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A new face for private providers in developing countries: what implications for public health?
Palmer,Natasha; Mills,Anne; Wadee,Haroon; Gilson,Lucy; Schneider,Helen;
Bulletin of the World Health Organization , 2003, DOI: 10.1590/S0042-96862003000400011
Abstract: the use of private health care providers in low- and middle-income countries (lmics) is widespread and is the subject of considerable debate. we review here a new model of private primary care provision emerging in south africa, in which commercial companies provide standardized primary care services at relatively low cost. the structure and operation of one such company is described, and features of service delivery are compared with the most probable alternatives: a private general practitioner or a public sector clinic. in a case study of cost and quality of services, the clinics were popular with service users and run at a cost per visit comparable to public sector primary care clinics. however, their current role in tackling important public health problems was limited. the implications for public health policy of the emergence of this new model of private provider are discussed. it is argued that encouraging the use of such clinics by those who can afford to pay for them might not help to improve care available for the poorest population groups, which are an important priority for the government. encouraging such providers to compete for government funding could, however, be desirable if the range of services presently offered, and those able to access them, could be broadened. however, the constraints to implementing such a system successfully are notable, and these are acknowledged. even without such contractual arrangements, these companies provide an important lesson to the public sector that acceptability of services to users and low-cost service delivery are not incompatible objectives.
A new face for private providers in developing countries: what implications for public health?
Palmer Natasha,Mills Anne,Wadee Haroon,Gilson Lucy
Bulletin of the World Health Organization , 2003,
Abstract: The use of private health care providers in low- and middle-income countries (LMICs) is widespread and is the subject of considerable debate. We review here a new model of private primary care provision emerging in South Africa, in which commercial companies provide standardized primary care services at relatively low cost. The structure and operation of one such company is described, and features of service delivery are compared with the most probable alternatives: a private general practitioner or a public sector clinic. In a case study of cost and quality of services, the clinics were popular with service users and run at a cost per visit comparable to public sector primary care clinics. However, their current role in tackling important public health problems was limited. The implications for public health policy of the emergence of this new model of private provider are discussed. It is argued that encouraging the use of such clinics by those who can afford to pay for them might not help to improve care available for the poorest population groups, which are an important priority for the government. Encouraging such providers to compete for government funding could, however, be desirable if the range of services presently offered, and those able to access them, could be broadened. However, the constraints to implementing such a system successfully are notable, and these are acknowledged. Even without such contractual arrangements, these companies provide an important lesson to the public sector that acceptability of services to users and low-cost service delivery are not incompatible objectives.
Impacts of Water Development Plans on Regional Water Cooperation—A Case Study of Amu River Basin  [PDF]
Haroon Ahmad Haleemzai, Atiqullah Sediqi
Journal of Water Resource and Protection (JWARP) , 2018, DOI: 10.4236/jwarp.2018.1010059
Abstract: The trans-boundary Amu River Basin (ARB), which is shared among Afghanistan, Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan, is a primary source for human population and ecosystem. Future water demand in Afghanistan is likely to increase due to ambitious development plans after long-term unrest in the country. In accordance with high water abstraction in the Afghan part of ARB and its impacts on the downstream countries, water cooperation mechanisms are analyzed using the desk study approach. The results concerning regional water cooperation on the ARB show that, the level of cooperation between Afghanistan and central Asian riparian countries is reasonably weak. There are certain issues causing lack of cooperation between Afghanistan and central Asian riparian countries. Developmental and political interests of riparian states are key impediments to regional water cooperation on ARB. Technical impediments include the lack of human capacity, no application of basin approach and, lack of donor coordination at regional level. The policy analysis as a result of this study envisaged that initiatives to improve water management practices and increase productivity are highly needed in the study area to mitigate the foreseeing increase in irrigated water demand. The international framework law of UNWCC 1997 cannot be applied generally in central Asia and particularly in Afghanistan. Thirdly, Afghanistan’s participation in regional water cooperation framework i.e. ICWC is highly needed though participation as permanent member requires a “revise water demand assessment by ICWC” on the basis of reliable data, current infrastructural development and irrigation expansion plans of Afghanistan albeit donor agencies could play a mediation role in establishing agreement on water allocation between Afghanistan and other riparian countries.
