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Pandya S, Kan L, Parr E, Twose C, Labrique AB, Agarwal S. How Can Community Data Be Leveraged to Advance Primary Health Care? A Scoping Review of Community-Based Health Information Systems. GLOBAL HEALTH, SCIENCE AND PRACTICE 2024; 12:e2300429. [PMID: 38626945 PMCID: PMC11057800 DOI: 10.9745/ghsp-d-23-00429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 03/19/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND Community-based health information systems (CBISs) can provide critical insights into how community health systems function, and digitized CBISs may improve the quality of community-level data and facilitate integration and use of CBISs within the broader health system. This scoping review aims to understand how CBISs have been implemented, integrated, and used to support community health outcomes in low- and middle-income countries (LMICs). METHODS Both peer-reviewed and gray literature were included; relevant articles were identified using key terms and controlled vocabulary related to community/primary health care, health information systems, digital health, and LMICs. A total of 11,611 total records were identified from 5 databases and the gray literature. After deduplication, 6,985 peer-reviewed/gray literature were screened, and 95 articles/reports were included, reporting on 105 CBIS implementations across 38 countries. RESULTS Findings show that 55% of CBISs included some level of digitization, with just 28% being fully digitized (for data collection and reporting). Data flow from the community level into the health system varied, with digitized CBISs more likely to reach national-level integration. National-level integration was primarily seen among vertical CBISs. Data quality challenges were present in both paper-based and digitized CBISs, exacerbated by fragmentation of the community health landscape with often parallel reporting systems. CBIS data use was constrained to mostly vertical and digitized (partially or fully) CBISs at national/subnational levels. CONCLUSION Digitization can play a pivotal role in strengthening CBIS use, but findings demonstrate that CBISs are only as effective as the community health systems they are embedded within. Community-level data are often not being integrated into national/subnational health information systems, undermining the ability to understand what the community health needs are. Furthermore, stronger investments within community health systems need to be in place broadly to reduce fragmentation and provide stronger infrastructural and systemic support to the community health workforce.
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Affiliation(s)
- Shivani Pandya
- Center for Global Digital Health Innovation, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Lena Kan
- Center for Global Digital Health Innovation, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Emily Parr
- Center for Global Digital Health Innovation, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Claire Twose
- Welch Medical Library, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Alain B Labrique
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Smisha Agarwal
- Center for Global Digital Health Innovation, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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López-López S, Abuín-Porras V, Berlanga LA, Martos-Duarte M, Perea-Unceta L, Romero-Morales C, Pareja-Galeano H. Functional mobility and physical fitness are improved through a multicomponent training program in institutionalized older adults. GeroScience 2024; 46:1201-1209. [PMID: 37493861 PMCID: PMC10828358 DOI: 10.1007/s11357-023-00877-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 07/14/2023] [Indexed: 07/27/2023] Open
Abstract
Physical exercise has demonstrated its effectiveness in the management of the deleterious process of aging. However, it is less studied in institutionalized elderly people. This investigation aims to clarify the benefits of a multicomponent training program in institutionalized older adults. A randomized controlled trial was conducted with institutionalized older adults (≥ 70 years old). Intervention group (IG; N = 18) were submitted to a multicomponent training program based on muscle power training and interval endurance exercise, 2 times/week for 12 weeks. Control group (CG; N = 16) continued their usual mobility exercises. Independence was estimated with the Barthel index, and physical fitness and functional mobility were evaluated by the Short Physical Performance Battery (SPPB), the Timed Up and Go (TUG) test, the 6-min Walking Test (6'WT), the 10-Meter Walking Test (10MWT), hand grip strength dynamometry, and lower limb muscle strength and power. The IG improved, compared with the CG, in TUG scores in -7.43 s (95% IC: 3.28, 11.59; p < 0.001); in 10MWT scores in -5.19 s (95% IC: 1.41, 8.97; p = 0.004) and -4.43 s (95% IC: 1.14, 7.73; p = 0.002), 6'WT scores in + 54.54 m (95% IC: 30.24, 78.84; p < 0.001); and SPPB in + 2.74 points (95% IC: 2.10, 3.37; p < 0.001). Maximum muscle power and maximum strength did not show statistically significant differences. The multicomponent training program based on muscle power and interval endurance exercise was shown to be safe, well tolerated and effective for the improvement of functional mobility and physical fitness, but not for independence in institutionalized older adults.
