MDG 4) and HIV/AIDS, TB and malaria (MDG 6). Conclusions Substantial gaps exist in health systems and access to MDG-related health interventions. It is imperative that countries

  3. 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.

  4. 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. PMID:24347709

  5. 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

  6. 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.

  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. PMID:26704179

  8. How changes to Irish healthcare financing are affecting universal health coverage.

    PubMed

    Briggs, Adam D M

    2013-11-01

    In 2010, the World Health Organisation (WHO) published the World Health Report - Health systems financing: the path to universal coverage. The Director-General of the WHO, Dr Margaret Chan, commissioned the report "in response to a need, expressed by rich and poor countries alike, for practical guidance on ways to finance health care". Given the current context of global economic hardship and difficult budgetary decisions, the report offered timely recommendations for achieving universal health coverage (UHC). This article analyses the current methods of healthcare financing in Ireland and their implications for UHC. Three questions are asked of the Irish healthcare system: firstly, how is the health system financed; secondly, how can the health system protect people from the financial consequences of ill-health and paying for health services; and finally, how can the health system encourage the optimum use of available resources? By answering these three questions, this article argues that the Irish healthcare system is not achieving UHC, and that it is unclear whether recent changes to financing are moving Ireland closer or further away from the WHO's ambition for healthcare for all.

  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. PMID:24268605

  10. 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.

  11. 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.

  12. 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

    2014-01-01

    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. PMID:24559232

  13. Future of Japan's system of good health at low cost with equity: beyond universal coverage.

    PubMed

    Shibuya, Kenji; Hashimoto, Hideki; Ikegami, Naoki; Nishi, Akihiro; Tanimoto, Tetsuya; Miyata, Hiroaki; Takemi, Keizo; Reich, Michael R

    2011-10-01

    Japan's premier health accomplishment in the past 50 years has been the achievement of good population health at low cost and increased equity between different population groups. The development of Japan's policies for universal coverage are similar to the policy debates that many countries are having in their own contexts. The financial sustainability of Japan's universal coverage is under threat from demographic, economic, and political factors. Furthermore, a series of crises-both natural and nuclear-after the magnitude 9·0 Great East Japan Earthquake on March 11, 2011, has shaken up the entire Japanese social system that was developed and built after World War 2, and shown existing structural problems in the Japanese health system. Here, we propose four major reforms to assure the sustainability and equity of Japan's health accomplishments in the past 50 years-implement a human-security value-based reform; redefine the role of the central and local governments; improve the quality of health care; and commit to global health. Now is the time for rebirth of Japan and its health system.

  14. 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…

  15. Universal health insurance coverage for 1.3 billion people: What accounts for China's success?

    PubMed

    Yu, Hao

    2015-09-01

    China successfully achieved universal health insurance coverage in 2011, representing the largest expansion of insurance coverage in human history. While the achievement is widely recognized, it is still largely unexplored why China was able to attain it within a short period. This study aims to fill the gap. Through a systematic political and socio-economic analysis, it identifies seven major drivers for China's success, including (1) the SARS outbreak as a wake-up call, (2) strong public support for government intervention in health care, (3) renewed political commitment from top leaders, (4) heavy government subsidies, (5) fiscal capacity backed by China's economic power, (6) financial and political responsibilities delegated to local governments and (7) programmatic implementation strategy. Three of the factors seem to be unique to China (i.e., the SARS outbreak, the delegation, and the programmatic strategy.) while the other factors are commonly found in other countries' insurance expansion experiences. This study also discusses challenges and recommendations for China's health financing, such as reducing financial risk as an immediate task, equalizing benefit across insurance programs as a long-term goal, improving quality by tying provider payment to performance, and controlling costs through coordinated reform initiatives. Finally, it draws lessons for other developing countries. PMID:26251322

  16. Universal coverage of renal dialysis in Thailand: promise, progress, and prospects.

    PubMed

    Tantivess, Sripen; Werayingyong, Pitsaphun; Chuengsaman, Piyatida; Teerawattananon, Yot

    2013-01-31

    Thailand's experience in introducing renal replacement therapy as part of its universal health coverage scheme shows the importance of evidence and stakeholders' active participation in all phases of policy development, say Sripen Tantivess and colleagues:

  17. 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

  18. 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).

  19. 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…

  20. 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

  1. Ethical Perspective: Five Unacceptable Trade-offs on the Path to Universal Health Coverage.

    PubMed

    Norheim, Ole Frithjof

    2015-01-01

    This article discusses what ethicists have called "unacceptable trade-offs" in health policy choices related to universal health coverage (UHC). Since the fiscal space is constrained, trade-offs need to be made. But some trade-offs are unacceptable on the path to universal coverage. Unacceptable choices include, among other examples from low-income countries, to expand coverage for services with lower priority such as coronary bypass surgery before securing universal coverage for high-priority services such as skilled birth attendance and services for easily preventable or treatable fatal childhood diseases. Services of the latter kind include oral rehydration therapy for children with diarrhea and antibiotics for children with pneumonia. The article explains why such trade-offs are unfair and unacceptable even if political considerations may push in the opposite direction. PMID:26673330

  2. A road map for universal coverage: finding a pass through the financial mountains.

    PubMed

    Sessions, Samuel Y; Lee, Philip R

    2008-04-01

    Government already pays for more than half of U.S. health care costs, and nearly all universal health insurance proposals assume continued government involvement through tax subsidies and other means. The question of what specific taxes could be used to finance universal coverage is, however, seldom carefully examined, in part due to efforts by health care reform proponents to downplay tax issues. In this article we undertake such an examination. We argue that the challenges of relying on taxes for universal coverage are even greater than is generally appreciated, but that they can nevertheless be met. A proposal to fund a universal health insurance voucher system with a value-added tax illustrates issues that would arise for tax-financed plans in general and provides a broad framework for a bipartisan approach to universal coverage. We discuss significant problems that such an approach would face and suggest solutions. We outline a long-term political and legislative strategy for enacting universal coverage that draws upon precedents set by comparable legislative initiatives, including tax reform and Medicare. The results are an improved understanding of the relationship between systemic health care finance reform and taxation and a politically realistic plan for universal coverage that employs undisguised taxes. PMID:18325897

  3. 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

  4. 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. PMID:24347714

  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. Promoting universal financial protection: a policy analysis of universal health coverage in Costa Rica (1940–2000)

    PubMed Central

    2013-01-01

    Background This paper explores the implementation and sustenance of universal health coverage (UHC) in Costa Rica, discussing the development of a social security scheme that covered 5% of the population in 1940, to one that finances and provides comprehensive healthcare to the whole population today. The scheme is financed by mandatory, tri-partite social insurance contributions complemented by tax funding to cover the poor. Methods The analysis takes a historical perspective and explores the policy process including the key actors and their relative influence in decision-making. Data were collected using qualitative research instruments, including a review of literature, institutional and other documents, and in-depth interviews with key informants. Results Key lessons to be learned are: i) population health was high on the political agenda in Costa Rica, in particular before the 1980s when UHC was enacted and the transfer of hospitals to the social security institution took place. Opposition to UHC could therefore be contained through negotiation and implemented incrementally despite the absence of real consensus among the policy elite; ii) since the 1960s, the social security institution has been responsible for UHC in Costa Rica. This institution enjoys financial and managerial autonomy relative to the general government, which has also facilitated the UHC policy implementation process; iii) UHC was simultaneously constructed on three pillars that reciprocally strengthened each other: increasing population coverage, increasing availability of financial resources based on solidarity financing mechanisms, and increasing service coverage, ultimately offering comprehensive health services and the same benefits to every resident in the country; iv) particularly before the 1980s, the fruits of economic growth were structurally invested in health and other universal social policies, in particular education and sanitation. The social security institution became a

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

    PubMed Central

    2014-01-01

    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. PMID:24559232

  8. Towards universal health coverage for reproductive health services in Ethiopia: two policy recommendations.

    PubMed

    Onarheim, Kristine Husøy; Taddesse, Mieraf; Norheim, Ole Frithjof; Abdullah, Muna; Miljeteig, Ingrid

    2015-01-01

    Reproductive health services are crucial for maternal and child health, but universal health coverage is still not within reach in most societies. Ethiopia's goal of universal health coverage promises access to all necessary services for everyone while providing protection against financial risk. When moving towards universal health coverage, health plans and policies require contextualized knowledge about baseline indicators and their distributions. To understand more about the factors that explain coverage, we study the relationship between socioeconomic and geographic factors and the use of reproductive health services in Ethiopia, and further explore inequalities in reproductive health coverage. Based on these findings, we discuss the normative implications of these findings for health policy. Using population-level data from the Ethiopian Demographic and Health Survey (2011) in a multivariate logistic model, we find that family planning and use of antenatal care are associated with higher wealth, higher education and being employed. Skilled attendance at birth is associated with higher wealth, higher education, and urban location. There is large variation between Addis Ababa (the capital) and other administrative regions. Concentration indices show substantial inequalities in the use of reproductive health services. Decomposition of the concentration indices indicates that difference in wealth is the most important explanatory factor for inequality in reproductive health coverage, but other factors, such as urban setting and previous health care use, are also associated with inequalities. When aiming for universal health coverage, this study shows that different socioeconomic factors as well as health-sector factors should be addressed. Our study re-confirms the importance of a broader approach to reproductive health, and in particular the importance of inequality in wealth and geography. Poor, non-educated, non-employed women in rural areas are

  9. 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

  10. 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

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

    PubMed Central

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

    2014-01-01

    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

  12. 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

  13. 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.

  14. 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. PMID:24940017

  15. 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.

  16. "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.

  17. 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.

  18. 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.

  19. 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. PMID:26077857

  20. Improved genetic testing: a new impetus toward universal coverage.

    PubMed

    Sureka, A

    2000-01-01

    As the Human Genome Project increases the predictive power of human genetics, emerging gene chip technology and other advances of genetic testing will give more information to people about their genetic predilections. If insurance companies were allowed to use this information, they would set premiums such that many who need life-saving medical treatment would have no access to it. Americans would not accept this disparity; instead, genetic information will likely remain private, making the modern health insurance system unprofitable for companies and thus pushing the United States towards a universal health care system in the near future.

  1. 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.

  2. The importance of Leadership towards universal health coverage in Low Income Countries.

    PubMed

    Gonani, A; Muula, A S

    2015-03-01

    Universal health coverage--defined as access to the full range of the most appropriate health care and technology for all people at the lowest possible price or with social health protection--was the goal of the 1978 Alma-Ata Conference on Primary Health Care in Kazakhstan. Many low-income (developing) countries are currently unable to reach this goal despite having articulated the same in their health-related documents. In this paper we argue that, over 30 years on, inadequate political and technical leadership has prevented the realization of universal health coverage in low-income countries. PMID:26137197

  3. The importance of Leadership towards universal health coverage in Low Income Countries.

    PubMed

    Gonani, A; Muula, A S

    2015-03-01

    Universal health coverage--defined as access to the full range of the most appropriate health care and technology for all people at the lowest possible price or with social health protection--was the goal of the 1978 Alma-Ata Conference on Primary Health Care in Kazakhstan. Many low-income (developing) countries are currently unable to reach this goal despite having articulated the same in their health-related documents. In this paper we argue that, over 30 years on, inadequate political and technical leadership has prevented the realization of universal health coverage in low-income countries.

  4. 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.

  5. 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.

  6. 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

    2012-09-01

    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. PMID:22959390

  7. 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…

  8. 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…

  9. 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 Regional…

  10. 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…

  11. 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

  12. 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…

  13. 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

  14. 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…

  15. 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…

  16. 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…

  17. Which Tibial Tray Design Achieves Maximum Coverage and Ideal Rotation: Anatomic, Symmetric, or Asymmetric? An MRI-based study.

    PubMed

    Stulberg, S David; Goyal, Nitin

    2015-10-01

    Two goals of tibial tray placement in TKA are to maximize coverage and establish proper rotation. Our purpose was to utilize MRI information obtained as part of PSI planning to determine the impact of tibial tray design on the relationship between coverage and rotation. MR images for 100 consecutive knees were uploaded into PSI software. Preoperative planning software was used to evaluate 3 different tray designs: anatomic, symmetric, and asymmetric. Approximately equally good coverage was achieved with all three trays. However, the anatomic compared to symmetric/asymmetric trays required less malrotation (0.3° vs 3.0/2.4°; P < 0.001), with a higher proportion of cases within 5° of neutral (97% vs 73/77%; P < 0.001). In this study, the anatomic tibia optimized the relationship between coverage and rotation.

  18. 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.

  19. 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

  20. 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

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

    PubMed

    Tangcharoensathien, Viroj; Mills, Anne; Palu, Toomas

    2015-01-01

    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. PMID:25925656

  2. 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. PMID:27108079

  3. 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.

  4. Second Conference of the African Health Economics and Policy Association: towards universal healthcare coverage in Africa.

    PubMed

    Atim, Chris

    2011-06-01

    This report discusses the key messages coming out of the papers presented at the second African Health Economics and Policy Association conference, with a particular focus on innovative and recent research results of interest to a wider audience. It also covers the scientific structure and organization of the conference, including the various sessions and key note speeches. The 3-day conference discussed the definition and scope as well as the key issues concerned, the challenges involved, and the role of leadership and country ownership in achieving universal health coverage in low-income countries. A special effort was also made to link the research outputs of the conference to policy-making in the region, through the participation of high-level decision-makers from countries as well as the production of policy briefs targeting policy-makers and based on the conference outputs and relevant research. Sub-themes of the conference included user fee removal and exemptions, covering those outside the formal sector, improved domestic funding of healthcare, purchasing of services and policy processes. The conference was attended by approximately 230 participants drawn from over 30 African countries as well as abroad, mostly from academia, research institutions, Ministries of Health and other relevant Government agencies, as well as donor and technical partners.

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

    PubMed Central

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

    2015-01-01

    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. PMID:25249293

  6. 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.

  7. 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. PMID:25249293

  8. Universal hepatitis B vaccination coverage in children and adolescents with intellectual disabilities.

    PubMed

    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 composed of 495 primary caregivers of children and adolescents with ID (age 3-24 years) who studying in 3 special education schools in Taiwan. The results showed that coverage rate of completed hepatitis B vaccination was 74.34% in children and adolescents with ID. Although hepatitis B vaccination is a universal health policy in Taiwan, the uncompleted coverage rate of our study subjects was 2 times of the Taiwan general population at the same age. In the logistic regression analysis of hepatitis B vaccination coverage, we found that the factors of household income and ID individual's age were variables that can significantly predict they did not accept a completed vaccination. The present study suggests that parents and providers should routinely review immunizations of children and adolescents with ID.

  9. 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. PMID:27086193

  10. The Role of Universities in Achieving Social Justice

    ERIC Educational Resources Information Center

    Jiang, Kai

    2009-01-01

    Social justice is not only a vital ethical principle of the human society but also the all-important value of the entire social system. As a public sphere, the university undertakes the purpose to achieve public interest. It plays a significant role in reflecting, defending, and fostering social justice. Nurturing people with social justice…

  11. 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

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

    PubMed Central

    2013-01-01

    Abstract 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. PMID:23940408

  13. Integrating social determinants of health in the universal health coverage monitoring framework.

    PubMed

    Vega, Jeanette; Frenz, Patricia

    2013-12-01

    Underpinning the global commitment to universal health coverage (UHC) is the fundamental role of health for well-being and sustainable development. UHC is proposed as an umbrella health goal in the post-2015 sustainable development agenda because it implies universal and equitable effective delivery of comprehensive health services by a strong health system, aligned with multiple sectors around the shared goal of better health. In this paper, we argue that social determinants of health (SDH) are central to both the equitable pursuit of healthy lives and the provision of health services for all and, therefore, should be expressly incorporated into the framework for monitoring UHC. This can be done by: (a) disaggregating UHC indicators by different measures of socioeconomic position to reflect the social gradient and the complexity of social stratification; and (b) connecting health indicators, both outcomes and coverage, with SDH and policies within and outside of the health sector. Not locating UHC in the context of action on SDH increases the risk of going down a narrow route that limits the right to health to coverage of services and financial protection.