The Crisis in Perspective
Haroon Sheikh
Amsterdam Law Forum , 2009,
Abstract: The crisis that is currently unfolding is unlike the recessions we have seen in previous decades and spells the end of an era. To gain an adequate understanding of such a watershed, we need to look at the crisis from a broad perspective. Otherwise we run the risk of merely looking at the symptoms rather than fundamental causes. This article first deals with structural economic imbalances that underpin the current crisis. Next it takes a more broad perspective by placing these imbalances in a social context that requires a reorientation. Finally, the prospects for such a reorientation are considered in the light of historical parallels.
The Effect of Applying Human Resources Information System in Corporate Performance in the Banking Sector in Jordanian Firms  [PDF]
Mohammad Al-Tarawneh, Haroon Tarawneh
Intelligent Information Management (IIM) , 2012, DOI: 10.4236/iim.2012.42005
Abstract: This paper aimed to demonstrate the impact of the effectiveness of the Application of human Resources Management System in Corporate Performance which perspective of workers in the Banking Sector in Jordanian Firm, and to achieve the purpose of the study questionnaire was developed to measure the impact of the effectiveness of the Applica-tion of human Resources Management System in Corporate Performance, and the sample consists of the study (500) employees in the banking sector, and used statistical methods appropriate to answer the study questions and test hy-potheses. The study found asset of results, including: 1) There is a significant effect between the quality of the output of human resources information system and institutional performance in banking sector in the Jordanian firm. 2) There is a statistically significant effect between motives and corporate performance in the banking sector in the Jordanian firm. 3) There is a significant effect between training and organizational performance in the banking sector in the Jordanian firm. The study was presented a set of recommendations, including: activating the role of human resources information system, where still the information system performs the function of traditional supply the decision maker authorized one to read the outputs historical information when they want, either directly or after completing a series of routine procedures that enable it, without that, this applies to access information system to avoid problems that many occur later. Must go beyond human resources information system (HRIS) traditional role in the process of selection and appointment of the new human resource to work in the organization, which is merely providing information to decision makers about the people who stepped forward to fill a job order that differentiation among those application. That the ambitious goal of that system to provide a base for data (data bank) includes all of the details of the employment available in the market.
Single Stage Oncologic Resection and Reconstruction: A Step toward Development of Sarcoma Service in Resource Constrained Country  [PDF]
Haroon ur Rashid, Kashif Abbas, Masood Umer
Modern Plastic Surgery (MPS) , 2013, DOI: 10.4236/mps.2013.34028
Abstract:

Tumor free-margin surgical resection remains the single most important treatment in the curative therapy of musculoskeletal tumor of limbs. Refinements in surgical techniques have led to increased function preservation and limb salvage. Patients and Methods: The records of patients (n = 24) who underwent microsurgical soft tissue reconstruction subsequent to resection of limb tumour during the period 2006 to 2011 were reviewed. Primary outcome i.e. uptake of the flap was evaluated. Perioperative morbidities were also noted including donor as well as recipient site complications. Assessment of Functional outcome (Musculoskeletal Tumor Society score, MSTS) local recurrence, free survival, and disease-specific survival was also made. Results: Twenty four patients (age range: 7 - 72 years) who have undergone tumor resection followed by flap coverage were identified. Lower limb reconstruction outnumbered upper limb by 6:1. Complications included, one complete failure of free vascularized iliac crest flap done for reconstruction of a

Balancing Profession, Family and Cultural Norms by Women Dentists in Pakistan  [PDF]
Rubina Mumtaz, Sheze Haroon Qazi, Sadia Sajjad
Open Journal of Social Sciences (JSS) , 2018, DOI: 10.4236/jss.2018.65013