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Affiliation(s)
| | | | - Luis A Berlanga
- Department of Physical Activity and Sport, Centro de Estudios Universitarios Cardenal Spínola CEU, Seville, Spain
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Madrid, Spain
| | | | - Luis Perea-Unceta
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
| | | | - Helios Pareja-Galeano
- Department of Physical Education, Sport and Human Movement, Universidad Autónoma de Madrid, Madrid, Spain
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Mbonane H, Sibanda M, Godman B, Meyer JC, Matlala M. Knowledge, attitudes and practices of healthcare professionals on the use of an electronic stock visibility and management tool in a middle-income country: Implications for access to medicines. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2023; 9:100233. [PMID: 36845673 PMCID: PMC9945761 DOI: 10.1016/j.rcsop.2023.100233] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 01/17/2023] [Accepted: 01/28/2023] [Indexed: 02/04/2023] Open
Abstract
Background The Stock Visibility System (SVS) is a mobile application and web-based management tool used at public primary health care (PHC) facilities in South Africa to capture and monitor medicines availability, providing visibility at national level. Medicine stock-outs are prevalent despite the implementation of SVS, compromising patient care. This study aimed to assess the knowledge, attitudes and practices (KAP) of healthcare professionals (HCPs) on the use of the SVS at PHC level to provide future guidance. Method A cross-sectional study using a structured self-administered questionnaire among 206 HCPs at 21 randomly selected PHC facilities located in a health district in KwaZulu-Natal Province, South Africa. Closed-ended questions were used to collect data on socio-demographic characteristics, knowledge on the SVS and practices on its use. A Likert scale was used to determine attitudes towards the SVS. Cronbach's alpha (α) was used to assess the internal consistency of the questionnaire and independent samples t-test and one-way analysis of variance (ANOVA) was used to test statistical difference in the mean scores for KAP and socio-demographic variables. Association between knowledge and practices, and attitude and practices was determined using odds ratios (OR) and Chi-square. Results The majority (99.5%) of HCPs had previous training on SVS. Nearly two thirds (62.1%; 128/206) generally had good knowledge about the SVS and 76.7% (158/206) had positive attitudes towards the SVS while only 17.0% had a good practice score. There was no statistically significant association between KAP of HCPs on the use of the SVS, and sociodemographic variables (HCP qualification, age and sex). There was a significant association between the knowledge and practice scores (aOR: 5.44; 95% CI: 1.92-15.4; p = 0.001). Although positive attitudes, was associated with good practices, it was not statistically significant (OR: 1.21; 95% CI: 0.46-3.22; p = 0.702). Conclusions HCPs in this district had poor practices when using SVS despite good knowledge and positive attitudes towards SVS and the higher the HCPs knowledge of SVS, the more desirable the practices on SVS. This underscores the need for continuous training of HCPs to ensure a constant and efficient supply of medicines to meet the health needs of the population.
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Affiliation(s)
- Hlalanathi Mbonane
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University; Molotlegi Street, Ga-Rankuwa 0208, South Africa,East Boom Community Health Centre, 541 Boom Street, Pietermaritzburg 3201, South Africa
| | - Mncengeli Sibanda
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University; Molotlegi Street, Ga-Rankuwa 0208, South Africa,South African Vaccination and Immunisation Centre, Sefako Makgatho Health Sciences University, Pretoria, Molotlegi Street, Ga-Rankuwa 0208, South Africa,Corresponding author at: Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Molotlegi Street, Ga-Rankuwa 0208, South Africa.
| | - Brian Godman
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University; Molotlegi Street, Ga-Rankuwa 0208, South Africa,Centre of Medical and Bio-allied Health Sciences Research, Ajman University, United Arab Emirates,Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK
| | - Johanna C. Meyer
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University; Molotlegi Street, Ga-Rankuwa 0208, South Africa,South African Vaccination and Immunisation Centre, Sefako Makgatho Health Sciences University, Pretoria, Molotlegi Street, Ga-Rankuwa 0208, South Africa
| | - Moliehi Matlala
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University; Molotlegi Street, Ga-Rankuwa 0208, South Africa
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Miranda WDD, Silva GDMD, Fernandes LDMM, Silveira F, Sousa RPD. Health inequalities in Brazil: proposed prioritization to achieve the Sustainable Development Goals. CAD SAUDE PUBLICA 2023; 39:e00119022. [PMID: 37132719 DOI: 10.1590/0102-311xpt119022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 02/13/2023] [Indexed: 05/04/2023] Open
Abstract
This study aimed to develop a prioritization index to speed up the achievement of national health targets proposed in the 2030 Agenda. This is an ecological study that addressed the Health Regions in Brazil. The index incorporated 25 indicators with analytical proximity to the official indicators of the 2030 Agenda whose data are available from public municipal sources for the period of 2015-2019. According to our study, the index was a powerful method to support health management decisions. The results showed the most vulnerable territories are located in the North Region of the country, and therefore, these are priority areas for resource allocation. The analysis of subindices highlighted local health bottlenecks, reinforcing the need for municipalities in each region to set their own priorities while making decisions for health resource allocation. By indicating Health Regions and priority themes for more investments, this investigation shows paths to support the implementation of the 2030 Agenda, from the local to the national level, in addition to providing elements that can be used by policy makers to minimize the effects of social inequalities on health, prioritizing territories with worse indices.