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

    PubMed Central

    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. PMID:22992484

  15. How much does it cost to achieve coverage targets for primary healthcare services? A costing model from Aceh, Indonesia.

    PubMed

    Abdullah, Asnawi; Hort, Krishna; Abidin, Azwar Zaenal; Amin, Fadilah M

    2012-01-01

    Despite significant investment in improving service infrastructure and training of staff, public primary healthcare services in low-income and middle-income countries tend to perform poorly in reaching coverage targets. One of the factors identified in Aceh, Indonesia was the lack of operational funds for service provision. The objective of this study was to develop a simple and transparent costing tool that enables health planners to calculate the unit costs of providing basic health services to estimate additional budgets required to deliver services in accordance with national targets. The tool was developed using a standard economic approach that linked the input activities to achieving six national priority programs at primary healthcare level: health promotion, sanitation and environment health, maternal and child health and family planning, nutrition, immunization and communicable diseases control, and treatment of common illness. Costing was focused on costs of delivery of the programs that need to be funded by local government budgets. The costing tool consisting of 16 linked Microsoft Excel worksheets was developed and tested in several districts enabled the calculation of the unit costs of delivering of the six national priority programs per coverage target of each program (such as unit costs of delivering of maternal and child health program per pregnant mother). This costing tool can be used by health planners to estimate additional money required to achieve a certain level of coverage of programs, and it can be adjusted for different costs and program delivery parameters in different settings.

  16. 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.

  17. Will Universal Health Coverage (UHC) lead to the freedom to lead flourishing and healthy lives?

    PubMed Central

    Matheson, Don

    2015-01-01

    The focus on public policy and health equity is discussed in reference to the current global health policy discussion on Universal Health Coverage (UHC). This initiative has strong commitment from the leadership of the international organizations involved, but a lack of policy clarity outside of the health financing component may limit the initiative’s impact on health inequity. In order to address health inequities there needs to be greater focus on the most vulnerable communities, subnational health systems, and attention paid to how communities, civil society and the private sector engage and participate in health systems. PMID:25584354

  18. 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. PMID:27471548

  19. 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

  20. 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.

  1. Content Coverage and Students' Achievements in Secondary School Physics: The Delta State Example of Nigeria

    ERIC Educational Resources Information Center

    Abamba, Emmanuel Ikechuku

    2012-01-01

    The consistent poor achievement of students in physics tests and in science generally is one problem attracting researchers because of the danger it poses to the nation's technological advancement. This work focused on the effect of content thought on students' achievement. Two research questions were put forward which led to the formulation of…

  2. 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.

  3. 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

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

    PubMed

    Offodile, Anaeze C; Guo, Lifei

    2016-06-01

    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

  5. 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.

  6. 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.

  7. 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…

  8. 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

  9. PAHO'S Strategy for Universal Access to Health and Universal Health Coverage: implications for health services and hospitals in LAC.

    PubMed

    Holder, Reynaldo; Fabrega, Ricardo

    2015-01-01

    Moving towards Universal Access to Health and Universal Health Coverage (UAH/UHC) is an imperative task on the health agenda for the Americas. The Directing Council of the Pan American Health Organization (PAHO) recently approved resolution CD53.R14, titled Strategy for Universal Access to Health and Universal Health Coverage. From the perspective of the Region of the Americas, UAH/UHC "imply that all people and communities have access, without any kind of discrimination, to comprehensive, appropriate and timely, quality health services determined at the national level according to needs, as well as access to safe, affordable, effective, quality medicines, while ensuring that the use of these services does not expose users to financial hardship, especially groups in conditions of vulnerability". PAHO's strategic approach to UAH/UHC sets out four specific lines of action toward effective universal health systems. The first strategic line proposes: a) implementation of integrated health services delivery networks (IHDSNs) based on primary health care as the key strategy for reorganizing, redefining and improving healthcare services in general and the role of hospitals in particular; and b) increasing the response capacity of the first level of care. An important debate initiated in 2011 among hospital and healthcare managers in the region tried to redefine the role of hospitals in the context of IHSDNs and the emerging UAH/UHC movement. The debates resulted in agreements around three main propositions: 1) IHSDNs cannot be envisioned without hospitals; 2) The status-quo and current hospital organizational culture makes IHSDNs inviable; and 3) Without IHSDNs, hospitals will not be sustainable. This process, that predates the approval of PAHO's UAH/UHC resolution, now becomes more relevant with the recognition that UAH/UHC cannot be attained without a profound change in healthcare service and particularly in hospitals. In this context, a set of challenges both for

  10. 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

  11. 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.

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

    PubMed

    Norheim, Ole F

    2016-01-01

    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. PMID:27170046

  13. Strengthening the health workforce and rolling out universal health coverage: the need for policy analysis.

    PubMed

    Koon, Adam D; Mayhew, Susannah H

    2013-07-24

    This article opens a debate about how to think about moving forward with the emerging twin movements of human resources for health (HRH) and universal health coverage (UHC). There is sufficient evidence to warrant these movements, but actors and the policy process significantly affect which policies are adopted and how they are implemented. How exactly this occurs in low- and middle-income countries (LMICs) is not very well understood. Furthermore, it is not clear whether actors will mobilize for or against the emergent HRH and UHC agendas. Policy analysis should help illuminate potential strategies to account for multiple interests and divergent values in volatile stakeholder environments. We argue that not only should the movement for UHC be paired with current efforts to address the human resources crisis, but also, for both to succeed, we need to know more about how health policy works in LMICs.

  14. India's "tryst" with universal health coverage: reflections on ethnography in Indian health policymaking.

    PubMed

    Nambiar, Devaki

    2013-12-01

    In 2011, India stood at the crossroads of potentially major health reform. A High Level Expert Group (HLEG) on universal health coverage (UHC), convened by the Indian Planning Commission, proposed major changes in the structure and functioning of the country's health system. This paper presents reflections on the role of ethnography in policy-based social change for health in India, drawing from year-long participation in the aforementioned policy development process. It theorizes that international discourses have been (re)appropriated in the Indian case by recourse to both experience and evidence, resulting in a plurality of concepts that could be prioritized for Indian health reform. This articulation involved HLEG members exerting para-ethnographic labour and paying close attention to context, suggesting that ethnographic sensibilities can reside within the interactive and knowledge production practices among experts oriented toward policy change.

  15. Strengthening the health workforce and rolling out universal health coverage: the need for policy analysis

    PubMed Central

    Koon, Adam D.; Mayhew, Susannah H.

    2013-01-01

    This article opens a debate about how to think about moving forward with the emerging twin movements of human resources for health (HRH) and universal health coverage (UHC). There is sufficient evidence to warrant these movements, but actors and the policy process significantly affect which policies are adopted and how they are implemented. How exactly this occurs in low- and middle-income countries (LMICs) is not very well understood. Furthermore, it is not clear whether actors will mobilize for or against the emergent HRH and UHC agendas. Policy analysis should help illuminate potential strategies to account for multiple interests and divergent values in volatile stakeholder environments. We argue that not only should the movement for UHC be paired with current efforts to address the human resources crisis, but also, for both to succeed, we need to know more about how health policy works in LMICs. PMID:23886375

  16. Advancing universal coverage of healthcare in China: translating political will into policy and practice.

    PubMed

    Tang, Shenglan; Brixi, Hana; Bekedam, Henk

    2014-01-01

    China launched its new health system reform plan in 2009 to advance its universal coverage of healthcare, after more than 4 years' consultations and discussions with various stakeholders including the public. This paper aims to introduce and discuss the context and process of China's current health system reform and analyse how political will in China has been translated into policy practice over the past decade. The paper also shares the insights of World Health Organization's contribution to China's health system reform, as the authors advised the Chinese government on the reform options and process. Furthermore, the paper describes and discusses key challenges in the implementation of the reform plan over the past 3 years and draws lessons for other countries.

  17. Health financing lessons from Thailand for South Africa on the path towards universal health coverage.

    PubMed

    Blecher, Mark; Pillay, Anban; Patcharanarumol, Walaiporn; Panichkriangkrai, Warisa; Tangcharoensathien, Viroj; Teerawattananon, Yot; Pannarunothai, Supasit; Davén, Jonatan

    2016-06-01

    Five years after the release of its Green Paper on National Health Insurance (NHI),years after the institution of NHI pilot sites and following the recent release of the White Pa 4 per on NHI, South Africa (SA) needs to move beyond the phase 1 plans of policy making and healthening activities to phase 2 - putting into place the legal and institutional frameth system strengworks and systems for implementation of its universal health coverage (UHC) system. In doing so, SA can draw on considerable practical lessons from other countries' reforms in managing UHC with favourable equity outcomes over the past decade. We outline some potentially significant lessons from the Thai health financing system for SA. PMID:27245713

  18. 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

  19. Untangling the debate surrounding strategies for achieving sustainable high coverage of insecticide-treated nets.

    PubMed

    Stevens, Warren

    2005-01-01

    On the question of how to achieve the goal of long-term high utilisation of insecticide-treated nets (ITNs), most protagonists fall into one of two camps: free distribution or market development. The 'free distribution' camp argue that given the health benefit to be gained and lives saved, not to mention the relative cost effectiveness of ITNs, such an intervention should be provided free and paid for by governments or donors. In addition, they argue that it is unrealistic to ask the poorest of the population, who are often the ones at most risk, to pay for an ITN, and this risks producing greater inequalities in health. The market advocates counter that free distribution compromises sustainability, both in terms of demand and supply. Firstly they argue that, without a price, people will be less inclined to value ITNs. In turn this could mean lower utilisation, and a lower inclination to replace such an asset at the end of its useful life. In addition, on the supply side, without a price there is little chance of a local market developing for ITNs, although this would be the surest way to ensure a sustainable supply. It is hard to argue with either viewpoint, as both have merit. This article considers three major issues in the debate, and attempts to draw policy conclusions.

  20. 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.

  1. 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.

  2. 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. PMID:27145710

  3. 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. PMID:24793339

  4. 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.

  5. 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.

  6. Medicalization of global health 4: the universal health coverage campaign and the medicalization of global health

    PubMed Central

    Clark, Jocalyn

    2014-01-01

    Universal health coverage (UHC) has emerged as the leading and recommended overarching health goal on the post-2015 development agenda, and is promoted with fervour. UHC has the backing of major medical and health institutions, and is designed to provide patients with universal access to needed health services without financial hardship, but is also projected to have ‘a transformative effect on poverty, hunger, and disease’. Multiple reports and resolutions support UHC and few offer critical analyses; but among these are concerns with imprecise definitions and the ability to implement UHC at the country level. A medicalization lens enriches these early critiques and identifies concerns that the UHC campaign contributes to the medicalization of global health. UHC conflates health with health care, thus assigning undue importance to (biomedical) health services and downgrading the social and structural determinants of health. There is poor evidence that UHC or health care alone improves population health outcomes, and in fact health care may worsen inequities. UHC is reductionistic because it focuses on preventative and curative actions delivered at the individual level, and ignores the social and political determinants of health and right to health that have been supported by decades of international work and commitments. UHC risks commodifying health care, which threatens the underlying principles of UHC of equity in access and of health care as a collective good. PMID:24848662

  7. 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.

  8. 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

  9. 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

  10. 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

  11. Promoting universal financial protection: constraints and enabling factors in scaling-up coverage with social health insurance in Nigeria

    PubMed Central

    2013-01-01

    Background The National Health Insurance Scheme (NHIS) in Nigeria was launched in 2005 as part of efforts by the federal government to achieve universal coverage using financial risk protection mechanisms. However, only 4% of the population, and mainly federal government employees, are currently covered by health insurance and this is primarily through the Formal Sector Social Health Insurance Programme (FSSHIP) of the NHIS. This study aimed to understand why different state (sub-national) governments decided whether or not to adopt the FSSHIP for their employees. Methods This study used a comparative case study approach. Data were collected through document reviews and 48 in-depth interviews with policy makers, programme managers, health providers, and civil servant leaders. Results Although the programme’s benefits seemed acceptable to state policy makers and the intended beneficiaries (employees), the feasibility of employer contributions, concerns about transparency in the NHIS and the role of states in the FSSHIP, the roles of policy champions such as state governors and resistance by employees to making contributions, all influenced the decision of state governments on adoption. Overall, the power of state governments over state-level health reforms, attributed to the prevailing system of government that allows states to deliberate on certain national-level policies, enhanced by the NHIS legislation that made adoption voluntary, enabled states to adopt or not to adopt the program. Conclusions The study demonstrates and supports observations that even when the content of a programme is generally acceptable, context, actor roles, and the wider implications of programme design on actor interests can explain decision on policy adoption. Policy implementers involved in scaling-up the NHIS programme need to consider the prevailing contextual factors, and effectively engage policy champions to overcome known challenges in order to encourage adoption by sub

  12. 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

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

    PubMed

    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

  14. 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. PMID:23317644

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

    PubMed

    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. 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

  17. 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

  18. Using economic levers to change behaviour: the case of Thailand's universal coverage health care reforms.

    PubMed

    Hughes, David; Leethongdee, Songkramchai; Osiri, Sunantha

    2010-02-01

    Thailand's universal coverage health care policy has been presented as a knowledge-based reform involving substantial pre-planning, including expert economic analysis of the financing mechanism. This paper describes the new financing system introduced from 2001 in which the Ministry of Public Health allocated monies to local Contracted Units for Primary Care (CUPs) on the basis of population. It discusses the policy intention to use capitation funding to change incentive structures and engineer a transfer of professional staff from over-served urban areas to under-served rural areas. The paper utilises qualitative data from national policy makers and health service staff in three north-eastern provinces to tell the story of the reforms. We found that over time government moved away from the original capitation funding model as the result of (a) a macro-allocation problem arising from system disturbance and professional opposition, and (b) a micro-allocation problem that emerged when local budgets were not shared equitably. In many CUPs, the hospital directors controlling resource allocation channelled funds more towards curative services than community facilities. Taken together the macro and micro problems led to the dilution of capitation funding and reduced the re-distributive effects of the reforms. This strand of policy foundered in the face of structural and institutional barriers to change.

  19. The impact of Universal Health Coverage on health care consumption and risky behaviours: evidence from Thailand.

    PubMed

    Ghislandi, Simone; Manachotphong, Wanwiphang; Perego, Viviana M E

    2015-07-01

    Thailand is among the first non-OECD countries to have introduced a form of Universal Health Coverage (UHC). This policy represents a natural experiment to evaluate the effects of public health insurance on health behaviours. In this paper, we examine the impact of Thailand's UHC programme on preventive activities, unhealthy or risky behaviours and health care consumption using data from the Thai Health and Welfare Survey. We use doubly robust estimators that combine propensity scores and linear regressions to estimate differences-in-differences (DD) and differences-in-DD models. Our results offer important insights. First, UHC increases individuals' likelihood of having an annual check-up, especially among women. Regarding health care consumption, we observe that UHC increases hospital admissions by over 2% and increases outpatient visits by 13%. However, there is no evidence that UHC leads to an increase in unhealthy behaviours or a reduction of preventive efforts. In other words, we find no evidence of ex ante moral hazard. Overall, these findings suggest positive health impacts among the Thai population covered by UHC. PMID:25116081

  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. PMID:23317639

  1. 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.