Abstract: “Feminization of dentistry” in Pakistan is clearly visible in the gender distribution of an average dental class that boasts of 70% - 80% female students. Yet after graduation, many of these women choose not to pursue their careers, resulting in a void of practicing dentists in the country, despite an exponential increase in private sector dental colleges. This phenomenological designed qualitative study aimed to investigate the reasons behind this dynamic. Fourteen in-depth interviews’ and two focus groups’ discussion from a rich and diverse sample of 20 purposively selected working and non-working, younger and older women dentists from the cities of Islamabad, Rawalpindi, Lahore, Peshawar and Abbottabad obtained data to achieve saturation. All interviews were audio recorded with consent, transcribed verbatim, transcripts analyzed and coded into themes and sub-themes. Respondent validation and investigator triangulation ensured validity and credibility of findings. The core finding is that a support system is an essential pre-requisite facilitating a woman dentist to pursue her career; the primary driver for this support is “economic need”. This core factor circuitously interlinks three peripheral themes, which are 1) traditional gender roles dominate, restricting women dentists from pursuance of career, especially if they have a strong economic base; 2) becoming a dentist enhances social capital and lucrative marriage prospects, lending to the concept of “doctor brides” which becomes a prime reason for choosing this education. Practicing the profession becomes secondary, especially when the marital union is with a well-to-do family; 3) life stage priorities with respect to motherhood is a barrier to full time career pursuance and if economic needs are met, most prioritize motherhood over profession. In conclusion, the average graduating dentist is female, from an expensive private sector dental college, affordable by the socio-economically privileged class; she often marries into an equivalent or higher SES class based on her “doctor” title. Since “economic need” is a dominant determinant of pursuance of career, a majority of women dentists opt for the luxury of choosing not to work. Recommendations include revision of policies for admission into dental colleges and retentive protocols on renewal of license to practice.
Spectrum Sensing for Cognitive Vehicular Networks over Composite Fading
Haroon Rasheed,Nandana Rajatheva
International Journal of Vehicular Technology , 2011, DOI: 10.1155/2011/630467
Abstract: Recent advancement in vehicular wireless applications is also a major contributing factor in spectrum scarcity. Cognitive radio system is a mechanism which allows unlicensed cognitive users (CUs) to utilize idle unused bands. Fast and reliable detection of primary legacy user is the key component of cognitive radio networks. However, hidden terminal and low SNR problems due to shadow fading put fundamental limit to the sensing performance and practical entailments in design of the cognitive vehicular networks. Extensive modeling is being carried out to specify varying channel characteristics, particularly multipath fading and shadowing. Energy detection-(ED-) based spectrum sensing is a viable choice for many vehicle-to-vehicle (V2V) and vehicle to-road-side infrastructure (V2I) communications. This paper examines the performance of spectrum sensing using ED over Gamma-shadowed Nakagami-m composite fading channel to cater for both small-and-large scale fading. The results highlight the notable impact of shadowing spread and fading severity on detection performance. The relevant simulation results are presented to support our analytical results for average detection probability. Furthermore, these results are investigated and compared to other compound and classical channels. 1. Introduction Radio spectrum is a limited resource, and almost all frequency bands are allocated to licensed users. The underutilization of spectrum bands extends to the definition of term spectrum hole as shown in Figure 1. It is actually an allotted band of frequencies, but at a specific time and geographic perspective, the band is not being employed by that user [1]. Cognitive radio is a compelling and innovative need for future wireless demands. There is a tremendous possibility to improve spectrum efficiency and quality of services through shared utilization. This system has also attracted a lot of interest in intelligent transportation networks (ITS). Cognitive radio-based vehicular transportation system in V2I and V2V communications and even interactions among on board devices within vehicles will help improve radio resource, energy efficiency, traffic network management, vehicular diagnostics and reduce accidents by road traffic awareness and route planning [2]. Figure 1: Spectrum holes concept. Spectrum sensing is the first step, as it should be carried out before permitting a cognitive client to approach an authorized channel. Fast and reliable detection of licensed user is the key component of cognitive radio networks. Thus, CUs need to have such cognitive abilities