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Affiliation(s)
| | | | | | - Fabrício Silveira
- Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brasil
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Saha S, Pandya A, Raval D, Saxena D. Cost-Effectiveness of mHealth Intervention (TeCHO+) for Improving Maternal and Child Health Indicators in Gujarat, India. Indian J Community Med 2022; 47:549-554. [PMID: 36742961 PMCID: PMC9891040 DOI: 10.4103/ijcm.ijcm_192_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 08/24/2022] [Indexed: 02/07/2023] Open
Abstract
Background Gujarat has implemented an mHealth program, technology for community health operations-plus (TeCHO+) in 2019. TeCHO+ is a mobile and web-based application that essentially enables data entry by the frontline workers providing service at the time and place of service delivery to improve the coverage and data quality. It also facilitates early identification of morbid condition and timely treatment. This study assessed the cost-effectiveness of TeCHO+ program in Gujarat. Materials and Methods The study compared key program outcome indicators before and after the launch of TeCHO+ program. As the program was launched across the State, eMamta, the previous version of mother and child tracking system was used for comparison. A decision tree was parameterized to estimate change in disability-adjusted life year (DALY) and cost as a result of implementing TeCHO+ from a health system perspective. Results TeCHO+ incurred a cost of Rs. 2,624 per beneficiary against Rs. 1,075 per beneficiary under the previous eMamta program. TeCHO+ has resulted in significant DALY averted through early identification of high-risk cases both among pregnant women and children. Overall, cost-effectiveness analysis indicated that TeCHO+ incurred an incremental cost of Rs. 1802.84 per DALY averted, which is 1.19% of the GDP per capita of India (year 2020). Conclusion This study concludes that TeCHO+ is cost-effective for mother and child care and can be considered for replicating.
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Affiliation(s)
- Somen Saha
- Public Health, Indian Institute of Public Health, Gandhinagar, Gujarat, India
| | - Apurvakumar Pandya
- Public Health, Indian Institute of Public Health, Gandhinagar, Gujarat, India
- Director, Parul Institute of Public Health, Parul University, Gandhinagar, Gujarat, India
| | - Devang Raval
- Regional Resource Centre for Health Technology, Indian Institute of Public Health, Gandhinagar, Gujarat, India
| | - Deepak Saxena
- Public Health, Indian Institute of Public Health, Gandhinagar, Gujarat, India
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Factors associated with health insurance ownership among women of reproductive age: A multicountry study in sub-Saharan Africa. PLoS One 2022; 17:e0264377. [PMID: 35413063 PMCID: PMC9004737 DOI: 10.1371/journal.pone.0264377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 02/10/2022] [Indexed: 11/29/2022] Open
Abstract
Background Promoting the coverage and ownership of health insurance constitutes a key strategy to achieving universal healthcare, thereby meeting the Sustainable Development Goal (SDG 3.8) of safeguarding the vulnerable population from financial risk resulting from catastrophic health expenditures. In sub-Saharan Africa, accessing medical services is particularly challenging among women due to inadequate opportunities for socio-economic empowerment and meeting their unique healthcare needs. The present study aimed to explore the sociodemographic factors associated with health insurance ownership among women in selected countries in sub-Saharan Africa. Methods We extracted cross-sectional data on health insurance ownership and conceptually relevant sociodemographic variables on women aged 15–49 years from Demographic and Health Surveys on five selected countries in sub-Saharan Africa (n = 55,438), including Burkina Faso, DR Congo, Cameroon, Gabon and Kenya. Data were analyzed using descriptive and multivariate regression analysis, and the associations were reported in terms of average marginal effects. Results Data revealed considerable cross-country variation in health insurance ownership: Gabon (57.9%), Kenya (6.1%), DR Congo (2.8%), Cameroon (1.1%), Burkina Faso (0.4%). In the multivariate regression analysis, women’s age, marital status, place of residency, educational level, household wealth status, employment, and media access were significant predictors of insurance ownership. The associations were generally similar across the five countries, with higher age, better educational level and wealth status showing a consistently positive relationship with insurance ownership. Conclusion Our findings revealed striking inequality in health insurance ownership among the studied countries, which should be given due attention to achieving universal healthcare-related goals. There also exist considerable sociodemographic disparities in health insurance ownership among women that should be addressed using context-specific programmatic interventions. Our findings revealed striking inequality in health insurance ownership among the studied countries, which should be given due attention to achieving universal healthcare-related goals. There also exist considerable sociodemographic disparities in health insurance ownership among women that should be addressed using context-specific programmatic interventions.