  2. 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. PMID:26452699

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

    PubMed

    Morgan, Rosemary; Ensor, Tim; Waters, Hugh

    2016-08-01

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

  4. Prescription pattern for treatment of hemorrhoids under the universal coverage policy of Thailand.

    PubMed

    Laosee, Orapin C; Pathanapornpandh, Nopporn; Sitthi-amorn, Chitr; Khiewyoo, Jiraporn; Somrongthong, Ratana; Dulyavoranun, Namthip

    2005-07-01

    The Universal Coverage Policy (UCP) or "30 Baht Scheme" was launched in Thailand in 2001. The policy caused a cutback in the budgets of all public hospitals and health service centers. Traditional medicine was then viewed as an alternative to save costs. This study examines whether this had any influence on hemorrhoid treatment prescription patterns, ratio of traditional/modern medicine, or the cost of hemorrhoid treatment after the UCP was implemented at a community hospital. The traditional medicine prescribed was Petch Sang Kart and the modern alternative was Proctosedyl. All hemorrhoid prescriptions at a community hospital from October 2000 to January 2003 were surveyed. Segmented Regression Analysis was applied to evaluate prescription trends, the ratios between the types of medicine, and the hemorrhoid treatment cost. A total of 256 prescriptions were analyzed. The average number of traditional medicine prescriptions per month were more than modern medicine (41 versus 16). During the study period, the trend of modern medicine use and the treatment cost was decreased (p < 0.01). The ratio of traditional/modern medicine increased 0.2 times (p = 0.02).

  5. Social determinants of health, universal health coverage, and sustainable development: case studies from Latin American countries.

    PubMed

    de Andrade, Luiz Odorico Monteiro; Pellegrini Filho, Alberto; Solar, Orielle; Rígoli, Félix; de Salazar, Lígia Malagon; Serrate, Pastor Castell-Florit; Ribeiro, Kelen Gomes; Koller, Theadora Swift; Cruz, Fernanda Natasha Bravo; Atun, Rifat

    2015-04-01

    Many intrinsically related determinants of health and disease exist, including social and economic status, education, employment, housing, and physical and environmental exposures. These factors interact to cumulatively affect health and disease burden of individuals and populations, and to establish health inequities and disparities across and within countries. Biomedical models of health care decrease adverse consequences of disease, but are not enough to effectively improve individual and population health and advance health equity. Social determinants of health are especially important in Latin American countries, which are characterised by adverse colonial legacies, tremendous social injustice, huge socioeconomic disparities, and wide health inequities. Poverty and inequality worsened substantially in the 1980s, 1990s, and early 2000s in these countries. Many Latin American countries have introduced public policies that integrate health, social, and economic actions, and have sought to develop health systems that incorporate multisectoral interventions when introducing universal health coverage to improve health and its upstream determinants. We present case studies from four Latin American countries to show the design and implementation of health programmes underpinned by intersectoral action and social participation that have reached national scale to effectively address social determinants of health, improve health outcomes, and reduce health inequities. Investment in managerial and political capacity, strong political and managerial commitment, and state programmes, not just time-limited government actions, have been crucial in underpinning the success of these policies.

  6. 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.

  7. 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.

  8. 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. PMID:26559018

  9. Social determinants of health, universal health coverage, and sustainable development: case studies from Latin American countries.

    PubMed

    de Andrade, Luiz Odorico Monteiro; Pellegrini Filho, Alberto; Solar, Orielle; Rígoli, Félix; de Salazar, Lígia Malagon; Serrate, Pastor Castell-Florit; Ribeiro, Kelen Gomes; Koller, Theadora Swift; Cruz, Fernanda Natasha Bravo; Atun, Rifat

    2015-04-01

    Many intrinsically related determinants of health and disease exist, including social and economic status, education, employment, housing, and physical and environmental exposures. These factors interact to cumulatively affect health and disease burden of individuals and populations, and to establish health inequities and disparities across and within countries. Biomedical models of health care decrease adverse consequences of disease, but are not enough to effectively improve individual and population health and advance health equity. Social determinants of health are especially important in Latin American countries, which are characterised by adverse colonial legacies, tremendous social injustice, huge socioeconomic disparities, and wide health inequities. Poverty and inequality worsened substantially in the 1980s, 1990s, and early 2000s in these countries. Many Latin American countries have introduced public policies that integrate health, social, and economic actions, and have sought to develop health systems that incorporate multisectoral interventions when introducing universal health coverage to improve health and its upstream determinants. We present case studies from four Latin American countries to show the design and implementation of health programmes underpinned by intersectoral action and social participation that have reached national scale to effectively address social determinants of health, improve health outcomes, and reduce health inequities. Investment in managerial and political capacity, strong political and managerial commitment, and state programmes, not just time-limited government actions, have been crucial in underpinning the success of these policies. PMID:25458716

  10. Using economic levers to change behaviour: the case of Thailand's universal coverage health care reforms.

    PubMed

    Hughes, David; Leethongdee, Songkramchai; Osiri, Sunantha

    2010-02-01

    Thailand's universal coverage health care policy has been presented as a knowledge-based reform involving substantial pre-planning, including expert economic analysis of the financing mechanism. This paper describes the new financing system introduced from 2001 in which the Ministry of Public Health allocated monies to local Contracted Units for Primary Care (CUPs) on the basis of population. It discusses the policy intention to use capitation funding to change incentive structures and engineer a transfer of professional staff from over-served urban areas to under-served rural areas. The paper utilises qualitative data from national policy makers and health service staff in three north-eastern provinces to tell the story of the reforms. We found that over time government moved away from the original capitation funding model as the result of (a) a macro-allocation problem arising from system disturbance and professional opposition, and (b) a micro-allocation problem that emerged when local budgets were not shared equitably. In many CUPs, the hospital directors controlling resource allocation channelled funds more towards curative services than community facilities. Taken together the macro and micro problems led to the dilution of capitation funding and reduced the re-distributive effects of the reforms. This strand of policy foundered in the face of structural and institutional barriers to change. PMID:19914757

  11. 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

  12. 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

  13. 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

  14. The Longitudinal Effects of Achievement Goals and Perceived Control on University Student Achievement

    ERIC Educational Resources Information Center

    Daniels, Lia M.; Perry, Raymond P.; Stupnisky, Robert H.; Stewart, Tara L.; Newall, Nancy E. G.; Clifton, Rodney A.

    2014-01-01

    In the area of achievement motivation, students' beliefs pertaining to achievement goals and perceived control have separately guided a large amount theoretical and empirical research. However, limited research has considered the simultaneous effects of goals and control on achievement. The purpose of this study was to examine primary and…

  15. 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.

  16. 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…

  17. Particle creation in the early Universe: Achievements and problems

    NASA Astrophysics Data System (ADS)

    Grib, A. A.; Pavlov, Yu. V.

    2016-04-01

    Results on particle creation from vacuum by the gravitational field of the expanding Friedmann Universe are presented. Finite results for the density of particles and the energy density for created particles are given for different exact solutions for different regimes of the expansion of the Universe. The results are obtained as for conformal as for nonconformal particles. The hypothesis of the origination of visible matter from the decay of created from vacuum superheavy particles identified with the dark matter is discussed.

  18. 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.…

  19. A qualitative study of DRG coding practice in hospitals under the Thai Universal Coverage Scheme

    PubMed Central

    2011-01-01

    Background In the Thai Universal Coverage health insurance scheme, hospital providers are paid for their inpatient care using Diagnosis Related Group-based retrospective payment, for which quality of the diagnosis and procedure codes is crucial. However, there has been limited understandings on which health care professions are involved and how the diagnosis and procedure coding is actually done within hospital settings. The objective of this study is to detail hospital coding structure and process, and to describe the roles of key hospital staff, and other related internal dynamics in Thai hospitals that affect quality of data submitted for inpatient care reimbursement. Methods Research involved qualitative semi-structured interview with 43 participants at 10 hospitals chosen to represent a range of hospital sizes (small/medium/large), location (urban/rural), and type (public/private). Results Hospital Coding Practice has structural and process components. While the structural component includes human resources, hospital committee, and information technology infrastructure, the process component comprises all activities from patient discharge to submission of the diagnosis and procedure codes. At least eight health care professional disciplines are involved in the coding process which comprises seven major steps, each of which involves different hospital staff: 1) Discharge Summarization, 2) Completeness Checking, 3) Diagnosis and Procedure Coding, 4) Code Checking, 5) Relative Weight Challenging, 6) Coding Report, and 7) Internal Audit. The hospital coding practice can be affected by at least five main factors: 1) Internal Dynamics, 2) Management Context, 3) Financial Dependency, 4) Resource and Capacity, and 5) External Factors. Conclusions Hospital coding practice comprises both structural and process components, involves many health care professional disciplines, and is greatly varied across hospitals as a result of five main factors. PMID:21477310

  20. Using stakeholder analysis to support moves towards universal coverage: lessons from the SHIELD project.

    PubMed

    Gilson, Lucy; Erasmus, Ermin; Borghi, Jo; Macha, Janet; Kamuzora, Peter; Mtei, Gemini

    2012-03-01

    Stakeholder analysis is widely recommended as a tool for gathering insights on policy actor interests in, positions on, and power to influence, health policy issues. Such information is recognized to be critical in developing viable health policy proposals, and is particularly important for new health care financing proposals that aim to secure universal coverage (UC). However, there remain surprisingly few published accounts of the use of stakeholder analysis in health policy development generally, and health financing specifically, and even fewer that draw lessons from experience about how to do and how to use such analysis. This paper, therefore, aims to support those developing or researching UC reforms to think both about how to conduct stakeholder analysis, and how to use it to support evidence-informed pro-poor health policy development. It presents practical lessons and ideas drawn from experience of doing stakeholder analysis around UC reforms in South Africa and Tanzania, combined with insights from other relevant material. The paper has two parts. The first presents lessons of experience for conducting a stakeholder analysis, and the second, ideas about how to use the analysis to support policy design and the development of actor and broader political management strategies. Comparison of experience across South Africa and Tanzania shows that there are some commonalities concerning which stakeholders have general interests in UC reform. However, differences in context and in reform proposals generate differences in the particular interests of stakeholders and their likely positioning on reform proposals, as well as in their relative balance of power. It is, therefore, difficult to draw cross-national policy comparisons around these specific issues. Nonetheless, the paper shows that cross-national policy learning is possible around the approach to analysis, the factors influencing judgements and the implications for, and possible approaches to, management

  1. Universal coverage challenges require health system approaches; the case of India.

    PubMed

    Duran, Antonio; Kutzin, Joseph; Menabde, Nata

    2014-02-01

    This paper uses the case of India to demonstrate that Universal Health Coverage (UHC) is about not only health financing; personal and population services production issues, stewardship of the health system and generation of the necessary resources and inputs need to accompany the health financing proposals. In order to help policy makers address UHC in India and sort out implementation issues, the framework developed by the World Health Organization (WHO) in the World Health Report 2000 and its subsequent extensions are advocated. The framework includes final goals, generic intermediate objectives and four inter-dependent functions which interact as a system; it can be useful by diagnosing current shortcomings and facilitating the filling up of gaps between functions and goals. Different positions are being defended in India re the preconditions for UHC to succeed. This paper argues that more (public) money will be important, but not enough; it needs to be supplemented with broad interventions at various health system levels. The paper analyzes some of the most important issues in relation to the functions of service production, generation of inputs and the necessary stewardship. It also pays attention to reform implementation, as different from its design, and suggests critical aspects emanating from a review of recent health system reforms. Precisely because of the lack of comparative reference for India, emphasis is made on the need to accompany implementation with analysis, so that the "solutions" ("what to do?", "how to do it?") are found through policy analysis and research embedded into flexible implementation. Strengthening "evidence-to-policy" links and the intelligence dimension of stewardship/leadership as well as accountability during implementation are considered paramount. Countries facing similar challenges to those faced by India can also benefit from the above approaches.

  2. 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.

  3. [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

  4. [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.

  5. 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

  6. Predictive Validity of Pre-University Examinations Test Scores for University Science Undergraduates' Academic Achievement in South West, Nigeria

    ERIC Educational Resources Information Center

    Gbore, L. O.

    2012-01-01

    This study examined the predictive validity of pre-university examinations test scores (university matriculation examination (UME), Post-UME and pre-degree) for undergraduate academic achievement. The study is planned along the lines of correlational and ex-post-facto research design. A sample of four hundred university science based…

  7. 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

  8. 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

    2014-01-01

    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 international equalization scheme

  9. 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…

  10. 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…

  11. 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.

  12. 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…

  13. The importance of values in shaping how health systems governance and management can support universal health coverage.

    PubMed

    Fattore, Giovanni; Tediosi, Fabrizio

    2013-01-01

    In this article, we use cultural theory to investigate the nature of health systems governance and management, showing that it may be helpful in identifying key aspects of the debate about how to promote universal health coverage. Cultural theory argues that "how" we govern and manage health services depends on what we think about the nature of government organizations and the legitimacy of their scope of action. The values that are implied by universal health coverage underlie choices about "how" health systems are governed and their organizations are managed. We draw two main conclusions. First, the translation of principles and goals into practice requires exceptional efforts to design adequate decision-making arrangements (the essence of governance) and management practices. Management and governance, or "how" policies are decided and conducted, are not secondary to the selection of the best policy solutions (the "what"). Second, governance and management solutions are not independent of the values that they are expected to serve. Instead, they should be designed to be consonant with these values. Cultural theory suggests-and experience supports-the idea that "group identity" is favorable for shaping different forms of social life and public administrations. This approach should thus be a starting point for those who strive to obtain universal health coverage.

  14. 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

  15. 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

    2014-01-01

    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.

  16. 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

  17. 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

  18. 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…

  19. 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 university students…

  20. Socially oriented achievement goals of Chinese university students in Singapore: structure and relationships with achievement motives, goals and affective outcomes.

    PubMed

    Chang, Weining C; Wong, Kaishi

    2008-10-01

    Contemporary literature on culture, self, and motivations (Markus & Kitayama, 1991) suggests that in collectivistic cultures, individual achievement is interdependent of one's social others. We proposed that this cultural characteristic could be exemplified in the achievement goal orientation and tested the notion with university students in a collectivistic community-Singapore. A socially oriented achievement goal construct was developed by taking into consideration the significant social others in the students' lives. A measuring instrument was established with a sample of Singaporean Chinese university students (N = 196; 144 females and 52 males); its relationships to achievement motives, goals, and consequences were examined. Although the socially oriented achievement goal items were originally constructed from four categories of social others, confirmatory factor analysis suggested a unifactor structure. Results showed that the socially oriented goal was related positively with students' performance goal, mastery goal, and competitive motive; it bore no relationship to mastery motive, work ethic, and interest in learning; and it predicted negatively future engagement. After the effects of mastery and performance goals were controlled for, the socially oriented goal did not predict test anxiety. PMID:22022792

  1. Socially oriented achievement goals of Chinese university students in Singapore: structure and relationships with achievement motives, goals and affective outcomes.