Learning from a Rapid Health Impact Assessment of a proposed maternity service reconfiguration in the English NHS
Greg Fell, Sophie Haroon
BMC Public Health , 2008, DOI: 10.1186/1471-2458-8-138
Abstract: This HIA used routine maternity data for 2004–2005 in Huddersfield, in addition to published evidence. Standard HIA techniques were used.We re-highlighted the socio economic differences in smoking status at booking and quitting during pregnancy. We focused on the key concerns of the public, that of adverse obstetric events on a Midwife Led Unit (MLU) with distant obstetric cover. We estimate that twenty percent of women giving birth in a MLU may require urgent transfer to obstetric care during labour. There were no significant socio economic differences. Much of the risk can be mitigated though robust risk management policies. Additional travelling distances and costs could affect lower socio-economic groups the greatest because of lower car ownership and geographical location in relation to the units. There is potential that with improved community antenatal and post natal care, population outcomes could improve significantly, the available evidence supports this view.Available evidence suggests that maternity reconfiguration towards enhanced community care could have many potential benefits but carries risk. Investment is needed to realise the former and mitigate the latter.The usefulness of this Health Impact Assessment may have been impeded by its timing, and the politically charged environment of the proposals. Nonetheless, the methods used are readily applicable to assess the impact of other service reconfigurations. The analysis was simple, not time intensive and used routinely available data. Careful consideration should be given to both the timing and the political context in which an analysis is undertaken.Within many parts of the country, the NHS is undertaking reconfiguration of services. The push for this is coming from a number of sources; the drive for greater efficiency, choice, practical issues such as workforce shortages and the Working Time Directive [1]. In many districts, commissioners and provider organisations are initiating significant consul
Renoprotection, renin inhibition, and blood pressure control: the impact of aliskiren on integrated blood pressure control
Haroon-Ur Rashid
Integrated Blood Pressure Control , 2010, DOI: http://dx.doi.org/10.2147/IBPC.S12407
Abstract: oprotection, renin inhibition, and blood pressure control: the impact of aliskiren on integrated blood pressure control Review (3418) Total Article Views Authors: Haroon-Ur Rashid Published Date October 2010 Volume 2010:3 Pages 133 - 144 DOI: http://dx.doi.org/10.2147/IBPC.S12407 Haroon-Ur Rashid Department of Cardiology, Baylor College of Medicine, Texas Heart Institute, Houston, TX, USA Abstract: Hypertension (HTN) is an important factor in progressive loss of renal function. The kidney can be both a contributor to and a target of HTN. The functional integrity of the kidney is vital for the maintenance of cardiovascular homeostasis. Chronic activation of the renin system causes HTN and, ultimately, end-organ damage. Direct renin inhibitors (DRIs) inhibit plasma renin activity (PRA), thereby preventing the conversion of angiotensinogen to angiotensin I; consequently, the levels of both Ang I and Ang II are reduced. There is no compensatory increase in PRA activity with DRIs as seen with angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs). There are reasons to speculate that renin inhibition might prove to be a superior strategy for blocking the renin–angiotensin–aldosterone system compared with ACEIs or ARBs. Evidence for the efficacy of aliskiren (a DRI) is considered to be relatively strong, based on published, short-term, double-blind, randomized, controlled trials showing that aliskiren is as effective as other antihypertensive agents in reducing blood pressure (BP), with no rebound effects on BP after treatment withdrawal. When combined with diuretics, fully additive BP reduction is seen. When given with an ACEI or ARB, aliskiren produces significant additional BP reduction indicative of complimentary pharmacology and more complete renin–angiotensin system blockade.
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