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Aljabri D. Associations Between Obesity, Physical Inactivity, Healthcare Capacity, and the Built Environment: Geographic Information System Analysis. J Multidiscip Healthc 2022; 15:689-704. [PMID: 35399806 PMCID: PMC8985911 DOI: 10.2147/jmdh.s345458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 02/21/2022] [Indexed: 12/01/2022] Open
Abstract
Background Obesity is one of the major critical health conditions affecting many people across the world. One of the major causes of obesity is identified to be sedentary lifestyles and physical inactivity, which may be associated with environmental factors. Objective The study analyzes variations in obesity and physical inactivity in the State of South Carolina, US, and their association with healthcare capacity and the built environment. Methods Data were obtained from different secondary sources and surveys, 2012, and then linked on the county-level using ArcGIS. Global Moran’s I was used to examine the spatial distribution at the state level, and Anselin’s local Moran’s I was used to detect any significant clusters at the county level. Ordinary least squares regression models were calculated for obesity and physical inactivity separately. Results More than 70% of SC counties had high levels of obesity and physical inactivity. Spatial analysis showed statistical clusters of high obesity, high physical inactivity, and low access to exercise opportunities in rural areas compared to urban areas. Conversely, clusters of high density of health-care facilities appeared in urban areas. Through the regression models, the density of primary care physicians (p = 0.025) and access to exercise opportunities (p = 0.075) were negatively associated with obesity, while the low perception of own health (p = 0.001) and obesity rate (0.011) were positively associated with physical inactivity. Conclusion GIS was useful to illustrate and identify significant geographic variations and high clusters of obesity and physical inactivity in rural areas, compared with high clusters of access to exercise opportunities and health-care facilities in urban areas. The international health community is encouraged to utilize spatial information systems to examine variations and recommend evidence-based recommendations to redistribute equitable public health efforts. The development of strategies and initiatives toward reducing variation in health and sustainable development is key to promote the population wellbeing.
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Affiliation(s)
- Duaa Aljabri
- Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
- Correspondence: Duaa Aljabri, Email
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Kahindo CK, Mukuku O, Wembonyama SO, Tsongo ZK. Prevalence and Factors Associated with Acute Kidney Injury in Sub-Saharan African Adults: A Review of the Current Literature. Int J Nephrol 2022; 2022:5621665. [PMID: 35342649 PMCID: PMC8941586 DOI: 10.1155/2022/5621665] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 02/26/2022] [Accepted: 03/01/2022] [Indexed: 02/05/2023] Open
Abstract
Acute kidney injury (AKI) is a complex condition that can occur in both community and hospital settings and has many aetiologies. These aetiologies may be infectious, toxic, surgical, or related to the different management methods. Although it is a major public health problem worldwide, it must be emphasised that both its incidence and mortality rate appear to be very high in sub-Saharan African (SSA) countries compared to developed countries. The profile of AKI is very different from that of more developed countries. There are no reliable statistics on the incidence of AKI in SSA. Infections (malaria, HIV, diarrhoeal, and other diseases), nephrotoxins, and obstetric and surgical complications are the main aetiologies in Africa. The management of AKI is costly and associated with high rates of prolonged hospitalisation and in-hospital mortality.
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Affiliation(s)
- Charles Kangitsi Kahindo
- Faculty of Medicine, University of Goma, Goma, Democratic Republic of the Congo
- Clinique Internationnale de Medecine Avancee au Kivu, Goma, Democratic Republic of the Congo
| | - Olivier Mukuku
- Institut Supérieur des Techniques Médicales de Lubumbashi, Lubumbashi, Democratic Republic of the Congo
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Dasgupta RR, Mao W, Ogbuoji O. Addressing child health inequity through case management of under-five malaria in Nigeria: an extended cost-effectiveness analysis. Malar J 2022; 21:81. [PMID: 35264153 PMCID: PMC8905868 DOI: 10.1186/s12936-022-04113-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 03/02/2022] [Indexed: 11/27/2022] Open
Abstract
Background Under-five malaria in Nigeria is a leading cause of global child mortality, accounting for 95,000 annual child deaths. High out-of-pocket medical expenditure contributes to under-five malaria mortality by discouraging care-seeking and use of effective anti-malarials in the poorest households. The significant inequity in child health outcomes in Nigeria stresses the need to evaluate the outcomes of potential interventions across socioeconomic lines. Methods Using a decision tree model, an extended cost-effectiveness analysis was done to determine the effects of subsidies covering the direct and indirect costs of case management of under-five malaria in Nigeria. This analysis estimates the number of child deaths averted, out-of-pocket (OOP) expenditure averted, cases of catastrophic health expenditure (CHE) averted, and cost of implementation. An optimization analysis was also done to determine how to optimally allocate money across wealth groups using different combinations of interventions. Results Fully subsidizing direct medical, non-medical, and indirect costs could annually avert over 19,000 under-five deaths, 8600 cases of CHE, and US$187 million in OOP spending. Per US$1 million invested, this corresponds to an annual reduction of 76 under-five deaths, 34 cases of CHE, and over US$730,000 in OOP expenditure. Due to low initial treatment coverage in poorer socioeconomic groups, health and financial-risk protection benefits would be pro-poor, with the poorest 40% of Nigerians accounting for 72% of all deaths averted, 55% of all OOP expenditure averted, and 74% of all cases of CHE averted. Subsidies targeted to the poor would see greater benefits per dollar spent than broad, non-targeted subsidies. In an optimization scenario, the strategy of fully subsidizing direct medical costs would be dominated by a partial subsidy of direct medical costs as well as a full subsidy of direct medical, nonmedical, and indirect costs. Conclusion Subsidizing case management of under-five malaria for the poorest and most vulnerable would reduce illness-related impoverishment and child mortality in Nigeria while preserving limited financial resources. This study is an example of how focusing a targeted policy-intervention on a single, high-burden disease can yield large health and financial-risk protection benefits in a low and middle-income country context and address equity consideration in evidence-informed policymaking. Supplementary Information The online version contains supplementary material available at 10.1186/s12936-022-04113-w.