    PubMed

    Chang, Weining C; Wong, Kaishi

    2008-10-01

    Contemporary literature on culture, self, and motivations (Markus & Kitayama, 1991) suggests that in collectivistic cultures, individual achievement is interdependent of one's social others. We proposed that this cultural characteristic could be exemplified in the achievement goal orientation and tested the notion with university students in a collectivistic community-Singapore. A socially oriented achievement goal construct was developed by taking into consideration the significant social others in the students' lives. A measuring instrument was established with a sample of Singaporean Chinese university students (N = 196; 144 females and 52 males); its relationships to achievement motives, goals, and consequences were examined. Although the socially oriented achievement goal items were originally constructed from four categories of social others, confirmatory factor analysis suggested a unifactor structure. Results showed that the socially oriented goal was related positively with students' performance goal, mastery goal, and competitive motive; it bore no relationship to mastery motive, work ethic, and interest in learning; and it predicted negatively future engagement. After the effects of mastery and performance goals were controlled for, the socially oriented goal did not predict test anxiety.

  2. Helicopter Dropping of 50 Free Allopathic Medicines; Prescribed by Homoeopathic Doctors at Ground: Sorry this is not Universal Health Coverage

    PubMed Central

    Kumar, Raman

    2014-01-01

    The provision of Universal Health Coverage (UHC) is being discussed in India. Crippled by the charges of corruption and unethical practice by media and public at large, medical professionals are largely unaware, disinterested, isolated and edged out from this debate. The traditional general practitioner is a dying breed and deficiency of doctors willing to work in community settings is rampant. Is UHC model proposed in present form good for an ordinary Indian citizen? This editorial looks into the underlying politics of health care in India in the past and how this ongoing debate could impact the future of primary care and health care of people in India. PMID:25161961

  3. 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

  4. Helicopter Dropping of 50 Free Allopathic Medicines; Prescribed by Homoeopathic Doctors at Ground: Sorry this is not Universal Health Coverage.

    PubMed

    Kumar, Raman

    2014-04-01

    The provision of Universal Health Coverage (UHC) is being discussed in India. Crippled by the charges of corruption and unethical practice by media and public at large, medical professionals are largely unaware, disinterested, isolated and edged out from this debate. The traditional general practitioner is a dying breed and deficiency of doctors willing to work in community settings is rampant. Is UHC model proposed in present form good for an ordinary Indian citizen? This editorial looks into the underlying politics of health care in India in the past and how this ongoing debate could impact the future of primary care and health care of people in India.

  5. Income-based disparities in health care utilisation under universal health coverage in Brazil, 2002-2003.

    PubMed

    Cataife, Guido; Courtemanche, Charles

    2014-01-01

    Since Brazil's adoption of universal health care in 1988, the country's health care system has consisted of a mix of private providers and free public providers. We test whether income-based disparities in medical visits and medications remain in Brazil despite universal coverage using a nationally representative sample of over 48,000 households. Additional income is associated with less public sector utilisation and more private sector utilisation, both using simple correlations and regressions controlling for household characteristics and local area fixed effects. Importantly, the increase in private care use is greater than the drop in public care use. Also, income and unmet medical needs are negatively associated. These results suggest that access limitations remain for low-income households despite the availability of free public care.

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

    ERIC Educational Resources Information Center

    Leinbach, D. Timothy; Bailey, Thomas R.

    2006-01-01

    This chapter analyzes whether Hispanics and Hispanic immigrants in the City University of New York system have the same levels of access and achievement as other racial and ethnic populations. (Contains 3 tables.)

  7. 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.

  8. 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. PMID:27079441

  9. 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.

  10. 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.

  11. Universal health care coverage in the United States: is it "slip slidin' away"?

    PubMed

    Doherty, Robert B

    2011-01-18

    With passage of the Affordable Care Act, affordable health insurance for all Americans is in sight, yet politics could cause it to slip away. A resurgent Republican Party will mount a sustained challenge at the federal and state levels, but the new Congress will not bring about the Affordable Care Act's repeal. More likely, the law's effectiveness could be undermined by congressional restrictions on its implementation, underfunding of programs to improve public health and train more primary care physicians, and resistance by many states to its mandates. Congress could instead seek a bipartisan accord on improving the law, such as by giving the states more options, but this is unlikely in the current polarized environment. This debate is occurring even as the United States faces an unprecedented crisis in access to health insurance coverage, affecting nearly every demographic group, yet the uninsured have largely become an afterthought. Medical professionalism requires a commitment to improving access to care, and physicians could play a crucial role in informing lawmakers that providing all Americans with affordable health care coverage is a moral and medical imperative to prevent needless suffering and death, and must not be allowed to slip away.

  12. 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

  13. 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. PMID:25552773

  14. 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…

  15. The Failure of Non-Binding Declarations to Achieve University Sustainability: A Need for Accountability

    ERIC Educational Resources Information Center

    Bekessy, S. A.; Samson, K.; Clarkson, R. E.

    2007-01-01

    Purpose: This paper aims to assess the impact and value of non-binding agreements or declarations in achieving sustainability in universities. Design/methodology/approach: A case study of Royal Melbourne Institute of Technology (RMIT) University is presented, analysing the reasons for lack of progress towards sustainability and evaluating best…

  16. 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…

  17. The Impact of Inattention, Hyperactivity and Impulsivity on Academic Achievement in UK University Students

    ERIC Educational Resources Information Center

    Pope, Debbie J.

    2010-01-01

    Increasing numbers of students in UK universities are presenting with a diagnosis of attention deficit hyperactivity disorder (ADHD). However, the impact of ADHD symptomatology on academic achievement in university students in the UK has not previously been explored. This study investigates the prevalence of self-reported ADHD symptoms…

  18. 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…

  19. 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…

  20. 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…

  1. Achieving Systemic Change with Universal Design for Learning and Digital Content

    ERIC Educational Resources Information Center

    Ender, Karen E.; Kinney, Barbara J.; Penrod, William M.; Bauder, Debra K.; Simmons, Thomas

    2007-01-01

    Systemic change may be achieved through a combination of the Universal Design for Learning (UDL) principles in instructional delivery, the integration of accessible digital materials, and the use of state-of-the-art technology tools. To demonstrate this premise, the Kentucky Department of Education (KDE) partnered with the University of Louisville…

  2. 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.

  3. 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. PMID:25691148

  4. 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.

  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. 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…

  7. 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…

  8. 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).…

  9. 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…

  10. 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…

  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. PMID:26044851

  12. 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.

  13. Sustaining universal health coverage: the interaction of social, political, and economic sustainability.

    PubMed

    Borgonovi, Elio; Compagni, Amelia

    2013-01-01

    The sustainability of health care systems, particularly those supporting universal health care, is a matter of current discussion among policymakers and scholars. In this article, we summarize the controversies around the economic sustainability of health care. We attempt to extend the debate by including a more comprehensive conceptualization of sustainability in relation to health care systems and by examining the dimensions of social and political sustainability. In conclusion, we argue that policymakers when taking decisions around universal health care should carefully consider issues of social, political, and economic sustainability, their interaction, and often their inherent trade-offs.

  14. HEPATITIS B VACCINATION COVERAGE AND POSTVACCINATION SEROLOGIC TESTING AMONG MEDICAL STUDENTS AT A PUBLIC UNIVERSITY IN BRAZIL

    PubMed Central

    de Souza, Eduardo Pernambuco; Teixeira, Marcelo de Souza

    2014-01-01

    The aim of this cross-sectional study was to determine the hepatitis B vaccination coverage among medical students at a public university in Rio de Janeiro, Brazil, and their compliance with the postvaccination serologic testing recommendations. Of the total of 858 students, 675 (78.7%) participated in the study. Among the participants, 48.9% (95% CI: 45.1% to 52.7%) were vaccinated against hepatitis B (received ≥ 3 doses of the vaccine), 31.6% were not (received 0, 1 or 2 doses), and 19.6% did not know their vaccination status. Hepatitis B vaccination coverage increased from 26.0% among first-year students to 70.6% among sixth-year students while the prevalence of unknown vaccination status decreased from 39.7% among first-year students to 2.4% among sixth-year students. The frequency of unvaccinated students ranged from 23.7% among fifth-year students to 34.4% among first-year students. Only 34.8% of the vaccinated students performed the anti-HBs testing after vaccination. Among these medical students, we found a low adherence to the hepatitis B vaccination and to the postvaccination serologic testing. A comprehensive hepatitis B immunization program should be offered to students at this medical school. PMID:25076431

  15. Achieving Community Borrower Compliance with an Urban University Library's Circulation Policies: One University's Solution.

    ERIC Educational Resources Information Center

    Nicewarner, Metta; Simon, Matthew

    1996-01-01

    Discussion of the use of academic libraries by public borrowers focuses on policies developed at the University of Nevada, Las Vegas. Highlights include library networks and identity problems; access to materials; fee-based reference services; and requiring patrons to register a credit card to be used for replacement materials and fines. (LRW)

  16. 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.

  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. 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

  19. Incoherent policies on universal coverage of health insurance and promotion of international trade in health services in Thailand.

    PubMed

    Pachanee, Cha-aim; Wibulpolprasert, Suwit

    2006-07-01

    The Thai government has implemented universal coverage of health insurance since October 2001. Universal access to antiretroviral (ARV) drugs has also been included since October 2003. These two policies have greatly increased the demand for health services and human resources for health, particularly among public health care providers. After the 1997 economic crisis, private health care providers, with the support of the government, embarked on new marketing strategies targeted at attracting foreign patients. Consequently, increasing numbers of foreign patients are visiting Thailand to seek medical care. In addition, the economic recovery since 2001 has greatly increased the demand for private health services among the Thai population. The increasing demand and much higher financial incentives from urban private providers have attracted health personnel, particularly medical doctors, from rural public health care facilities. Responding to this increasing demand and internal brain drain, in mid-2004 the Thai government approved the increased production of medical doctors by 10,678 in the following 15 years. Many additional financial incentives have also been applied. However, the immediate shortage of human resources needs to be addressed competently and urgently. Equity in health care access under this situation of competing demands from dual track policies is a challenge to policy makers and analysts. This paper summarizes the situation and trends as well as the responses by the Thai government. Both supply and demand side responses are described, and some solutions to restore equity in health care access are proposed.

  20. Incoherent policies on universal coverage of health insurance and promotion of international trade in health services in Thailand.

    PubMed

    Pachanee, Cha-aim; Wibulpolprasert, Suwit

    2006-07-01

    The Thai government has implemented universal coverage of health insurance since October 2001. Universal access to antiretroviral (ARV) drugs has also been included since October 2003. These two policies have greatly increased the demand for health services and human resources for health, particularly among public health care providers. After the 1997 economic crisis, private health care providers, with the support of the government, embarked on new marketing strategies targeted at attracting foreign patients. Consequently, increasing numbers of foreign patients are visiting Thailand to seek medical care. In addition, the economic recovery since 2001 has greatly increased the demand for private health services among the Thai population. The increasing demand and much higher financial incentives from urban private providers have attracted health personnel, particularly medical doctors, from rural public health care facilities. Responding to this increasing demand and internal brain drain, in mid-2004 the Thai government approved the increased production of medical doctors by 10,678 in the following 15 years. Many additional financial incentives have also been applied. However, the immediate shortage of human resources needs to be addressed competently and urgently. Equity in health care access under this situation of competing demands from dual track policies is a challenge to policy makers and analysts. This paper summarizes the situation and trends as well as the responses by the Thai government. Both supply and demand side responses are described, and some solutions to restore equity in health care access are proposed. PMID:16728511

  1. 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…

  2. 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…

  3. 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.

  4. 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…

  5. 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…

  6. Explaining Mathematics Achievement of Mature Internal and External Students at the University of Papua New Guinea.

    ERIC Educational Resources Information Center

    Kaeley, Gurcham S.

    1993-01-01

    Develops a causal model that explains over 40% of the variance in matriculation mathematics achievement of mature internal and external students at the University of Papua New Guinea. Background variables seem more important in the learning of mathematics compared to mediating variables for external students than for internal students. (MDH)

  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. 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…

  9. Confronting the Universal Disbelief that Poor Children Can Achieve at High Levels

    ERIC Educational Resources Information Center

    Kelleher, Paul

    2006-01-01

    In her first year as superintendent of the Atlanta Public Schools, Beverly Hall encountered what she describes as the nearly universal disbelief that poor children of color can achieve high levels of learning. This chapter recounts how she confronted this and other obstacles and challenges as the new leader of the Atlanta Public Schools. Hall is…

  10. 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…

  11. 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…

  12. 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…

  13. 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,…

  14. 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…

  15. 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…

  16. 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…

  17. 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.…

  18. 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…

  19. 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…

  20. 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

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

    PubMed Central

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

    2016-01-01

    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. PMID:27801355

  2. 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. PMID:26774008

  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. Challenges in universal coverage and utilization of insecticide-treated bed nets in migrant plantation workers in Myanmar

    PubMed Central

    2014-01-01

    Background High coverage of the bed nets can reduce mortality and morbidity of mosquito-borne diseases including malaria. Although the migrant workers are at high risk of malaria, there are many hidden challenges in universal coverage and utilization of the insecticide-treated nets (ITNs) in this populations. Methods Cross sectional study was conducted in 170 migrant workers in palm oil plantation sites in Tanintharyi Region and 175 in rubber plantation sites in Mon State. A multistage stratified cluster sampling was applied to select the participants. During household visit, face-to-face interviews using structured pre-coded, pre tested questionnaires and direct observation on installation of the bed nets was conducted. Two focus group discussions in each site were done by sample stratified purposive sampling method mainly focused on effective utilization of bed nets. Results Among them, 332 (96.2%) had a bed net and 284 (82.3%) had an ITN, while 204 (59.1%) had unused extranets. Among the ITNs users, 28.9% reported problems including insecticide smell (56.9%), dizziness (20.2%), headache (12.8%) and itchiness (9.2%). More than 75% received ITNs from health authorities and NGOs free-of-charge. More than 70% wanted to buy a net but they were unaffordable for 64% of them. On observation, only five families could show no bed net, but 80% showed 1–3 ITNs. Consistent utilization in all seasons was noted in 189 (53.1%), that was higher in palm oil plantation than rubber plantation workers (p = 0.0001) due to the nature of the work at night. Perceived malaria risk was also significantly higher ITNs consistent users than non-users (p = 0.0004) and better willingness to buy an ITN by themselves (p = 0.0005). They said that effectiveness of the ITNs was reduced after 6 months and 2–3 times washing. They wished to receive more durable smooth nets with small holes in lace. Misuses of the ITNs such as use the nets for animals and fishing, were also noted

  5. 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.…

  6. 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…

  7. Growth of health maintenance organisations in Nigeria and the potential for a role in promoting universal coverage efforts.

    PubMed

    Onoka, Chima A; Hanson, Kara; Mills, Anne

    2016-08-01

    There has been growing interest in the potential for private health insurance (PHI) and private organisations to contribute to universal health coverage (UHC). Yet evidence from low and middle income countries remains very thin. This paper examines the evolution of health maintenance organisations (HMOs) in Nigeria, the nature of the PHI plans and social health insurance (SHI) programmes and their performance, and the implications of their business practices for providing PHI and UHC-related SHI programmes. An embedded case study design was used with multiple subunits of analysis (individual HMOs and the HMO industry) and mixed (qualitative and quantitative) methods, and the study was guided by the structure-conduct-performance paradigm that has its roots in the neo-classical theory of the firm. Quantitative data collection and 35 in-depth interviews were carried out between October 2012 to July 2013. Although HMOs first emerged in Nigeria to supply PHI, their expansion was driven by their role as purchasers in the government's national health insurance scheme that finances SHI programmes, and facilitated by a weak accreditation system. HMOs' characteristics distinguish the market they operate in as monopolistically competitive, and HMOs as multiproduct firms operating multiple risk pools through parallel administrative systems. The considerable product differentiation and consequent risk selection by private insurers promote inefficiencies. Where HMOs and similar private organisations play roles in health financing systems, effective regulatory institutions and mandates must be established to guide their behaviours towards attainment of public health goals and to identify and control undesirable business practices. Lessons are drawn for policy makers and programme implementers especially in those low and middle-income countries considering the use of private organisations in their health financing systems.

