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Public-private mix for DOTS implementation: what makes it work?
L?nnroth,Knut; Uplekar,Mukund; Arora,Vijay K.; Juvekar,Sanjay; Lan,Nguyen T.N.; Mwaniki,David; Pathania,Vikram;
Bulletin of the World Health Organization , 2004, DOI: 10.1590/S0042-96862004000800007
Abstract: objective: to compare processes and outcomes of four public-private mix (ppm) projects on dots implementation for tuberculosis (tb) control in new delhi, india; ho chi minh city, viet nam; nairobi, kenya; and pune, india. methods: cross-project analysis of secondary data from separate project evaluations was used. differences among ppm project sites in impact on tb control (change in case detection, treatment outcomes and equity in access) were correlated with differences in chosen intervention strategies and structural conditions. findings: the analysis suggests that an effective intervention package should include the following provider-side components: (1) orienting private providers (pps) and the staff of the national tb programme (ntp); (2) improving the referral and information system through simple practical tools; (3) the ntp adequately supervising and monitoring pps; and (4) the ntp providing free anti-tb drugs to patients treated in the private sector. conclusion: getting such an intervention package to work requires that the ntp be strongly committed to supporting, supervising and evaluating ppm projects. further, using a local nongovernmental organization or a medical association as an intermediary may facilitate collaboration. investing time and effort to ensure that sufficient dialogue takes place among all stakeholders is important to help build trust and achieve a high level of agreement.
Common Diseases of Poultry in Kaduna State: Perspective of a Private Clinic
JI Barde, A Garba, MM Gashua, MA Talba, VT Gugong, I Saádatu, AH Owada, L Konzing, SJ Awulu, MN Mohammed
Nigerian Veterinary Journal , 2012,
Abstract: Several reports on prevailing poultry diseases across some states in Nigeria have been documented. The common prevailing poultry diseases in Kaduna Sate were investigated. The records of poultry diseases as presented to and diagnosed at the ECWA Veterinary Clinic, Kaduna during a 10-year (January1997 and December2006) period was retrieved and analyzed retrospectively using descriptive statistics. The diagnosis at the clinic was based on clinical and post mortem findings. The results indicate that a total of 5131 poultry disease conditions were presented, diagnosed and treated over the study period. A total of 21 different poultry diseases were diagnosed, the most common being bacterial infections with 2082(40.6%) of all cases, then Coccidiosis 1750(34.1%), Gumboro 465(9.1%), Helminthosis 197(3.8%), Omphilitis 193(%), New castle disease 135(2.6%), stampede 114(2.2%), tumor 65(1.3%), cannibalism 44(0.9%). The less occurring included drug toxicity 23(0.45%) cases, chronic respiratory diseases 20(0.4%), Pullorum 12(0.2%), malnutrition 8(0.16%), lousiness 8(0.16%), Aspergillosis 6(0.12%) and Mareks 2(0.04%). Other, occurring only once totaling 5(0.1%) included aortic rupture, snake bite (on Ostrich), congenital malformation, air sacculitis and traumatic peritonitis. As a single entity, Coccidiosis appeared to be the most occurring disease condition in Kaduna metropolis, followed by Gumboro. Poor management practices and lack of proper vaccination may have been responsible for these findings. Good management practices enhance flock hygiene and adequate vaccination schedules is key to effective and efficient poultry production in the state and Nigeria at large. Private Veterinary Clinics have pivotal role to play in disease reporting in the country
Impact of the Programmes of the National Directorate of Employment on Graduate Employment and Unemployment in Kaduna State of Nigeria
Yemisi I. Ogunlela
Pakistan Journal of Social Sciences , 2012, DOI: 10.3923/pjssci.2012.40.45
Abstract: The seriousness and gravity of the issue of graduate employment in Nigeria informed this study which was to appraise the impact of the activities of the National Directorate of Employment on graduate employment and job creation in Kaduna State. The study was aimed at determining the various programmes of the directorate and assessing the level of its success with respect to graduate employment creation in Kaduna State. Secondary data were collected as well as oral interview of personnel in the course of the study. It was found that the impact of the NDE on graduate employment in Kaduna State has not been particularly positive and much still needs to be done. Only modest achievement in the area of generation of graduate employment has so far been recorded. A thorough re-appraisal of its programme in order to overhaul the system is desirable.
Health public private mix and the basic package  [cached]
Bogdan Pan?
Management in Health , 2008,
Abstract: The basic package of health services is a key component of a public and private mix in health care. But to develop a basic package is a difficult task due to all constraints of public demand, health budget, and the population ability to pay. There are some elements that have to be taken into consideration and balanced in the evaluation of the health services. Universality, comprehensiveness, and type of services are the most critical, and within a given budget these components are difficult to be increased all at once. Therefore there are services that need to be left outside the basic package and to be covered with private schemes. In this evaluation the elasticity of health services can be used to define the behaviour of health services consumption and refine the decision.