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Affiliation(s)
- Rishav Raj Dasgupta
- Trinity College of Arts and Sciences, Duke University, Durham, NC, USA. .,Center for Policy Impact in Global Health at Duke Global Health Institute, Durham, NC, USA.
| | - Wenhui Mao
- Center for Policy Impact in Global Health at Duke Global Health Institute, Durham, NC, USA
| | - Osondu Ogbuoji
- Center for Policy Impact in Global Health at Duke Global Health Institute, Durham, NC, USA. .,Duke Margolis Center for Health Policy, Durham, NC, USA.
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Tenriawaru AN, Yustisia I, Arsyad M, Jamil MH, Kawamura Y. The linkages between health and agriculture sectors through regional expenditure review. GACETA SANITARIA 2021; 35 Suppl 2:S596-S600. [PMID: 34929909 DOI: 10.1016/j.gaceta.2021.10.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 07/30/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To analyze government allocations in the health and agriculture sector expenditure and find out their linkages based on the output of each sector. METHOD The research was conducted in Bima Regency, Indonesia, by employing descriptive statistical analysis to describe linkages between the health and agriculture sectors. RESULTS The health sector (including education and infrastructure) is a priority sector in the allocation of regional expenditure with a greater proportion compared to the agriculture sector. However, the allocation of expenditure in the health sector seems to have implications for the improvement of health status, which ultimately affects the production of leading commodities in the agriculture sector as indicated by increased production from year to year. CONCLUSION There was a linkage between the performance of health and agriculture sectors as an implication of the allocation of health and agriculture sector expenditure, which was carried out proportionally by the Bima government. In addition, the agriculture sector will strengthen the health sector in terms of nutrition and environmental health. This implies that linkages between agriculture and health sectors are necessary to accelerate development in the country.
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Affiliation(s)
| | - Ika Yustisia
- Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia
| | - Muhammad Arsyad
- Faculty of Agriculture, Universitas Hasanuddin, Makassar, Indonesia
| | - Muh Hatta Jamil
- Faculty of Agriculture, Universitas Hasanuddin, Makassar, Indonesia
| | - Yoshio Kawamura
- Kyoto Prefectural College of Agriculture and Ryukoku Extension Center, Ryukoku University, Kyoto, Japan
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De Luca V, Tramontano G, Riccio L, Trama U, Buono P, Losasso M, Bracale UM, Annuzzi G, Zampetti R, Cacciatore F, Vallefuoco G, Lombardi A, Marro A, Melone MAB, Ponsiglione C, Chiusano ML, Bracale G, Cafiero G, Crudeli A, Vecchione C, Taglialatela M, Tramontano D, Iaccarino G, Triassi M, Roller-Wirnsberger R, Bousquet J, Illario M. "One Health" Approach for Health Innovation and Active Aging in Campania (Italy). Front Public Health 2021; 9:658959. [PMID: 34046390 PMCID: PMC8144456 DOI: 10.3389/fpubh.2021.658959] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 03/18/2021] [Indexed: 12/23/2022] Open
Abstract
This article describes how innovations are exploited in Campania (Italy) to improve health outcomes, quality of life, and sustainability of social and healthcare services. Campania's strategy for digitalization of health and care and for healthy aging is based on a person-centered, life-course, “One Health” approach, where demographic change is considered capable of stimulating a growth dynamic linked to the opportunities of combining the “Silver Economy” with local assets and the specific health needs of the population. The end-users (citizens, patients, and professionals) contribute to the co-creation of products and services, being involved in the identification of unmet needs and test-bed activity. The Campania Reference Site of the European Innovation Partnership on Active and Healthy Aging is a flexible regional ecosystem to address the challenge of an aging population with a life-course approach. The good practices, developed in the context of research and innovation projects and innovative procurements by local stakeholders and collaborations with international networks, have been allowing the transfer of innovative solutions, knowledge, and skills to the stakeholders of such a multi-sectoral ecosystem for health.