  8. Growth of health maintenance organisations in Nigeria and the potential for a role in promoting universal coverage efforts.

    PubMed

    Onoka, Chima A; Hanson, Kara; Mills, Anne

    2016-08-01

    There has been growing interest in the potential for private health insurance (PHI) and private organisations to contribute to universal health coverage (UHC). Yet evidence from low and middle income countries remains very thin. This paper examines the evolution of health maintenance organisations (HMOs) in Nigeria, the nature of the PHI plans and social health insurance (SHI) programmes and their performance, and the implications of their business practices for providing PHI and UHC-related SHI programmes. An embedded case study design was used with multiple subunits of analysis (individual HMOs and the HMO industry) and mixed (qualitative and quantitative) methods, and the study was guided by the structure-conduct-performance paradigm that has its roots in the neo-classical theory of the firm. Quantitative data collection and 35 in-depth interviews were carried out between October 2012 to July 2013. Although HMOs first emerged in Nigeria to supply PHI, their expansion was driven by their role as purchasers in the government's national health insurance scheme that finances SHI programmes, and facilitated by a weak accreditation system. HMOs' characteristics distinguish the market they operate in as monopolistically competitive, and HMOs as multiproduct firms operating multiple risk pools through parallel administrative systems. The considerable product differentiation and consequent risk selection by private insurers promote inefficiencies. Where HMOs and similar private organisations play roles in health financing systems, effective regulatory institutions and mandates must be established to guide their behaviours towards attainment of public health goals and to identify and control undesirable business practices. Lessons are drawn for policy makers and programme implementers especially in those low and middle-income countries considering the use of private organisations in their health financing systems. PMID:27322911

  9. 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

  10. 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.

  11. 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.

  12. 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

  13. Constraints to universal coverage: inequities in health service use and expenditures for different health conditions and providers

    PubMed Central

    2011-01-01

    Background There is need for new information about the socio-economic and geographic differences in health seeking and expenditures on many health conditions, so to help to design interventions that will reduce inequity in utilisation of healthcare services and ensure universal coverage. Objectives The paper contributes additional knowledge about health seeking and economic burden of different health conditions. It also shows the level of healthcare payments in public and private sector and their distribution across socioeconomic and geographic population groups. Methods A questionnaire was used to collect data from randomly selected householders from 4,873 households (2,483 urban and 2,390 rural) in southeast Nigeria. Data was collected on: health problems that people had and sought care for; type of care sought, outpatient department (OPD) visits and inpatient department (IPD) stays; providers visited; expenditures; and preferences for improving access to care. Data was disaggregated by socio-economic status (SES) and geographic location (urban versus rural) of the households. Results Malaria and hypertension were the major communicable and non-communicable diseases respectively that required OPD and IPD. Patent medicine dealers (PMDs) were the most commonly used providers (41.1%), followed by private hospitals (19.7%) and pharmacies (16.4%). The rural dwellers and poorer SES groups mostly used low-level and informal providers. The average monthly treatment expenditure in urban area was 2444 Naira (US$20.4) and 2267 Naira (US$18.9) in the rural area. Higher SES groups and urbanites incurred higher health expenditures. People that needed healthcare services did not seek care mostly because the health condition was not serious enough or they could not afford the cost of services. Conclusion There were inequities in use of the different providers, and also in expenditures on treatment. Reforms should aim to decrease barriers to access to public and formal health

  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. 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…

  16. [Coverage of health services].

    PubMed

    Martínez-Narváez, G

    1992-01-01

    In this paper the concepts and criteria related to health coverage are discussed in the context of the organization of national health systems. The main international agreements based on WHO/PAHO proposals are also described. The relationship between primary health care and health coverage is analyzed and the evolution of the programs for the extension of health coverage in Mexico are discussed, with emphasis on the problems of overlap and definition of the universe in the several institutions of the health sector. Finally, the author reviews the problems to measure coverage in order to guarantee social and operative efficiency of the Mexican health system. PMID:1411776

  17. 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.

  18. Differences between High and Low Academic Achieving University Students in Learning and Study Strategies: A Further Investigation

    ERIC Educational Resources Information Center

    Yip, Michael C. W.

    2009-01-01

    Following up on the general framework of the research study of Yip (2007), this article sets out a similar research question, investigating the differences between high and low academic achieving Hong Kong university students based on their different learning and study strategies. In this study, we recruited 100 university students who pursued…

  19. 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…

  20. 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…

  1. Subjective wellbeing and its relationship with academic achievement and multilinguality among Lebanese university students.

    PubMed

    Ayyash-Abdo, Huda; Sánchez-Ruiz, María-José

    2012-01-01

    The study investigated three subjective wellbeing (SWB) components, namely positive affect (PA), negative affect (NA), and life satisfaction (LS), along with optimism and self-esteem and their association with academic achievement and multilinguality in a sample of 1401 Lebanese university students. As predicted, optimism and self-esteem correlated positively with LS and PA, and negatively with NA. Optimism, self-esteem and each of the SWB components jointly predicted academic achievement (GPA), with PA being an individually significant positive predictor. There were differences in the five key variables across language groups, specifically between Arabic-only speakers and some other groups: Compared Arabic-only speakers, bilingual speakers of Arabic and either English or French scored higher on self-esteem, PA and optimism, and lower on NA, while trilingual speakers of Arabic, English, and French scored higher on self-esteem, PA and LS. Language grouping was a significant predictor of the SWB components, optimism, and self-esteem even when controlling for GPA, socioeconomic status (SES), and religion. Lastly, the relevance of SES and religion for the prediction of SWB is discussed, and implications and future research questions are advanced.

  2. Divergent Streams: Race-Gender Achievement Gaps at Selective Colleges and Universities

    PubMed Central

    Massey, Douglas S.; Probasco, LiErin

    2013-01-01

    In this paper, we extend previous research on racial performance gaps at 28 selective US colleges and universities by examining differences in grade achievement and graduate rates across race-gender categories. Using data from the National Longitudinal Survey of Freshmen, we show that black males, black females, and Hispanic males attain significantly lower grades than other race-gender groups, and that black males are 35% less likely to graduate on-time than other race-gender groups. Analyses consider an array of personal and institutional indicators of academic performance. Grades and graduation rates are improved by academic preparation (particularly high school GPA), scholarly effort, and, for graduation rates, membership in career-oriented or majority-white campus groups. Grade performance and graduation rates are undermined by a hostile racial climate on campus, family stress, and stereotype threat, all of which disproportionately affect minority students. We conclude with recommendations to college administrators for ways of selecting and supporting minority students to reduce differentials in academic achievement across race-gender groups. PMID:23646062

  3. Towards achievement of universal health care in India by 2020: a call to action

    PubMed Central

    Reddy, K Srinath; Patel, Vikram; Jha, Prabhat; Paul, Vinod K; Shiva Kumar, A K; Dandona, Lalit

    2016-01-01

    To sustain the positive economic trajectory that India has had during the past decade, and to honour the fundamental right of all citizens to adequate health care, the health of all Indian people has to be given the highest priority in public policy. We propose the creation of the Integrated National Health System in India through provision of universal health insurance, establishment of autonomous organisations to enable accountable and evidence-based good-quality health-care practices and development of appropriately trained human resources, the restructuring of health governance to make it coordinated and decentralised, and legislation of health entitlement for all Indian people. The key characteristics of our proposal are to strengthen the public health system as the primary provider of promotive, preventive, and curative health services in India, to improve quality and reduce the out-of-pocket expenditure on health care through a well regulated integration of the private sector within the national health-care system. Dialogue and consensus building among the stakeholders in the government, civil society, and private sector are the next steps to formalise the actions needed and to monitor their achievement. In our call to action, we propose that India must achieve health care for all by 2020. PMID:21227489

  4. 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.

  5. Reaching Mothers and Babies with Early Postnatal Home Visits: The Implementation Realities of Achieving High Coverage in Large-Scale Programs

    PubMed Central

    Sitrin, Deborah; Guenther, Tanya; Murray, John; Pilgrim, Nanlesta; Rubayet, Sayed; Ligowe, Reuben; Pun, Bhim; Malla, Honey; Moran, Allisyn

    2013-01-01

    Background Nearly half of births in low-income countries occur without a skilled attendant, and even fewer mothers and babies have postnatal contact with providers who can deliver preventive or curative services that save lives. Community-based maternal and newborn care programs with postnatal home visits have been tested in Bangladesh, Malawi, and Nepal. This paper examines coverage and content of home visits in pilot areas and factors associated with receipt of postnatal visits. Methods Using data from cross-sectional surveys of women with live births (Bangladesh 398, Malawi: 900, Nepal: 615), generalized linear models were used to assess the strength of association between three factors - receipt of home visits during pregnancy, birth place, birth notification - and receipt of home visits within three days after birth. Meta-analytic techniques were used to generate pooled relative risks for each factor adjusting for other independent variables, maternal age, and education. Findings The proportion of mothers and newborns receiving home visits within three days after birth was 57% in Bangladesh, 11% in Malawi, and 50% in Nepal. Mothers and newborns were more likely to receive a postnatal home visit within three days if the mother received at least one home visit during pregnancy (OR2.18, CI1.46–3.25), the birth occurred outside a facility (OR1.48, CI1.28–1.73), and the mother reported a CHW was notified of the birth (OR2.66, CI1.40–5.08). Checking the cord was the most frequently reported action; most mothers reported at least one action for newborns. Conclusions Reaching mothers and babies with home visits during pregnancy and within three days after birth is achievable using existing community health systems if workers are available; linked to communities; and receive training, supplies, and supervision. In all settings, programs must evaluate what community delivery systems can handle and how to best utilize them to improve postnatal care access. PMID

  6. (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…

  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. Community perceptions of health insurance and their preferred design features: implications for the design of universal health coverage reforms in Kenya

    PubMed Central

    2013-01-01

    Background Health insurance is currently being considered as a mechanism for promoting progress to universal health coverage (UHC) in many African countries. The concept of health insurance is relatively new in Africa, it is hardly well understood and remains unclear how it will function in countries where the majority of the population work outside the formal sector. Kenya has been considering introducing a national health insurance scheme (NHIS) since 2004. Progress has been slow, but commitment to achieve UHC through a NHIS remains. This study contributes to this process by exploring communities’ understanding and perceptions of health insurance and their preferred designs features. Communities are the major beneficiaries of UHC reforms. Kenyans should understand the implications of health financing reforms and their preferred design features considered to ensure acceptability and sustainability. Methods Data presented in this paper are part of a study that explored feasibility of health insurance in Kenya. Data collection methods included a cross-sectional household survey (n = 594 households) and focus group discussions (n = 16). Results About half of the household survey respondents had at least one member in a health insurance scheme. There was high awareness of health insurance schemes but limited knowledge of how health insurance functions as well as understanding of key concepts related to income and risk cross-subsidization. Wide dissatisfaction with the public health system was reported. However, the government was the most preferred and trusted agency for collecting revenue as part of a NHIS. People preferred a comprehensive benefit package that included inpatient and outpatient care with no co-payments. Affordability of premiums, timing of contributions and the extent to which population needs would be met under a contributory scheme were major issues of concern for a NHIS design. Possibilities of funding health care through tax instead of

  9. 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

  10. 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

  11. 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.

  12. 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…

  13. 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. PMID:23025869

  14. Where Do the Rural Poor Deliver When High Coverage of Health Facility Delivery Is Achieved? Findings from a Community and Hospital Survey in Tanzania

    PubMed Central

    Straneo, Manuela; Fogliati, Piera; Azzimonti, Gaetano; Mangi, Sabina; Kisika, Firma

    2014-01-01

    Introduction As part of maternal mortality reducing strategies, coverage of delivery care among sub-Saharan African rural poor will improve, with a range of facilities providing services. Whether high coverage will benefit all socio-economic groups is unknown. Iringa rural District, Southern Tanzania, with high facility delivery coverage, offers a paradigm to address this question. Delivery services are available in first-line facilities (dispensaries, health centres) and one hospital. We assessed whether all socio-economic groups access the only comprehensive emergency obstetric care facility equally, and surveyed existing delivery services. Methods District population characteristics were obtained from a household community survey (n = 463). A Hospital survey collected data on women who delivered in this facility (n = 1072). Principal component analysis on household assets was used to assess socio-economic status. Hospital population socio-demographic characteristics were compared to District population using multivariable logistic regression. Deliveries' distribution in District facilities and staffing were analysed using routine data. Results Women from the hospital compared to the District population were more likely to be wealthier. Adjusted odds ratio of hospital delivery increased progressively across socio-economic groups, from 1.73 for the poorer (p = 0.0031) to 4.53 (p<0.0001) for the richest. Remarkable dispersion of deliveries and poor staffing were found. In 2012, 5505/7645 (72%) institutional deliveries took place in 68 first-line facilities, the remaining in the hospital. 56/68 (67.6%) first-line facilities reported ≤100 deliveries/year, attending 33% of deliveries. Insufficient numbers of skilled birth attendants were found in 42.9% of facilities. Discussion Poorer women remain disadvantaged in high coverage, as they access lower level facilities and are under-represented where life-saving transfusions and caesarean sections are

  15. 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

  16. 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)

  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. 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…

  19. 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…

  20. 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…

  1. 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…

  2. 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…

  3. 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…

  4. An Evaluative Study of the Academic Achievement of Homeschooled Students versus Traditionally Schooled Students Attending a Catholic University

    ERIC Educational Resources Information Center

    Snyder, Marc

    2013-01-01

    This research study was designed to provide a formal evaluation of the academic achievement of homeschooled students compared to traditionally schooled students attending a Catholic university located in South Florida. In addition, this study offers empirical data for all those interested in the academic success of homeschooled students in higher…

  5. 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…

  6. 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…

  7. 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…

  8. 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…

  9. Code RED (Remediation and Enrichment Days): The Complex Journey of a School and University Partnership's Process to Increase Mathematics Achievement

    ERIC Educational Resources Information Center

    Moyer, Patricia S.; Dockery, Kim; Jamieson, Spencer; Ross, Julie

    2007-01-01

    This study examined a focused remediation and enrichment effort among school and university faculty to affect the mathematics achievement of a group of third-grade students in a Title I elementary school. A total of 87 students participated in the Code RED (Remediation and Enrichment Days) Project. During the Code RED Project, student assessment…

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

    ERIC Educational Resources Information Center

    Ramirez, Adrian Dee

    2010-01-01

    The purpose of the 7-year longitudinal study was to examine the College Assistance Migrant Program (CAMP), a student services intervention, to determine its impact on migrant student achievement in the California State University (CSU) system. Participants included 336 migrant students who were enrolled as first-time, full-time freshmen in fall…

  11. 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…

  12. Applying the CHAID Algorithm to Analyze How Achievement Is Influenced by University Students' Demographics, Study Habits, and Technology Familiarity

    ERIC Educational Resources Information Center

    Baran, Bahar; Kiliç, Eylem

    2015-01-01

    The purpose of this study is to analyze three separate constructs (demographics, study habits, and technology familiarity) that can be used to identify university students' characteristics and the relationship between each of these constructs with student achievement. A survey method was used for the current study, and the participants included…

  13. Immunization Coverage

    MedlinePlus

    ... underused vaccines is increasing. Immunization currently averts an estimated 2 to 3 million deaths every year. An ... avoided, however, if global vaccination coverage improves. An estimated 19.4 million infants worldwide are still missing ...

