scholarly journals Decentralization of health systems in Ghana, Zambia, Uganda and the Philippines: a comparative analysis of decision space

2002 ◽  
Vol 17 (1) ◽  
pp. 14-31 ◽  
Author(s):  
T. J Bossert
2021 ◽  
Vol 13 (15) ◽  
pp. 8164
Author(s):  
Brian E. Bautista ◽  
Lessandro E. O. Garciano ◽  
Luis F. Lopez

There are limited published studies related to the mechanical properties of bamboo species in the Philippines. In this study, the shear strength properties of some economically viable bamboo species in the Philippines were properly characterized based on 220 shear test results. The rationales of selecting this mechanical property are the following: (1) Shear strength, parallel to the fiber, has the highest variability among the mechanical properties; and (2) Shear is one of the governing forces on joint connections, and such connections are the points of failure on bamboo structures when subjected to extreme loading conditions. ISO 22157-1 (2017) test protocol for shear was used for all tests. The results showed that Bambusa blumeana has the highest average shear strength, followed by Gigantochloa apus, Dendrocalamus asper, Bambusa philippinensis, and Bambusa vulgaris. However, comparative analysis, using One-way ANOVA, showed that shear strength values among these bamboo species have significant differences statistically. A linear regression model is also established to estimate the shear strength of bamboo from the physical properties. Characteristic shear strength is also determined using ISO 12122-1 (2014) for future design reference.


2021 ◽  
Author(s):  
Kevin Paul Ferraris ◽  
Eric Paolo Palabyab ◽  
Sergei Kim ◽  
Hideaki Matsumura ◽  
Maria Eufemia Yap ◽  
...  

Abstract Purpose: The aim of this study is to compare specific three-institution, cross-country data that are relevant to the Global Surgery indicators and the functioning of health systems. Methods: We retrospectively reviewed clinical and socioeconomic characteristics of pediatric patients who underwent CSF diversion surgery for hydrocephalus in three different centers: University of Tsukuba Hospital in Ibaraki, Japan (HIC), Jose R. Reyes Memorial Medical Center in Manila, Philippines (LMIC), and the Federal Neurosurgical Center in Novosibirsk, Russia (UMIC). The outcomes of interest were timing of CSF diversion surgery and mortality. Statistical tests included descriptive statistics, Cox proportional hazards model, and logistic regression. Nation-level data were also obtained to provide the relevant socioeconomic contexts in discussing the results. Results: In total, 159 children were included—13 from Japan, 99 from the Philippines, and 47 from the Russian Federation. The median time to surgery at the specific neurosurgical centers were 6 days in the Philippines and 1 day in both Japan and Russia. For the cohort from the Philippines, non-poor patients were more likely to receive CSF diversion surgery at an earlier time (HR=4.74, 95%CI 2.34–9.61, p<0.001). In the same center, those with infantile or post-hemorrhagic hydrocephalus (HR=3.72, 95%CI 1.70–8.15, p=0.001) were more likely to receive CSF diversion earlier compared to those with congenital hydrocephalus, and those with post-infectious (HR=0.39, 95%CI 0.22–0.70, p=0.002) or myelomeningocele-associated hydrocephalus (HR=0.46, 95%CI 0.22–0.95, p=0.037) were less likely to undergo surgery at an earlier time. For Russia, older patients were more likely to receive or require early CSF diversion (HR=1.07, 95%CI 1.01–1.14, p=0.035). EVD insertion was found to be associated with mortality (cOR 14.45, 95% CI 1.28–162.97, p = 0.031). Conclusion: In this study, Filipino children underwent late time-interval of CSF diversion surgery and had mortality differences compared to their Japanese and Russian counterparts. These disparities may reflect on the functioning of the respective country’s health systems.


2011 ◽  
pp. 1115-1139
Author(s):  
Adebusoye A. Anifalaje

This article attempts to elucidate the intricacies of primary health care delivery in Nigeria. Among myriad complexities, the central proposition made herein is that the absence of an effective regulatory and enforcement framework in developing countries results in a prominent informal decision space. The findings show that the prominence of an informal decision space compromises the objectives of an information-based public health system. The article concludes that decentralisation in developing countries must have a coordinated top-down and bottom-up development component for it to be effective in improving the performance of primary health systems. One of the implications of the study is that researching decentralised healthcare delivery requires analytical models which are able to illuminate the complexities of local accountability in developing countries. The study also reveals the need to further research the dynamics of democratic decentralisation in developing countries as this goes beyond administrative structures but involve socio-cultural institutions.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Neeraj Kak ◽  
Krishnapada Chakraborty ◽  
Swati Sadaphal ◽  
Hala Jassim AlMossawi ◽  
Marianne Calnan ◽  
...  

2012 ◽  
Vol 39 (12) ◽  
pp. 10769-10774 ◽  
Author(s):  
Khin-Ohnmar Lwin ◽  
Hiroki Matsui ◽  
Tomomi Ban-Tokuda ◽  
Makoto Kondo ◽  
Rosalina M. Lapitan ◽  
...  

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