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Affiliation(s)
- Vincenzo De Luca
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli "Federico II, " Naples, Italy
| | - Giovanni Tramontano
- Unità Operativa Semplice Ricerca e Sviluppo, Azienda Ospedaliera Universitaria Federico II, Naples, Italy
| | - Luigi Riccio
- Direzione Generale per la Tutela della Salute e il Coordinamento del Servizio Sanitario Regionale, Naples, Italy
| | - Ugo Trama
- Direzione Generale per la Tutela della Salute e il Coordinamento del Servizio Sanitario Regionale, Naples, Italy
| | - Pietro Buono
- Direzione Generale per la Tutela della Salute e il Coordinamento del Servizio Sanitario Regionale, Naples, Italy
| | - Mario Losasso
- Dipartimento di Architettura, Università degli Studi di Napoli "Federico II", Naples, Italy
| | | | - Giovanni Annuzzi
- Unità Operativa Semplice Microinfusori e tecnologie innovative, Azienda Ospedaliera Universitaria Federico II, Naples, Italy
| | | | - Francesco Cacciatore
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli "Federico II, " Naples, Italy
| | | | | | - Anna Marro
- Azienda Sanitaria Locale Avellino, Avellino, Italy
| | - Mariarosa Anna Beatrice Melone
- Dipartimento di Scienze Mediche e Chirurgiche Avanzate e Centro Interuniversitario di Ricerca in Neuroscienze, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy
| | - Cristina Ponsiglione
- Dipartimento di Ingegneria Industriale, Università degli Studi di Napoli "Federico II", Naples, Italy
| | - Maria Luisa Chiusano
- Dipartimento di Agraria, Università degli Studi di Napoli "Federico II", Naples, Italy
| | - Giancarlo Bracale
- Mediterranean Federation for Advancing Vascular Surgery, Naples, Italy
| | | | | | - Carmine Vecchione
- Dipartimento di Medicina, Chirurgia e Odontoiatria, Università degli Studi di Salerno, Salerno, Italy
| | - Maurizio Taglialatela
- Dipartimento di Neuroscienze e Scienze Riproduttive ed Odontostomatologiche, Università degli Studi di Napoli "Federico II," Naples, Italy
| | - Donatella Tramontano
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli "Federico II," Naples, Italy
| | - Guido Iaccarino
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli "Federico II," Naples, Italy
| | - Maria Triassi
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli "Federico II, " Naples, Italy
| | | | - Jean Bousquet
- MACVIA-France, Fondation Partenariale FMC VIA-LR, Montpellier, France
| | - Maddalena Illario
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli "Federico II, " Naples, Italy
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Müller L, El Oakley R, Saad M, Mokdad AH, Etolhi GA, Flahault A. A multidimensional framework for rating health system performance and sustainability: A nine plus one ranking system. J Glob Health 2021; 11:04025. [PMID: 34026052 PMCID: PMC8109277 DOI: 10.7189/jogh.11.04025] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background Health Care provision in terms of prevention, detection and treatment is primarily dependent on the quality of the hosting Health System. In its health report 2000, the WHO's attempt to assess and rank health systems’ quality Worldwide was heavily criticized. We propose a novel framework for health system performance and ranking using three indicators for three domains; general health system performance, clinical outcome of treatment applied to the main causes of death and health system sustainability domains. Methods Each domain was rated as “A – high”, “B – intermediate” or “C – poor” according to the aggregate score values of its three indicators. Hence the highest rank a health system can achieve is “AAA” and the lowest is “CCC”. If there is a need to define a “numerical rank” to further differentiate health systems with similar rating from one another, the total health expenditure per capita per year was used as an additional “number 10” indicator to achieve that level of differentiation. The framework was applied to Health Systems serving most of the World population including China, India, Brazil, USA, Russia, Germany, Japan, UK, France, Singapore and Switzerland. Data pertinent to each indicator was captured from published reports in peer-reviewed journals and/or from official websites. A Delphi survey was conducted for data not available online. Results Among the 11 health systems tested, no one scored AAA, Switzerland, France, Germany and Japan scored AAB, Singapore scored ABB, UK scored BBB, USA, Russia and China scored BBC, Brazil scored BCC while India scored CCC. Total health expenditure per capita per year lead to ranking Switzerland first followed by France, Germany, and Japan. Conclusion This novel ranking system is a practical and an applicable tool that test health system performance and sustainability. It can be utilized to guide all organizations, people and actions whose primary intent is to promote, restore or maintain health to achieve their targets. An International Health System Ranking database that will be hosted by the Institute of Global, Health, Faculty of Medicine, University of Geneva, Switzerland.
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Affiliation(s)
- Laura Müller
- Institute of Global, Health, Faculty of Medicine, University of Geneva, Switzerland
| | - Reida El Oakley
- Cardiac Centre, King Abdel Aziz Specialist Hospital, Taif, Saudi Arabia
| | - Mohammed Saad
- The Libyan International Medical University, Benghazi, Libya
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle,Washington, USA
| | - Giamal A Etolhi
- The Libyan International Medical University, Benghazi, Libya
| | - Antoine Flahault
- Institute of Global, Health, Faculty of Medicine, University of Geneva, Switzerland
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Warren CE, Bellows B, Marcus R, Downey J, Kennedy S, Kureshy N. Strength in Diversity: Integrating Community in Primary Health Care to Advance Universal Health Coverage. GLOBAL HEALTH, SCIENCE AND PRACTICE 2021; 9:S1-S5. [PMID: 33727314 PMCID: PMC7971373 DOI: 10.9745/ghsp-d-21-00125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 02/17/2021] [Indexed: 11/15/2022]
Abstract
The supplement highlights a systems approach that recognizes the communities' roles and their interactions with other health system actors to accelerate outcomes and reflect the diversity of the community health ecosystem. Several cross-cutting priorities emerge from the articles, namely coverage, community health financing, policy change, institutionalization, resilience, accountability, community engagement, and whole-of-society efforts.