  14. 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

  15. 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

  16. 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

  17. 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

  18. 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.

  19. 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…

  20. 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…

  1. 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)

  2. 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.…

  3. Lung cancer treatment is influenced by income, education, age and place of residence in a country with universal health coverage.

    PubMed

    Nilssen, Yngvar; Strand, Trond-Eirik; Fjellbirkeland, Lars; Bartnes, Kristian; Brustugun, Odd Terje; O'Connell, Dianne L; Yu, Xue Qin; Møller, Bjørn

    2016-03-15

    Selection of lung cancer treatment should be based on tumour characteristics, physiological reserves and preferences of the patient. Our aims were to identify and quantify other factors associated with treatment received. Lung cancer patient data from 2002 to 2011 were obtained from the national population-based Cancer Registry of Norway, Statistics Norway and the Norwegian Patient Register. Multivariable logistic regression examined whether year of diagnosis, age, sex, education, income, health trust, smoking status, extent of disease, histology and comorbidities were associated with choice of treatment; surgery or radical or palliative radiotherapy, within 1 year of diagnosis. Among the 24,324 lung cancer patients identified, the resection rate remained constant while the proportion of radical radiotherapy administered increased from 8.6 to 14.1%. Older patients, those with lower household incomes and certain health trusts were less likely to receive any treatment. Lower education and the male gender were identified as negative predictors for receiving surgery. Smoking history was positively associated with both radical and palliative radiotherapy, while comorbidity and symptoms were independently associated with receiving surgery and palliative radiotherapy. Although Norway is a highly egalitarian country with a free, universal healthcare system, this study indicates that surgery and radical and palliative radiotherapy were under-used among the elderly, those with a lower socioeconomic status and those living in certain health trusts.

  4. 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

  5. Development and Confirmatory Factory Analysis of the Achievement Task Value Scale for University Students

    ERIC Educational Resources Information Center

    Lou, Yu-Chiung; Lin, Hsiao-Fang; Lin, Chin-Wen

    2013-01-01

    The aims of the study were (a) to develop a scale to measure university students' task value and (b) to use confirmatory factor analytic techniques to investigate the construct validity of the scale. The questionnaire items were developed based on theoretical considerations and the final version contained 38 items divided into 4 subscales.…

  6. 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.

  7. 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…

  8. Living-Learning Communities and Ethnicity: A Study on Closing the Achievement Gap at Regional University

    ERIC Educational Resources Information Center

    Bewley, Jason Loyd

    2010-01-01

    This quasi-experimental study examined the impact of living-learning communities on GPA and fall-to-fall retention rates for college freshmen at Regional University (RU). The specific focus of this study was the effect of these communities on students of different ethnic groups and on the potential of these communities to reduce the academic…

  9. Effects of Computer Simulations Programs on University Students' Achievements in Physics

    ERIC Educational Resources Information Center

    Bayrak, Celal

    2008-01-01

    The present study investigated whether computer assisted instruction was more effective than face-to-face instruction in increasing student success in physics. The study was conducted in the spring semester of 2006 at the Department of Science and Mathematics for Secondary Education at Hacettepe University. Seventy-eight freshman students from…

  10. 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…

  11. 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.

  12. 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 presented in…

  13. 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…

  14. Using Integrated Enterprise Systems to Achieve Strategic Goals: A Case Study of a Dual Mode University

    ERIC Educational Resources Information Center

    Smith, Alan

    2005-01-01

    Since 1999, the University of Southern Queensland has embarked on a range of initiatives designed to improve the infrastructure and systems used to support its widely ranging activities in teaching and learning and research and its expansion into new international markets. This has involved the careful selection and implementation of various…

  15. Achieving Performance Excellence in University Administration. A Team Approach to Organizational Change and Employee Development.

    ERIC Educational Resources Information Center

    London, Manuel

    This book uses the experiences of a large state research university over the past 5 years to illustrate principles to improve administrative efficiency and manage change. In 12 chapters the book examines, provides lists, and gives examples of plans and strategies for dealing with matters such as: (1) change strategies; (2) leadership roles,…

  16. 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…

  17. Accelerators/decelerators of achieving universal access to sexual and reproductive health services: a case study of Iranian health system

    PubMed Central

    2013-01-01

    Background At the 1994 International Conference on Population and Development (ICPD), held in Cairo, the global community agreed to the goal of achieving universal access to sexual and reproductive health (SRH) and rights by 2015. This research explores the accelerators and decelerators of achieving universal access to the sexual and reproductive health targets and accordingly makes some suggestions. Method We have critically reviewed the latest national reports and extracted the background data on each SRH indicator. The key stakeholders, both national and international, were visited and interviewed at two sites. A total of 55 in-depth interviews were conducted with religious leaders, policy-makers, senior managers, senior academics, and health care managers. Six focus-group discussions were also held among health care providers. The study was qualitative in nature. Results Obstacles on the road to achieving universal access to SRH can be viewed from two perspectives. One gap exists between current achievements and the targets. The other gap arises due to age, marital status, and residency status. The most recently observed trends in the indicators of the universal access to SRH shows that the achievements in the “unmet need for family planning” have been poor. Unmet need for family planning could directly be translated to unwanted pregnancies and unwanted childbirths; the former calls for sexual education to underserved people, including adolescents; and the latter calls for access to safe abortion. Local religious leaders have not actively attended international goal-setting programs. Therefore, they usually do not presume a positive attitude towards these goals. Such negative attitudes seem to be the most important factors hindering the progress towards universal access to SRH. Lack of international donors to fund for SRH programs is also another barrier. In national levels both state and the society are interactively playing their roles. We have used a

  18. 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…

  19. 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

  20. 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

  1. 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.

  2. Universal Factors of Student Achievement in High-Performing Eastern and Western Countries

    ERIC Educational Resources Information Center

    Lee, Jihyun

    2014-01-01

    This study investigates whether a common set of student attitudes and behavioral tendencies can account for academic achievement across different, especially high-performing, countries via analysis of the PISA 2009 international data set. The 13 countries examined are 5 of the top-performing Eastern countries/systems, namely Shanghai China, South…

  3. 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…

  4. Blended Learning Approach Using Moodle and Student's Achievement at Sultan Qaboos University in Oman

    ERIC Educational Resources Information Center

    Al-Ani, Wajeha Thabit

    2013-01-01

    This study attempts to identify factors behind the usage of a blended learning approach that could have an effect on students' achievement, motivation, collaboration and communication as perceived by students. It also aims to analyze obstacles faced by students in using Moodle in blended learning. A sample of 283-students from all colleges at…

  5. 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…

  6. 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…

  7. 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…

  8. 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…

  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. 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.

  12. The Predictability of Enrolment and First-Year University Results from Secondary School Performance: The New Zealand National Certificate of Educational Achievement

    ERIC Educational Resources Information Center

    Shulruf, Boaz; Hattie, John; Tumen, Sarah

    2008-01-01

    This study investigates the predictive correlations between results from the New Zealand National Certificate of Educational Achievement (NCEA), a standards-based qualification, and university grade point averages achieved by first-year students in one large New Zealand University (and, for comparison purposes, also presents correlations from the…

  13. 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…

  14. [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. PMID:27459872

  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 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

  17. 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.

  18. 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. PMID:23638357

  19. Identification and Analysis of Labor Productivity Components Based on ACHIEVE Model (Case Study: Staff of Kermanshah University of Medical Sciences)

    PubMed Central

    Ziapour, Arash; Khatony, Alireza; Kianipour, Neda; Jafary, Faranak

    2015-01-01

    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. PMID:25560364

  20. 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

  1. 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…

  2. 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…

  3. A GPS coverage model

    NASA Technical Reports Server (NTRS)

    Skidmore, Trent A.

    1994-01-01

    The results of several case studies using the Global Positioning System coverage model developed at Ohio University are summarized. Presented are results pertaining to outage area, outage dynamics, and availability. Input parameters to the model include the satellite orbit data, service area of interest, geometry requirements, and horizon and antenna mask angles. It is shown for precision-landing Category 1 requirements that the planned GPS 21 Primary Satellite Constellation produces significant outage area and unavailability. It is also shown that a decrease in the user equivalent range error dramatically decreases outage area and improves the service availability.

  4. The achievements of "Chemistry in the Community" students compared to traditional chemistry students in an introductory university chemistry course

    NASA Astrophysics Data System (ADS)

    Brent, Bill M.

    found between the two groups of students using ANCOVAs with alpha = 0.05. To determine any difference in the attitude of the students toward STS issues, the Science, Technology, and Society Attitude Scale (1996 Iowa Assessment Handbook) was administered to the students. No significant difference was found between the two groups using a t test with alpha = 0.05. The ChemCom and non-ChemCom students with similar high school backgrounds were comparable in achievement in a university chemistry course and in attitude toward technological and societal issues.

  5. 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.

  6. Will Universal Health Coverage (UHC) lead to the freedom to lead flourishing and healthy lives?: Comment on "Inequities in the freedom to lead a flourishing and healthy life: issues for healthy public policy".

    PubMed

    Matheson, Don

    2015-01-01

    The focus on public policy and health equity is discussed in reference to the current global health policy discussion on Universal Health Coverage (UHC). This initiative has strong commitment from the leadership of the international organizations involved, but a lack of policy clarity outside of the health financing component may limit the initiative's impact on health inequity. In order to address health inequities there needs to be greater focus on the most vulnerable communities, subnational health systems, and attention paid to how communities, civil society and the private sector engage and participate in health systems. PMID:25584354

  7. Is It More Important to Address the Issue of Patient Mobility or to Guarantee Universal Health Coverage in Europe?: Comment on "Regional Incentives and Patient Cross-Border Mobility: Evidence From the Italian Experience".

    PubMed

    Legido-Quigley, Helena

    2015-09-02

    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.

  8. Is It More Important to Address the Issue of Patient Mobility or to Guarantee Universal Health Coverage in Europe?: Comment on "Regional Incentives and Patient Cross-Border Mobility: Evidence From the Italian Experience".

    PubMed

    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

  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. Media Coverage of the "Political Correctness" Debate.

    ERIC Educational Resources Information Center

    Whitney, D. Charles; Wartella, Ellen

    1992-01-01

    Points out that (1) there is no reason to believe that media coverage of the "political correctness" issue is firmly anchored in social reality; (2) the news media's approach reflects and reinforces a longer-term shift in the ways journalists cover the university; and (3) if coverage of political correctness has been misinformed and unproductive,…

  11. Hepatitis B Virus Infection in Indonesia 15 Years After Adoption of a Universal Infant Vaccination Program: Possible Impacts of Low Birth Dose Coverage and a Vaccine-Escape Mutant.

    PubMed

    Purwono, Priyo Budi; Juniastuti; Amin, Mochamad; Bramanthi, Rendra; Nursidah; Resi, Erika Maria; Wahyuni, Rury Mega; Yano, Yoshihiko; Soetjipto; Hotta, Hak; Hayashi, Yoshitake; Utsumi, Takako; Lusida, Maria Inge

    2016-09-01

    A universal hepatitis B vaccination program for infants was adopted in Indonesia in 1997. Before its implementation, the prevalence of hepatitis B surface antigen (HBsAg)-positive individuals in the general population was approximately 5-10%. The study aimed to investigate the hepatitis B virus (HBV) serological status and molecular profile among children, 15 years after adoption of a universal infant vaccination program in Indonesia. According to the Local Health Office data in five areas, the percentages of children receiving three doses of hepatitis B vaccine are high (73.9-94.1%), whereas the birth dose coverage is less than 50%. Among 967 children in those areas, the seropositive rate of HBsAg in preschool- and school-aged children ranged from 2.1% to 4.2% and 0% to 5.9%, respectively. Of the 61 HBV DNA-positive samples, the predominant genotype/subtype was B/adw2 Subtype adw3 was identified in genotype C for the first time in this population. Six samples (11.5%) had an amino acid substitution within the a determinant of the S gene region, and one sample had T140I that was suggested as a vaccine-escape mutant type. The low birth dose coverage and the presence of a vaccine-escape mutant might contribute to the endemicity of HBV infection among children in Indonesia. PMID:27402524

  12. Hepatitis B Virus Infection in Indonesia 15 Years After Adoption of a Universal Infant Vaccination Program: Possible Impacts of Low Birth Dose Coverage and a Vaccine-Escape Mutant.

    PubMed

    Purwono, Priyo Budi; Juniastuti; Amin, Mochamad; Bramanthi, Rendra; Nursidah; Resi, Erika Maria; Wahyuni, Rury Mega; Yano, Yoshihiko; Soetjipto; Hotta, Hak; Hayashi, Yoshitake; Utsumi, Takako; Lusida, Maria Inge

    2016-09-01

    A universal hepatitis B vaccination program for infants was adopted in Indonesia in 1997. Before its implementation, the prevalence of hepatitis B surface antigen (HBsAg)-positive individuals in the general population was approximately 5-10%. The study aimed to investigate the hepatitis B virus (HBV) serological status and molecular profile among children, 15 years after adoption of a universal infant vaccination program in Indonesia. According to the Local Health Office data in five areas, the percentages of children receiving three doses of hepatitis B vaccine are high (73.9-94.1%), whereas the birth dose coverage is less than 50%. Among 967 children in those areas, the seropositive rate of HBsAg in preschool- and school-aged children ranged from 2.1% to 4.2% and 0% to 5.9%, respectively. Of the 61 HBV DNA-positive samples, the predominant genotype/subtype was B/adw2 Subtype adw3 was identified in genotype C for the first time in this population. Six samples (11.5%) had an amino acid substitution within the a determinant of the S gene region, and one sample had T140I that was suggested as a vaccine-escape mutant type. The low birth dose coverage and the presence of a vaccine-escape mutant might contribute to the endemicity of HBV infection among children in Indonesia.

  13. Universal Design for Transition: A Single Subject Research Study on the Impact of UDT on Student Achievement, Engagement and Interest

    ERIC Educational Resources Information Center

    Scott, Laron; Saddler, Sterling; Thoma, Colleen A.; Bartholomew, Christina; Virginia, Nora Alder; Tamura, Ronald

    2011-01-01

    Universal design for transition (UDT) refers to an approach to instructional planning, delivery, and assessment that bridges the gap between teaching academic and functional/transition goals. It builds upon the principals of universal design for learning (UDL) assuring that instructional practices are designed to meet the needs of diverse learners…

  14. The Effect of Self-Regulated Jigsaw IV on University Students' Academic Achievements and Attitudes towards English Course

    ERIC Educational Resources Information Center

    Özdemir, Esin; Arslan, Ali

    2016-01-01

    This study aims to determine the effect of self-regulated jigsaw IV upon university students' learning a new grammar structure within EFL learning process and also their attitudes towards the English course. The research was carried out with 40 students studying in two different prep classes at Bulent Ecevit University Foreign Languages College in…

  15. Assessing General Education Learning Outcomes Achieved in the Inquiry-Guided, Self-Designed Major at North Carolina State University

    ERIC Educational Resources Information Center

    Greene, David B.