Efficiency of resource-use and elasticity of production among catfish farmers in Kaduna, Nigeria
CO Emokaro, PA Ekunwe
African Journal of Biotechnology , 2009,
Abstract: This study employed the use of the Stochastic Frontier Production Function in the empirical analysis of efficiency of resource-use and elasticity of production among catfish farmers in Kaduna, Nigeria. The simple random sampling technique was employed in selecting 60 catfish farmers drawn from the sampling frame obtained from the list of list of Agricultural Development Programme (ADP) contact farmers in the four Local Government Areas (LGAs) of Chikun, Igabi, Kaduna and Kaduna North, which made up the study area. Empirical estimates from the analysis showed Marginal Physical Product (MPP) values ranged from -430.850 for catfish feed to 1.004 for labour. It was equally established in this study that catfish farmers in the study area were not efficient in their use of production inputs, based on VMPi/Pxi ratios that ranged from -426.71 for catfish feed to 3.46 for labour, with none approximating to unity (which would have indicated that the farmers were optimally efficient in their use of production inputs). Also, production elasticity estimates indicated that the farmers were in stage 2 of the production process, with a return to scale of 0.664. These estimates indicate the existence of intervention points for relevant stakeholders in the bourgeoning catfish business in Kaduna.
Effectiveness of the Premarital Education Programme in Iran  [PDF]
Mahdieh Yazdanpanah,Mohammad Eslami,Nouzar Nakhaee
ISRN Public Health , 2014, DOI: 10.1155/2014/964087
Abstract: Introduction. Iran is confronted with increasing trend of divorce in recent decades. Considering the probable role of sexual dissatisfaction in the breakdown of marriages, the Ministry of Health recently decided to enrich the educational content of the premarital education programmes. The aim of this study was to compare the effectiveness of the new program with the classic one. Methods. Three hundred fifty-one women were divided into two premarital education groups: classic education and new education . The mental health, quality of life, marital satisfaction, and sexual satisfaction of women were evaluated one year after marriage. Results. At one-year followup, both groups showed improvement in mental health ; however physical health-related quality of life decreased in both groups. The two groups showed no significant difference in terms of sexual satisfaction and marital satisfaction. Marital satisfaction showed significant correlation with sexual satisfaction . Conclusion. The new program of premarital education showed no superiority over the classic method. Considering the increasing rate of divorce in Iran, the premarital education programmes may not be successful in achieving their goals. Revision of the premarital education programme is warranted. 1. Introduction As the backbone of society, marriage is considered to be one of the most important institutions in the world [1]. In most societies, be it in the East or West, most people marry at some stage during their life [1, 2]. There are a variety of motives behind marriage, among them being the need for friendship, social and emotional support, love, and sex [3]. Of course, it should be considered that in marriage, unlike in cohabitation, emotional satisfaction with sex is important due to the couples’ commitment toward each other [3]. However, everybody, regardless of his/her motives for marriage, expects a healthier and happier life after marriage. More recently, divorce and marital instability are an increasing trend in Iran; while most countries with the highest divorce rates are in the West, Iran is also considered a high-divorce country [4]. In 2011, the rate of divorce in Iran was 2.5 per 1000 people, which is even higher than the divorce rates in some western countries such as Ireland, Italy, and Spain. In Tehran, the capital of Iran, more than 30% of marriages end in divorce [4]. There are different reasons for the increasing divorce rates in Iran, including rapid socioeconomic changes resulting from modernization and urbanization, women’s empowerment, and a decreasing stigma
A systematic assessment of the concept and practice of public-private mix for tuberculosis care and control
Rasmus Malmborg, Gillian Mann, S Squire
International Journal for Equity in Health , 2011, DOI: 10.1186/1475-9276-10-49
Abstract: We undertook a systematic, multi-facetted assessment. The methods included interviews with National Tuberculosis Programme managers from high burden countries, clarification of key issues with the STOP TB Partnership PPM secretariat and a review of publicly accessible reports and published articles on PPM projects. Both the literature review and interviews with the National Tuberculosis Programme managers yielded data on project characteristics; PPM models at country level; National Tuberculosis Programme partners; and mechanisms for engagement. Matrices were developed from the literature review and the interviews to show the relationship between services and service providers for different PPM projects. Data from the literature were assessed against each of the four global PPM objectives.Twelve National Tuberculosis Programme managers from high burden countries were interviewed about the scope of PPM partnerships. Understanding of PPM and types of engaged providers varied considerably; 'private-for-profit qualified clinical providers' were the dominant category. The literature review yielded information on 22 projects in which 'private-for-profit qualified clinical providers' were again the dominant category. The contributions made by 'private-for-profit qualified clinical providers' and 'Non Governmental Organisation qualified clinical providers', were assessed against the four global PPM objectives. Reporting on tuberculosis case detection and treatment outcomes was generally good and demonstrated important PPM contributions in these areas. Reporting on equity, access and reduced patient costs was often lacking or inconclusive.PPM has improved case detection and treatment outcomes among patients seeking care with private providers. Evidence on reducing patient costs is inconclusive, and there is scope for increasing equity in access to care by systematically engaging those providers who are the primary agents for poor people seeking health care. Guidelines outlin