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Affiliation(s)
| | | | - Rachel Marcus
- U.S. Agency for International Development, Washington, DC, USA
| | | | | | - Nazo Kureshy
- Social Solutions International, supporting U.S. Agency for International Development, Washington, DC, USA
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Giunta DH, Marquez Fosser S, Boietti BR, Ación L, Pollan JA, Martínez B, Luna D, Bonella MB, Grande Ratti MF. Emergency department visits and hospital readmissions in an Argentine health system. Int J Med Inform 2020; 141:104236. [PMID: 32721852 PMCID: PMC7373686 DOI: 10.1016/j.ijmedinf.2020.104236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 06/21/2020] [Accepted: 07/19/2020] [Indexed: 12/02/2022]
Abstract
BACKGROUND AND GOAL OF STUDY The scope of health in the Sustainable Development Goals is much broader than the Millennium Development Goals, spanning functions such as health-system access and quality of care. Hospital readmission rate and ED-visits within 30 days from discharge are considered low-cost quality indicators. This work assesses an indicator of quality of care in a tertiary referral hospital in Argentina, using data available from clinical records. PURPOSE To estimate the rate of ED-visits and the hospital readmission rate (HRR) after a first hospitalization (First-H), and to identify associated factors. METHODS This retrospective cohort included patients who had a First-H in Hospital Italiano de Buenos Aires between 2014-2015. Follow-up occurred from discharge until ED-visit, readmission, death, disaffiliation from health insurance, or 13 months. We present HRR at 30 days and ED-visits rate at 72 h, using the Cox proportional-hazards regression model to explore associated factors, and reporting adjusted hazard ratios (HR) with their respective 95 %CI. RESULTS The study comprised 10,598 hospitalizations (median age was 68 years). Of these, 5966 had at least one consultation to the ED during follow up, resulting in a 24 h rate of consultations to ED of 1.51 % (95 %CI 1.29-1.72); at 48 h 3.18 % (95 %CI 2.86-3.54); at 72 h 4.71 % (95 %CI 4.32-5.13). In multivariable models, factors associated for 72 h ED-visits were: age (aHR 1.06), male (aHR 1.14), Charlson Comorbidity Index (aHR 1.16), unscheduled hospitalization (aHR 1.39), prior consultation with the ED (aHR 1.08) and long hospital stay (aHR 1.39). Meanwhile, 2345 patients had at least one hospital readmission (98 % unscheduled), resulting a 24 h rate of 0.5 % (95 %CI 0.42-0.71), at 48 h 0.98 % (95 %CI 0.80-1.18), at 72 h 1.4 % (95 %CI 1.2-1.6); at 30 days 7.7 % (95 %CI 7.2-8.2); at 90 days 13 % (95 %CI 12.4-13.8); and one-year 22.5 % (95 %CI 21.7-23.4). Associated factors for HRR at 30 days were: age (HR 1.16), male (HR 1.09), Charlson comorbidities score (HR 1.27), social service requirement during First-H (HR 1.37), unscheduled First-H (HR 1.16), previous ED-visits (HR 1.03) and length of stay (HR 1.08). CONCLUSION Priorities efforts to improve must include greater attention to patients' readiness prior discharge, to explore causes of preventable readmissions, and better support for patient self-management.
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Affiliation(s)
- Diego Hernán Giunta
- Internal Medicine Research Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | - Bruno Rafael Boietti
- Internal Medicine Research Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Laura Ación
- Instituto de Cálculo, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
| | - Javier Alberto Pollan
- Department of Internal Medicine, Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina
| | - Bernardo Martínez
- Department of Internal Medicine, Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina; Emergency Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Daniel Luna
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina
| | - Maria Belen Bonella
- Department of Internal Medicine, Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina
| | - María Florencia Grande Ratti
- Internal Medicine Research Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Emergency Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Department of Health Informatics, Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina.