    2003-01-01

    North Carolina State University (NCSU) is a Research Intensive (Research I) university located in Raleigh, the state capital. Increasingly over the past ten years, NCSU faculty interested in issues of teaching and learning have used the term "inquiry-guided learning" (IGL) to describe the kind of learning they are trying to promote. The term…

  16. 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…

  17. 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…

  18. 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…

  19. 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…

  20. 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…

  1. 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…

  2. The Role of Social Identification as University Student in Learning: Relationships between Students' Social Identity, Approaches to Learning, and Academic Achievement

    ERIC Educational Resources Information Center

    Bliuc, Ana-Maria; Ellis, Robert A.; Goodyear, Peter; Hendres, Daniela Muntele

    2011-01-01

    This article describes research exploring the relationship between students' self-perceptions in the context of university learning (i.e. student social identity), their approaches to learning, and academic achievement. The exploration of these inter-related aspects requires a mix of theoretical approaches, that is, in this research both social…

  3. 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…

  4. Air traffic coverage

    SciTech Connect

    George, L.L.

    1988-09-16

    The Federal Aviation Administration plans to consolidate several hundred air traffic control centers and TRACONs into area control facilities while maintaining air traffic coverage. This paper defines air traffic coverage, a performance measure of the air traffic control system. Air traffic coverage measures performance without controversy regarding delay and collision probabilities and costs. Coverage measures help evaluate alternative facility architectures and help schedule consolidation. Coverage measures also help evaluate protocols for handling one facility's air traffic to another facility in case of facility failure. Coverage measures help evaluate radar, communications and other air traffic control systems and procedures. 4 refs., 2 figs.,

  5. 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…

  6. 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

    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

    2016-06-20

    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

  7. 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

  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…

  9. 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…

  10. 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…

  11. Impact of universal health coverage on urban–rural inequity in psychiatric service utilisation for patients with first admission for psychosis: a 10-year nationwide population-based study in Taiwan

    PubMed Central

    Chiang, Chih-Lin; Chen, Pei-Chun; Huang, Ling-Ya; Kuo, Po-Hsiu; Tung, Yu-Chi; Liu, Chen-Chung; Chen, Wei J

    2016-01-01

    Objective To examine the disparities in psychiatric service utilisation over a 10-year period for patients with first admission for psychosis in relation to urban–rural residence following the implementation of universal health coverage in Taiwan. Design Population-based retrospective cohort study. Setting Taiwan's National Health Insurance Research Database, which has a population coverage rate of over 99% and contains all medical claim records of a nationwide cohort of patients with at least one psychiatric admission between 1996 and 2007. Participants 69 690 patients aged 15–59 years with first admission between 1998 and 2007 for any psychotic disorder. Main exposure measure Patients’ urban–rural residence at first admissions. Main outcome measures Absolute and relative inequality indexes of the following quality indicators after discharge from the first admission: all-cause psychiatric readmission at 2 and 4 years, dropout of psychiatric outpatient service at 30 days, and emergency department (ED) treat-and-release encounter at 30 days. Results Between 1998 and 2007, the 4-year readmission rate decreased from 65% to 58%, the 30-day dropout rate decreased from 18% to 15%, and the 30-day ED encounter rate increased from 8% to 10%. Risk of readmission has significantly decreased in rural and urban patients, but at a slower speed for the rural patients (p=0.026). The adjusted HR of readmission in rural versus urban patients has increased from 1.00 (95% CI 0.96 to 1.04) in 1998–2000 to 1.08 (95% CI 1.03 to 1.12) in 2005–2007, indicating a mild widening of the urban–rural gap. Urban–rural differences in 30-day dropout and ED encounter rates have been stationary over time. Conclusions The universal health coverage in Taiwan did not narrow urban–rural inequity of psychiatric service utilisation in patients with psychosis. Therefore, other policy interventions on resource allocation, service delivery and quality of care are needed to improve

  12. 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…

  13. Niggers No More: A Critical Race Counternarrative on Black Male Student Achievement at Predominantly White Colleges and Universities

    ERIC Educational Resources Information Center

    Harper, Shaun R.

    2009-01-01

    A methodological approach popularized by critical race theorists is used in this article to oppose dominant discourse concerning the social and educational status of Black men in America. Specifically, this counternarrative on student achievement was derived from face-to-face individual interviews with 143 Black male undergraduates at 30…

  14. 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…

  15. 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…

  16. Effect of Previous Agricultural Mechanics Training on Achievement in a Basic Metals and Welding Course at Iowa State University.

    ERIC Educational Resources Information Center

    Yoder, Benjamin Arthur

    The purposes of this study were to determine the effects of previous training in agricultural mechanics upon achievement of students enrolled in a college level agricultural mechanics course and to determine factors that affect performance in this course of basic metals and welding. Students enrolled in the course during the fall and winter…

  17. Accountability, Rigor, and Detracking: Achievement Effects of Embracing a Challenging Curriculum as a Universal Good for All Students

    ERIC Educational Resources Information Center

    Burris, Carol Corbet; Wiley, Ed; Welner, Kevin G.; Murphy, John

    2008-01-01

    Background: This longitudinal study examines the long-term effects on the achievement of students at a diverse suburban high school after all students were given accelerated mathematics in a detracked middle school as well as ninth-grade "high-track" curriculum in all subjects in heterogeneously grouped classes. Despite considerable research…

  18. 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…

  19. E-Learning Interactions, Information Technology Self Efficacy and Student Achievement at the University of Sharjah, UAE

    ERIC Educational Resources Information Center

    Abulibdeh, Enas Said; Hassan, Sharifah Sariah Syed

    2011-01-01

    The purpose for this study is to validate a model of student interactions (student-content, student-instructor and student-student interactions and vicarious interaction), information technology self efficacy and student achievement. Investigation of the relationships was undertaken with structural equation modeling analyses, in a study with 250…

  20. 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…

  1. 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…

  2. 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…

  3. 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

  4. Constellation Coverage Analysis

    NASA Technical Reports Server (NTRS)

    Lo, Martin W. (Compiler)

    1997-01-01

    The design of satellite constellations requires an understanding of the dynamic global coverage provided by the constellations. Even for a small constellation with a simple circular orbit propagator, the combinatorial nature of the analysis frequently renders the problem intractable. Particularly for the initial design phase where the orbital parameters are still fluid and undetermined, the coverage information is crucial to evaluate the performance of the constellation design. We have developed a fast and simple algorithm for determining the global constellation coverage dynamically using image processing techniques. This approach provides a fast, powerful and simple method for the analysis of global constellation coverage.

  5. Immunization Coverage Among Juvenile Justice Detainees.

    PubMed

    Gaskin, Gregory L; Glanz, Jason M; Binswanger, Ingrid A; Anoshiravani, Arash

    2015-07-01

    This study sought to (1) quantify the baseline immunization coverage of adolescents entering the juvenile justice system and (2) assess the effect of detention-based care on immunization coverage in youth. A cross-sectional retrospective chart review was performed of 279 adolescents detained at a large juvenile detention facility. Only 3% of adolescents had received all study immunizations prior to detention. Before detention, immunization coverage was significantly lower than that for the general adolescent population for all vaccines except the first doses of hepatitis A and varicella-zoster virus vaccines. Subsequent to detention, most individual immunization coverage levels increased and were significantly higher than in the general adolescent population. The routine administration of immunizations in the juvenile justice setting can help detained youth achieve levels of immunization coverage similar to their nondetained peers.

  6. 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

  7. Packaging Glass with a Hierarchically Nanostructured Surface: A Universal Method to Achieve Self-Cleaning Omnidirectional Solar Cells.

    PubMed

    Lin, Chin-An; Tsai, Meng-Lin; Wei, Wan-Rou; Lai, Kun-Yu; He, Jr-Hau

    2016-01-26

    Fused-silica packaging glass fabricated with a hierarchical structure by integrating small (ultrathin nanorods) and large (honeycomb nanowalls) structures was demonstrated with exceptional light-harvesting solar performance, which is attributed to the subwavelength feature of the nanorods and an efficient scattering ability of the honeycomb nanowalls. Si solar cells covered with the hierarchically structured packaging glass exhibit enhanced conversion efficiency by 5.2% at normal incidence, and the enhancement went up to 46% at the incident angle of 60°. The hierarchical structured packaging glass shows excellent self-cleaning characteristics: 98.8% of the efficiency is maintained after 6 weeks of outdoor exposure, indicating that the nanostructured surface effectively repels polluting dust/particles. The presented self-cleaning omnidirectional light-harvesting design using the hierarchical structured packaging glass is a potential universal scheme for practical solar applications. PMID:26623934

  8. 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

  9. 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 ...

  10. The student-institution fit at university: interactive effects of academic competition and social class on achievement goals.

    PubMed

    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

  11. 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

  12. 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.

  13. Drug Plan Coverage Rules

    MedlinePlus

    ... works with other insurance Find health & drug plans Drug plan coverage rules Note Call your Medicare drug ... shingles vaccine) when medically necessary to prevent illness. Drugs you get in hospital outpatient settings In most ...

  14. Are medical residents a "core group" for future improvement of influenza vaccination coverage in health-care workers? A study among medical residents at the University Hospital of Palermo (Sicily).

    PubMed

    Amodio, Emanuele; Tramuto, Fabio; Maringhini, Guido; Asciutto, Rosario; Firenze, Alberto; Vitale, Francesco; Costantino, Claudio; Calamusa, Giuseppe

    2011-10-19

    Despite international recommendations, vaccination coverage among European healthcare workers, including physicians, is widely recognized as unsatisfactory. In order to plan tailored vaccination campaigns and increase future coverage, we investigated reasons for refusing vaccination and determinants associated with influenza vaccine uptake among young health care workers. A survey was carried out during September and October 2010 on medical residents attending post-graduate Schools of the Medical Faculty at the University of Palermo (Italy). Each participant completed an anonymous web-based questionnaire including items on demographic and occupational characteristics, knowledge, attitudes and behaviours with regard to influenza and influenza vaccination, and main sources of information. A total of 202 (66.9%) out of 302 medical residents participated in the survey. During the 2009-2010 influenza vaccine campaign, 44 residents (21.8%) were vaccinated against seasonal influenza and 84 (41.6%) against pandemic influenza A (H1N1) 2009. For the impending 2010-2011 influenza season, 45 (22.3%) stated their intention to get vaccinated against seasonal influenza, 40 (19.8%) were uncertain and 117 (57.9%) were opposed. Considering themselves to be a high risk group for developing influenza was significantly associated with vaccination against both 2009-2010 seasonal (adj-OR=1.46; 95% CI=1.05-2.04) and pandemic A (H1N1) influenza (adj-OR 1.38; 95% CI=1.08-1.75). Intention to get vaccinated against 2010-2011 seasonal influenza was significantly more frequent in participants who had a high perception of efficacy/safety (adj-OR=1.49; 95% CI=1.05-2.12). After adjusting for confounding, vaccinations against seasonal 2009-2010 influenza, pandemic influenza A (H1N1) 2009 and seasonal 2010-2011 influenza were significantly more frequent in residents who were vaccinated against influenza at least once in the previous five influenza seasons. Influenza vaccination among medical

  15. Insurance Coverage Policies for Personalized Medicine

    PubMed Central

    Hresko, Andrew; Haga, Susanne B.

    2012-01-01

    Adoption of personalized medicine in practice has been slow, in part due to the lack of evidence of clinical benefit provided by these technologies. Coverage by insurers is a critical step in achieving widespread adoption of personalized medicine. Insurers consider a variety of factors when formulating medical coverage policies for personalized medicine, including the overall strength of evidence for a test, availability of clinical guidelines and health technology assessments by independent organizations. In this study, we reviewed coverage policies of the largest U.S. insurers for genomic (disease-related) and pharmacogenetic (PGx) tests to determine the extent that these tests were covered and the evidence basis for the coverage decisions. We identified 41 coverage policies for 49 unique testing: 22 tests for disease diagnosis, prognosis and risk and 27 PGx tests. Fifty percent (or less) of the tests reviewed were covered by insurers. Lack of evidence of clinical utility appears to be a major factor in decisions of non-coverage. The inclusion of PGx information in drug package inserts appears to be a common theme of PGx tests that are covered. This analysis highlights the variability of coverage determinations and factors considered, suggesting that the adoption of personal medicine will affected by numerous factors, but will continue to be slowed due to lack of demonstrated clinical benefit. PMID:25562360

  16. Insurance coverage policies for personalized medicine.

    PubMed

    Hresko, Andrew; Haga, Susanne B

    2012-10-30

    Adoption of personalized medicine in practice has been slow, in part due to the lack of evidence of clinical benefit provided by these technologies. Coverage by insurers is a critical step in achieving widespread adoption of personalized medicine. Insurers consider a variety of factors when formulating medical coverage policies for personalized medicine, including the overall strength of evidence for a test, availability of clinical guidelines and health technology assessments by independent organizations. In this study, we reviewed coverage policies of the largest U.S. insurers for genomic (disease-related) and pharmacogenetic (PGx) tests to determine the extent that these tests were covered and the evidence basis for the coverage decisions. We identified 41 coverage policies for 49 unique testing: 22 tests for disease diagnosis, prognosis and risk and 27 PGx tests. Fifty percent (or less) of the tests reviewed were covered by insurers. Lack of evidence of clinical utility appears to be a major factor in decisions of non-coverage. The inclusion of PGx information in drug package inserts appears to be a common theme of PGx tests that are covered. This analysis highlights the variability of coverage determinations and factors considered, suggesting that the adoption of personal medicine will affected by numerous factors, but will continue to be slowed due to lack of demonstrated clinical benefit.

  17. 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

  18. Network Evening News Coverage of Environmental Risk.

    ERIC Educational Resources Information Center

    Greenberg, Michael R.; And Others

    Focusing on ABC, NBC, and CBS's evening news broadcasts from January 1984 through February 1986, a study examined network news coverage of environmental risk--defined as manmade chemical, biological, and physical agents that create risk in the indoor, outdoor, and occupational environments. Using the Vanderbilt University "Television News Index…

  19. 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

  20. Coverage-based treatment planning: Optimizing the IMRT PTV to meet a CTV coverage criterion

    PubMed Central

    Gordon, J. J.; Siebers, J. V.