Early survival and duration of hospital admission in rhabdomyolysis: ICNARC Case Mix Programme Database
Colin A Hutchison, Krishna Patel, Tony Whitehouse
Critical Care , 2011, DOI: 10.1186/cc10492
Abstract: Acute kidney injury secondary to high serum myoglobin levels is a frequent cause of morbidity and mortality for patients with rhabdomyolysis [1]. Theoretically the severity and duration of the tubulointerstitial lesion that results could be reduced if rapid removal of myoglobin from the circulation was undertaken to reduce the tubules' exposure to myoglobin [2]. Recent case reports have highlighted that dialysis membranes with high molecular weight cut-off points (50 kDa) are able to provide significantly higher clearance rates of myoglobin compared with standard high-flux dialysis membranes [3,4].To determine the clinical benefit of providing rapid removal of myoglobin in patients with rhabdomyolysis, randomised controlled trials are now required to determine whether the procedure improves outcomes compared with standard care. Possible clinical outcomes for these studies would be the duration of hospital stay, rates of renal recovery and survival. To allow the design of these studies, current clinical outcomes for this population are required. We therefore interrogated a national database to determine the clinical outcomes for patients with rhabdomyolysis admitted to ICUs.The Case Mix Programme is the national clinical audit of adult, general critical care units in England, Wales and Northern Ireland coordinated by the Intensive Care National Audit & Research Centre. Data were extracted for 439,834 admissions to 210 ICUs from the Case Mix Programme Database, covering the period from January 2006 to December 2010. Admissions with rhabdomyolysis were identified from the reported primary (mandated), secondary (optional) and ultimate (optional) reasons for admission to the critical care unit and other conditions in past medical history, all coded using the Intensive Care National Audit & Research Centre Coding Method [5]. Survival data were extracted at discharge from the Case Mix Programme unit and hospital. Length of stay in the ICU was calculated in fractions of day
Drugs Supply and Laboratory Services in Dots System of Kaduna State: A Health Care Worker Perspective  [PDF]
Shehu Usman Adamu, D. McGill
Journal of Tuberculosis Research (JTR) , 2018, DOI: 10.4236/jtr.2018.61003
Abstract: A study was conducted in Kaduna State Nigeria to ascertain the impact of Drug Supply and laboratory services towards effective functioning of DOTS system. Six DOTS providing centres were identified for the study and in each centre, three respondents were selected based on their profession, the Medical Officer, the Pharmacist and the Laboratory Technician totaling 18. The officers were interviewed for the purpose of the research. Semi structured Interviews were conducted in this research as a means of obtaining Health workers perspective. The Interview which was conducted in their respective work station was open ended and all questions are same for all respondents. During the course of the study, all respondents agreed that the sources of drugs supply to their respective centres was the Kaduna State Tuberculosis and leprosy control Program office from the state capital and that drugs are been supplied quarterly and are adequate with slight interruption due to Logistic while for Laboratory services the respondents were of the view that there is the need to improve on it as there are cases of shortage of reagents and erratic supply of Electricity for effective Laboratory functioning.
Case mix, outcome, and activity for admissions to UK critical care units with severe acute pancreatitis: a secondary analysis of the ICNARC Case Mix Programme Database
David A Harrison, Giovanna D'Amico, Mervyn Singer
Critical Care , 2007, DOI: 10.1186/cc5682
Abstract: We conducted a secondary analysis of the ICNARC (Intensive Care National Audit & Research Centre) Case Mix Programme Database of 219,468 admissions to 159 adult, general critical care units in England, Wales, and Northern Ireland for the period of 1995 to 2003 to identify admissions with SAP. The ability of the modified Glasgow criteria to discriminate hospital survivors from non-survivors was compared to that of the Acute Physiology and Chronic Health Evaluation (APACHE) II score and a number of individual physiological parameters.A total of 2,677 admissions with SAP were identified (1.2% of all admissions). Mortality for these admissions was 31% in the critical care unit and 42% in hospital. The median length of stay in the critical care unit was 3.8 days and was similar for survivors and non-survivors. Increasing numbers of modified Glasgow criteria were associated with increasing hospital mortality, but better discrimination was provided by the APACHE II score and by several physiological parameters.SAP requiring critical care is associated with high mortality and long length of stay. The modified Glasgow criteria represent a simple measure of severity but were not designed to predict hospital mortality. It may be possible to develop a specific model for risk prediction in patients with SAP requiring critical care.Acute pancreatitis affects approximately 10 to 20 per million of the UK population per year [1] and approximately 25% of these require some form of critical care [2]. Severe acute pancreatitis (SAP) requiring admission to a critical care unit is associated with high mortality [1,3]. Management of SAP on the critical care unit is resource-intensive [4], and admissions have long stays in critical care [5]. However, data on outcomes and activity are sparse and predominantly from single specialist centres with limited numbers of patients.A number of severity scoring approaches exist for acute pancreatitis, the most commonly used being the criteria of Ranso
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