Health System in Zimbabwe and Delay in Seeking Health Care of Breast Cancer Among Women

Breast cancer, the most prevailing and only cancer considered universal among women worldwide. The rate of breast cancer per 100,000 women is higher in high income countries than in low income countries. However, mortality rates are high in low income countries due to the delay in seeking health care. A systematic literature review was carried out to document the health system implemented in Zimbabwe and its challenges that could be contributing to the delay in seeking health care of breast cancer among women in Zimbabwe. A content analysis was used to analyze articles, searching was done using the Boolean search strategy, articles from 2005 to 2021, which met the inclusion criteria were considered. Factors such as centralized services due to shortage of cancer specialists, lack of financial allocations on breast cancer health programs, shortage of screening and surgical equipment, lack of accurate data due to weak registration system and health management information system as well as poor governance and leadership have also been found to be challenges in the health system of Zimbabwe that may contribute to delay in seeking health care of breast cancer among women in Zimbabwe. Keywords: breast cancer, health system, health care, Zimbabwe

A comparison of approaches to measuring maternal mortality in Bangladesh, Mozambique, and Bolivia

Background Many low- and middle-income countries cannot measure maternal mortality to monitor progress against global and country-specific targets. While the ultimate goal for these countries is to have complete civil registrations systems, other interim strategies are needed to provide timely estimates of maternal mortality. Objective The objective is to inform on potential options for measuring maternal mortality. Methods This paper uses a case study approach to compare methodologies and estimates of pregnancy-related mortality ratio (PRMR)/maternal mortality ratio (MMR) obtained from four different data sources from similar time periods in Bangladesh, Mozambique, and Bolivia—national population census; post-census mortality survey; household sample survey; and sample vital registration system (SVRS). Results For Bangladesh, PRMR from the 2011 census falls closely in line with the 2010 household survey and SVRS estimates, while SVRS’ MMR estimates are closer to the PRMR estimates obtained from the household survey. Mozambique's PRMR from household survey method is comparable and shows an upward trend between 1994 and 2011, whereas the post-census mortality survey estimated a higher MMR for 2007. Bolivia's DHS and post-census mortality survey also estimated comparable MMR during 1998–2003. Conclusions Overall all these data sources presented in this paper have provided valuable information on maternal mortality in Bangladesh, Mozambique, and Bolivia. It also outlines recommendations to estimate maternal mortality based on the advantages and disadvantages of several approaches. Contribution Recommendations in this paper can help health administrators and policy planners in prioritizing investment for collecting reliable and contemporaneous estimates of maternal mortality while progressing toward a complete civil registration system.

Pricing Strategies of Registration System and Transaction System in Live Broadcast Platform

This paper investigates a supply chain consisting of the monopoly live broadcast platform, content producers, and consumers. Based on the two-sided market theory, the platform’s pricing strategies and their analysis are considered under the registration system and the transaction system. Firstly, it shows that platform users’ scale and profit are positively correlated with the intergroup network externality from both sides and the intragroup network externality inside the consumer group and negatively correlated with the intragroup network externality inside the content producer group. Secondly, the platform profit, registration fee charged to content producers, and transaction fee charged to consumers are negatively correlated to the content production cost and positively related to consumers’ content quality sensitivity coefficient. When consumers are more sensitive to content quality, they are positively correlated to content quality. Finally, the registration fee charged by the platform to consumers is positively correlated with the content production cost, negatively correlated with the content quality level, and positively associated with the consumer content quality sensitivity coefficient.

Assessing mortality registration in Kerala: the MARANAM study

Complete or improving civil registration systems in sub-national areas in low- and middle-income countries provide several opportunities to better understand population health and its determinants. In this article, we provide an assessment of vital statistics in Kerala, India. Kerala is home to more than 33 million people and is a comparatively low-mortality context. We use individual-level vital registration data on more than 2.8 million deaths between 2006 and 2017 from the Kerala MARANAM (Mortality and Registration Assessment and Monitoring) Study. Comparing age-specific mortality rates from the Civil Registration System (CRS) to those from the Sample Registration System (SRS), we do not find evidence that the CRS underestimates mortality. Instead, CRS rates are smoother across ages and less variable across periods. In particular, the CRS records higher death rates than the SRS for ages, where mortality is usually low and for women. Using these data, we provide the first set of annual sex-specific life tables for any state in India. We find that life expectancy at birth was 77.9 years for women in 2017 and 71.4 years for men. Although Kerala is unique in many ways, our findings strengthen the case for more careful attention to mortality records within low- and middle-income countries, and for their better dissemination by government agencies.