    2009-01-01

    This work demonstrates an iterative approach—referred to as coverage-based treatment planning—designed to produce treatment plans that ensure target coverage for a specified percentage of setup errors. In this approach the clinical target volume to planning target volume (CTV-to-PTV) margin is iteratively adjusted until the specified CTV coverage is achieved. The advantage of this approach is that it automatically compensates for the dosimetric margin around the CTV, i.e., the extra margin that is created when the dose distribution extends beyond the PTV. When applied to 27 prostate plans, this approach reduced the average CTV-to-PTV margin from 5 to 2.8 mm. This reduction in PTV size produced a corresponding decrease in the volume of normal tissue receiving high dose. The total volume of tissue receiving ≥65 Gy was reduced on average by 19.3% or about 48 cc. Individual reductions varied from 8.7% to 28.6%. The volume of bladder receiving ≥60 Gy was reduced on average by 5.6% (reductions for individuals varied from 1.7% to 10.6%), and the volume of periprostatic rectum receiving ≥65 Gy was reduced on average by 4.9% (reductions for individuals varied from 0.9% to 12.3%). The iterative method proposed here represents a step toward a probabilistic treatment planning algorithm which can generate dose distributions (i.e., treated volumes) that closely approximate a specified level of coverage in the presence of geometric uncertainties. The general principles of coverage-based treatment planning are applicable to arbitrary treatment sites and delivery techniques. Importantly, observed deviations between coverage implied by specified CTV-to-PTV margins and coverage achieved by a given treatment plan imply a generic need to perform coverage probability analysis on a per-plan basis to ensure that the desired level of coverage is achieved. PMID:19378757

  1. Coverage-based treatment planning: optimizing the IMRT PTV to meet a CTV coverage criterion.

    PubMed

    Gordon, J J; Siebers, J V

    2009-03-01

    This work demonstrates an iterative approach-referred to as coverage-based treatment planning-designed to produce treatment plans that ensure target coverage for a specified percentage of setup errors. In this approach the clinical target volume to planning target volume (CTV-to-PTV) margin is iteratively adjusted until the specified CTV coverage is achieved. The advantage of this approach is that it automatically compensates for the dosimetric margin around the CTV, i.e., the extra margin that is created when the dose distribution extends beyond the PTV. When applied to 27 prostate plans, this approach reduced the average CTV-to-PTV margin from 5 to 2.8 mm. This reduction in PTV size produced a corresponding decrease in the volume of normal tissue receiving high dose. The total volume of tissue receiving > or =65 Gy was reduced on average by 19.3% or about 48 cc. Individual reductions varied from 8.7% to 28.6%. The volume of bladder receiving > or =60 Gy was reduced on average by 5.6% (reductions for individuals varied from 1.7% to 10.6%), and the volume of periprostatic rectum receiving > or =65 Gy was reduced on average by 4.9% (reductions for individuals varied from 0.9% to 12.3%). The iterative method proposed here represents a step toward a probabilistic treatment planning algorithm which can generate dose distributions (i.e., treated volumes) that closely approximate a specified level of coverage in the presence of geometric uncertainties. The general principles of coverage-based treatment planning are applicable to arbitrary treatment sites and delivery techniques. Importantly, observed deviations between coverage implied by specified CTV-to-PTV margins and coverage achieved by a given treatment plan imply a generic need to perform coverage probability analysis on a per-plan basis to ensure that the desired level of coverage is achieved. PMID:19378757

  2. 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

  3. Routine EPI coverage: subdistrict inequalities and reasons for immunization failure in a rural setting in Pakistan.

    PubMed

    Khowaja, Asif Raza; Zaman, Umber; Feroze, Asher; Rizvi, Arjum; Zaidi, Anita K M

    2015-03-01

    High vaccine coverage at the district level may not translate with the same vigor to subdistrict levels; therefore, it is important to understand coverage inequalities. This study underscored vaccine coverage inequalities at subdistrict levels and explored reasons for immunization failure in a high-performing rural district of Pakistan. Parents of children aged 12 to 23 months were randomly selected and interviewed for child's vaccination history through a cross-sectional survey in 2008. Using secondary data (GIS maps and population census), coverage was plotted in respect to sociodemographic and presence of lady health workers. The proportion of children fully immunized was found notably low (75%) than officially reported (85%). Coverage inequalities were observed at subdistrict levels, ranging from 58% to 85% in rural to urban areas and from 60% to 80% in lower to higher income quintiles. Distance to immunization facility, parental unawareness, and wrong ideas about vaccination were statistically significant for immunization failure. Focus of immunization microplans at the subdistrict level are needed to achieve universal immunization goals.

  4. 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.

  5. 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

  6. Assessing immunization coverage in private practice.

    PubMed Central

    Hutchins, S. S.; Sherrod, J.; Bernier, R.

    2000-01-01

    To achieve national health objectives of eliminating most childhood vaccine-preventable diseases by the year 2010, all health care providers will have to improve the immunization rates of their patients. Currently, immunization rates of children 19 to 35 months of age are less than national objectives, suggesting a need for optimized immunization services. A key strategy for improving age-appropriate immunization coverage by health care providers is the assessment of immunization coverage. Because most (62%), immunization services in the United States are delivered in the private sector, a concerted effort in private practice is critical to improving immunization rates. Assessment of immunization coverage of patients enrolled in private practice serves 1) to measure the overall performance of the practice in providing the standard of care, 2) to identify strategies for improving coverage, and 3) to document the quality of health services delivered (report card). Assessment of immunization coverage has been demonstrated in several practice settings to be highly effective in improving immunization rates. All types of physicians should benefit from assessing immunization coverage of their patients. Simple assessment tools are available at no cost to the public and can be obtained by contacting the Centers for Disease Control and Prevention. These tools include a manual self-assessment or a computerized software package (CASA) to fit the needs of the practice. PMID:10976172

  7. 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…

  8. Determinants of antiretroviral therapy coverage in Sub-Saharan Africa.

    PubMed

    Furuoka, Fumitaka; Hoque, Mohammad Zahirul

    2015-01-01

    Among 35 million people living with the human immunodeficiency virus (HIV) in 2013, only 37% had access to antiretroviral therapy (ART). Despite global concerted efforts to provide the universal access to the ART treatment, the ART coverage varies among countries and regions. At present, there is a lack of systematic empirical analyses on factors that determine the ART coverage. Therefore, the current study aimed to identify the determinants of the ART coverage in 41 countries in Sub-Saharan Africa. It employed statistical analyses for this purpose. Four elements, namely, the HIV prevalence, the level of national income, the level of medical expenditure and the number of nurses, were hypothesised to determine the ART coverage. The findings revealed that among the four proposed determinants only the HIV prevalence had a statistically significant impact on the ART coverage. In other words, the HIV prevalence was the sole determinant of the ART coverage in Sub-Saharan Africa. PMID:26664812

  9. Determinants of antiretroviral therapy coverage in Sub-Saharan Africa

    PubMed Central

    Hoque, Mohammad Zahirul

    2015-01-01

    Among 35 million people living with the human immunodeficiency virus (HIV) in 2013, only 37% had access to antiretroviral therapy (ART). Despite global concerted efforts to provide the universal access to the ART treatment, the ART coverage varies among countries and regions. At present, there is a lack of systematic empirical analyses on factors that determine the ART coverage. Therefore, the current study aimed to identify the determinants of the ART coverage in 41 countries in Sub-Saharan Africa. It employed statistical analyses for this purpose. Four elements, namely, the HIV prevalence, the level of national income, the level of medical expenditure and the number of nurses, were hypothesised to determine the ART coverage. The findings revealed that among the four proposed determinants only the HIV prevalence had a statistically significant impact on the ART coverage. In other words, the HIV prevalence was the sole determinant of the ART coverage in Sub-Saharan Africa. PMID:26664812

  10. 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

  11. 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.

  12. 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…

  13. 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

  14. 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)

  15. 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…

  16. 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…

  17. [Dr. Michiharu Matsuoka, founder of the Department of Orthopaedic Surgery, Kyoto University, and his achievements (Part 6: Studying abroad of Dr. Matsuoka and opening to public, reputation and achievement of the department)].

    PubMed

    Hirotani, Hayato

    2011-03-01

    Dr. Michiharu Matsuoka studied orthopaedic surgery in Germany, Austria and other countries during the period from August, 1902 to May, 1906. He visited many university pathological institutes and surgical and orthopaedic clinics to study pathology and to learn the practice of orthopaedic surgery. After that, he started his practice at the newly established Department of Orthopaedic Surgery in the Medical School of Kyoto Imperial University in June, 1906. The department was opened in 1907 and in 1911 it was opened to all citizens and practical doctors in Kyoto City and exhibited many orthopaedic specimens and instruments. In particular, the x-ray apparatus of the Department was so well equipped that a German radiologist who visited the Department admired it in his article that was published in the journal of radiology in 1911. The Department was not surpassed by others for the number of patients with the dislocation of the hip and tuberculous spondylitis as well as the advanced quality and variety of roentgenological and pathological researches on these diseases. PMID:21797054

  18. [Dr. Michiharu Matsuoka, founder of the Department of Orthopaedic Surgery, Kyoto University, and his achievements (Part 6: Studying abroad of Dr. Matsuoka and opening to public, reputation and achievement of the department)].

    PubMed

    Hirotani, Hayato

    2011-03-01

    Dr. Michiharu Matsuoka studied orthopaedic surgery in Germany, Austria and other countries during the period from August, 1902 to May, 1906. He visited many university pathological institutes and surgical and orthopaedic clinics to study pathology and to learn the practice of orthopaedic surgery. After that, he started his practice at the newly established Department of Orthopaedic Surgery in the Medical School of Kyoto Imperial University in June, 1906. The department was opened in 1907 and in 1911 it was opened to all citizens and practical doctors in Kyoto City and exhibited many orthopaedic specimens and instruments. In particular, the x-ray apparatus of the Department was so well equipped that a German radiologist who visited the Department admired it in his article that was published in the journal of radiology in 1911. The Department was not surpassed by others for the number of patients with the dislocation of the hip and tuberculous spondylitis as well as the advanced quality and variety of roentgenological and pathological researches on these diseases.

  19. The adequacy of college health insurance coverage.

    PubMed

    McManus, M; Brauer, M; Weader, R; Newacheck, P

    1991-01-01

    This analysis of private health insurance plans offered in 100 four-year colleges and universities in 1988 indicates a tremendous diversity in plan options, benefits covered, cost-sharing requirements, and catastrophic protections. Consistent with relatively low premium prices, most student health insurance plans offer limited benefits and expose students to significant out-of-pocket medical cost liabilities. Only a minority of schools use financial incentives, such as preferred provider arrangements, to integrate their health insurance plans with their university health service system. We conclude that universities should carefully reexamine the adequacy of their health insurance plans and their relationship to student health centers. As more students rely on student health insurance as their only source of coverage, the quality of these plans assumes an even greater importance.

  20. 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

  1. [Dr. Michiharu Matsuoka, founder of the Department of Orthopaedic Surgery, Kyoto University, and his achievements. Part 4: Prof. M. Matsuoka's lecture to medical and civic communities].

    PubMed

    Hirotani, Hayato

    2010-03-01

    Dr. M. Matsuoka gave many lectures to physicians at the Postdoctoral Course Lectures sponsored by the Kyoto Eisei Kensasho (Kyoto Bacterial and Biochemical Laboratory) run by the Kyoto Medical Association, and the Postdoctoral Course Lectures of the Kyoto Medical School, Kyoto Imperial University. He was also invited to give lectures at several regional medical associations. He also was a speaker at the Kyoto Imperial University Extension course and he lectured at the Enryakuji Temple on Mt. Hiei, sponsored by a newspaper company. It is remarkable that these activities were carried out in addition to his other notable academic work previously reported.

  2. Newspaper Coverage of Racial Injustices.

    ERIC Educational Resources Information Center

    Martindale, Carolyn

    Noting that the press was criticized during the 1960s for failing to convey to white readers the problems and injustices experienced by black Americans, a study analyzed the nature and amount of civil rights coverage in five newspapers from 1963 through 1980. News coverage concerning blacks was examined in 66 issues from four major newspapers in…

  3. 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.

  4. First-Generation College Students and Undergraduate Research: Narrative Inquiry into the University of Arizona's Ronald E. McNair Achievement Program and the Phenomenon of Student Transformation

    ERIC Educational Resources Information Center

    Huerta, Andrew L.

    2013-01-01

    With increasing numbers of first-generation college students enrolling in colleges and universities across the US, so too is the need to begin preparing such underrepresented students for graduate school and a career in academia. As a phenomenological case study of student transformation, this dissertation examines the experience of nine…

  5. The Refinement and Modification of an Instrument for Assessing the Achievement of Interpersonal Skills of Social Work Students. Institutional Report No. 4. Wayne State University.

    ERIC Educational Resources Information Center

    Cooperative Assessment of Experiential Learning Project, Princeton, NJ.

    The Performance Assessment Checklist (PAC) was developed by the faculty of the Social Work Practice Sequence of the Wayne State University School of Social Work as a result of the need for a behaviorally specific instrument to assess student performance in the field work practicum. This instrument makes possible a systematic assessment of student…

  6. 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…

  7. 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…

  8. The Effect of Differentiated Instruction and Universally Designed Reading Curriculum on English Language Arts Achievement Scores of At-Risk Students

    ERIC Educational Resources Information Center

    Roberts, Jocylinn A.

    2012-01-01

    This quantitative study explored the academic progress of at-risk students in English language arts (ELA) when they were given differentiated instruction (DI) and universally designed curriculum (UDC) to address their academic needs. The purpose of the study was to determine if there was a significant change in passing rates on the California…

  9. 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…

  10. A Route for Every Learner: Universal Design for Learning (UDL) as a Framework for Supporting Learning and Improving Achievement for All Learners in Maryland, Prekindergarten through Higher Education

    ERIC Educational Resources Information Center

    Maryland State Department of Education, 2011

    2011-01-01

    Universal Design for Learning (UDL) is a framework for curriculum design, instruction, and assessment that gives all students equal opportunities to learn and to demonstrate what they have learned. UDL is built on the premise that there is not one kind of learning. Learning differs across tasks, across development, and among individuals. UDL is…

  11. Global routine vaccination coverage, 2014.

    PubMed

    Subaiya, Saleena; Dumolard, Laure; Lydon, Patrick; Gacic-Dobo, Marta; Eggers, Rudolf; Conklin, Laura

    2015-11-13

    The year 2014 marked the 40th anniversary of the World Health Organization’s (WHO) Expanded Program on Immunization, which was established to ensure equitable access to routine immunization services (1). Since 1974, global coverage with the four core vaccines (Bacille Calmette- Guérin vaccine [BCG; for protection against tuberculosis], diphtheria-tetanus-pertussis [DTP] vaccine, poliovirus vaccine, and measles vaccine) has increased from <5% to ≥85%, and additional vaccines have been added to the recommended schedule. Coverage with the 3rd dose of DTP vaccine (DTP3) by age 12 months is an indicator of immunization program performance because it reflects completion of the basic infant immunization schedule; coverage with other vaccines, including the 3rd dose of poliovirus vaccine (polio3); the 1st dose of measles-containing vaccine (MCV1) is also assessed. Estimated global DTP3 coverage has remained at 84%–86% since 2009, with estimated 2014 coverage at 86%. Estimated global coverage for the 2nd routine dose of measles-containing vaccine (MCV2) was 38% by age 24 months and 56% when older age groups were included, similar to levels reported in 2013 (36% and 55%, respectively). To reach and sustain high immunization coverage in all countries, adequate vaccine stock management and additional opportunities for immunization, such as through routine visits in the second year of life, are integral components to strengthening immunization programs and reducing morbidity and mortality from vaccine preventable diseases. PMID:26562454

  12. 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).

  13. Analysis of Achievement Data on Six Cohorts of Low-Income Children From 20 School Districts in the University of Oregon Direct Instruction Follow Through Model.

    ERIC Educational Resources Information Center

    Becker, Wesley C.; Engelmann, Siegfried

    This paper presents an analysis of data assessing the effectiveness of the Engelmann-Becker Direct Instruction Model (E-B) aimed at developing basic academic skills in disadvantaged primary-grade children (with the specific goal of enabling these children to achieve grade-level performance by the end of 3rd grade). The E-B model emphasizes…

  14. 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…

  15. 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…

  16. 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…

  17. 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…

  18. 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…

  19. 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

  20. 7 CFR 1437.5 - Coverage period.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 10 2013-01-01 2013-01-01 false Coverage period. 1437.5 Section 1437.5 Agriculture... Provisions § 1437.5 Coverage period. (a) The coverage period is the time during which coverage is available against loss of production of the eligible crop as a result of natural disaster. (b) The coverage...