Adapting and validating the log quadratic model to derive under-five age- and cause-specific mortality (U5ACSM): a preliminary analysis

Background The mortality pattern from birth to age five is known to vary by underlying cause of mortality, which has been documented in multiple instances. Many countries without high functioning vital registration systems could benefit from estimates of age- and cause-specific mortality to inform health programming, however, to date the causes of under-five death have only been described for broad age categories such as for neonates (0–27 days), infants (0–11 months), and children age 12–59 months. Methods We adapt the log quadratic model to mortality patterns for children under five to all-cause child mortality and then to age- and cause-specific mortality (U5ACSM). We apply these methods to empirical sample registration system mortality data in China from 1996 to 2015. Based on these empirical data, we simulate probabilities of mortality in the case when the true relationships between age and mortality by cause are known. Results We estimate U5ACSM within 0.1–0.7 deaths per 1000 livebirths in hold out strata for life tables constructed from the China sample registration system, representing considerable improvement compared to an error of 1.2 per 1000 livebirths using a standard approach. This improved prediction error for U5ACSM is consistently demonstrated for all-cause as well as pneumonia- and injury-specific mortality. We also consistently identified cause-specific mortality patterns in simulated mortality scenarios. Conclusion The log quadratic model is a significant improvement over the standard approach for deriving U5ACSM based on both simulation and empirical results.

Factors Affecting the Change of Agricultural Land Use to Tourism: A Case Study on the Southern Coasts of the Caspian Sea, Iran

This research investigates the reasons of changing the agricultural land use to tourism in a developing country with different political, economic and social context (Iran). The method used in this research is qualitative, and unstructured interviews have been used to collect data. The target population of the research includes farmers who have sold their farmlands to investors in the tourism sector and experts from the agricultural department of the relevant county. The interviewees have been selected through using snowball method and after reaching theoretical saturation, the data collection process was stopped. The results showed that various macro and micro factors affected the process of changing the agricultural land uses to tourism, including the weakness of the agricultural sector in creating income and job opportunities compared to the tourism sector, the weakness of the land use laws and the lack of inter-organizational coordination in law enforcement, the weakness of the property registration system and the lack of a national cadaster, the lack of effective government support of the agricultural sector, the rapid rise in land prices and, ultimately, the change in the attitude of farmers both old and young once towards the agricultural activity and the level of welfare.

Gender Inequalities and Sex-Differential Mortality in Pre-War Greece: A Regional Perspective

Previous studies have indicated gender-based discriminatory practices as a result of son preference up to the first half of the 20th century in Greece. Demographic indices calculated from published vital statistics, such as sex ratios at birth and at childhood, were distorted to such an extent that certain scholars suggest that this distortion was due to sex-selective infanticide and neglect of the girls. Although we cannot exclude this possibility, the aim of this paper is to assess to what extent under-registration of female births (in the civil registration system) and under-enumeration of females (in censuses) accounted for the skewed sex ratios and to pinpoint that gender-based discrimination was not the same all over Greece. There were areas in insular Greece, notably the Ionian islands and the Aegean Archipelago, and one area in mainland Greece (Epirus) where demographic indices imply that gender inequalities were less acute. On the other hand, there were areas in mainland Greece, notably in Thessaly, where sex-differential mortality denotes extremely unequal treatment of girls.

Conceptual confusing similarity and pictorial trade marks

Several high-profile rebrands, including those by Twitter and Starbucks, have involved removing text from logos. This move towards wordless, pictorial trade marks raises a difficult question about how the scope of protection of a registered trade mark should be determined. This article examines the particular issue of how much weight should be given to the idea or concept underlying a pictorial mark when assessing whether a defendant’s junior mark is ‘confusingly similar’. Drawing on legal principles and case examples from Europe, the United Kingdom, Singapore and New Zealand, it is claimed that courts and adjudicators should be careful not to overweight conceptual similarity. It is argued that a lack of care in assessing conceptual similarity risks awarding one trader overbroad protection, which may be tantamount to conferring on one trader a monopoly in an idea. A lack of care may also undermine the logic of a registration system by untethering protection from what is recorded on the Register, and may make trade mark law less predictable and certain. * The author declares that he was junior counsel in a case discussed in this article, Carabao Tawandang Co Ltd v Red Bull GmbH HC Wellington CIV-2005-485-1975, 31 August 2006. The views represented in this article are the author’s own, and do not reflect the views of his employer at the time, or the views of the client represented in that particular case.