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Yıldırım S, Yildirim DC, Calıskan H. The influence of health on economic growth from the perspective of sustainable development: a case of OECD countries. WORLD JOURNAL OF ENTREPRENEURSHIP MANAGEMENT AND SUSTAINABLE DEVELOPMENT 2020. [DOI: 10.1108/wjemsd-09-2019-0071] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThis study aims to explain the role of health on economic growth for OECD countries in the context of sustainable development. Accordingly, the study investigates the relationship between health and economic growth in OECD countries.Design/methodology/approachThis study employed cluster analysis and econometric methods. By cluster analysis, 12 OECD countries (France, Germany, Finland, Slovenia, Belgium, Portugal, Estonia, Czech Republic, Hungary, South Korea, Poland and Slovakia) were classified into two clusters as high and low health status through health indicators. For panel threshold analysis, the data included growth rates, life expectancy at birth, export rates, population data, fixed capital investments, inflation and foreign direct investment for the period of 1999–2016.FindingsThe study determined two main clusters as countries with high health status (level) and low health status (level), but there was no threshold effect in clusters. It was concluded that an increase in the life expectancy at birth of countries with higher health status had no significant impact on economic growth. However, the increase in the life expectancy at birth of countries with lower health status influenced economic growth positively.Research limitations/implicationsThis study used data that including period of 1999–2016 for OECD countries. In addition, the study used cluster analysis to determine health status of countries, and then panel threshold analysis was preferred to explain significant relations.Originality/valueThis study showed that the role of health on economic growth can change toward country groups as higher and lower health status. It was proved that higher life expectancy can influence economic growth positively in countries with worse or low health status. In this context, developing countries, which try to achieve sustainable development, should improve their health status to achieve economic and social development at the same time.
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Onwujekwe O, Mbachu C, Etiaba E, Ezumah N, Ezenwaka U, Arize I, Okeke C, Nwankwor C, Uzochukwu B. Impact of capacity building interventions on individual and organizational competency for HPSR in endemic disease control in Nigeria: a qualitative study. Implement Sci 2020; 15:22. [PMID: 32299484 PMCID: PMC7164165 DOI: 10.1186/s13012-020-00987-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 04/03/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The need to build capacity for health policy and systems research (HPSR) in low- and middle-income countries has been underscored as this encompasses the processes of decision-making at all levels of the health system. This implementation research project was undertaken in Southeast Nigeria to evaluate whether the capacity-building intervention improves the capacity to produce and use research evidence for decision making in endemic disease control. METHODS Three training workshops were organized for purposively selected participants comprising "producers of evidence" such as health research scientists in three universities and "users of evidence" such as policy makers, program managers, and implementers in the public health sector. Participants also held step-down workshops in their organizations. The last workshop was used to facilitate the formation of knowledge networks comprising of both producers and users, which is a critical step for getting research into policy and practice (GRIPP). Three months after the workshops, a subset, 40, of workshop participants was selected for in-depth interviews. Information was collected on (i) perceptions of usefulness of capacity-building workshops, (ii) progress with proposed research and research uptake activities, (iii) effects of these activities on evidence-informed decision making, and (iv) constraints and enablers to implementation of proposed activities. RESULTS Most participants felt the workshops provided them with new competencies and skills in one or more of research priority setting, evidence generation, communication, and use for the control of endemic diseases. Participants were at different stages of planning and implementing their proposed research and research uptake activities, and were engaging across professional and disciplinary boundaries to ensure relevance and usefulness of outputs for decision making. Key enablers of successful implementation of activities were positive team dynamics, good balance of competencies, effective communication and engagement within teams, team leader's capacity to innovate, and personal interests such as career progress. Lack of funding, limited decision space, organizational bureaucracies, and poor infrastructure were the key constraints to the implementation of proposed activities. Lack of mentorship and continuous support from trainers delayed progress with implementing proposed activities. CONCLUSIONS The capacity-building interventions contributed to the development of a critical mass of research scientists, policy makers, and practitioners who have varying levels of competencies in HPSR for endemic disease control and would require further support in carrying out their medium and long-term goals.
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Affiliation(s)
- Obinna Onwujekwe
- Department of Health Administration and Management, University of Nigeria Enugu campus, Nsukka, Nigeria
- Health Policy Research Group, University of Nigeria Nsukka, Nsukka, Nigeria
| | - Chinyere Mbachu
- Department of Health Administration and Management, University of Nigeria Enugu campus, Nsukka, Nigeria.
- Department of Community Medicine, University of Nigeria Enugu campus, Nsukka, Nigeria.
| | - Enyi Etiaba
- Department of Health Administration and Management, University of Nigeria Enugu campus, Nsukka, Nigeria
- Health Policy Research Group, University of Nigeria Nsukka, Nsukka, Nigeria
| | - Nkoli Ezumah
- Health Policy Research Group, University of Nigeria Nsukka, Nsukka, Nigeria
| | - Uchenna Ezenwaka
- Health Policy Research Group, University of Nigeria Nsukka, Nsukka, Nigeria
| | - Ifeyinwa Arize
- Department of Health Administration and Management, University of Nigeria Enugu campus, Nsukka, Nigeria
- Health Policy Research Group, University of Nigeria Nsukka, Nsukka, Nigeria
| | - Chinyere Okeke
- Department of Health Administration and Management, University of Nigeria Enugu campus, Nsukka, Nigeria
- Department of Community Medicine, University of Nigeria Enugu campus, Nsukka, Nigeria
| | - Chikezie Nwankwor
- Department of Health Administration and Management, University of Nigeria Enugu campus, Nsukka, Nigeria
- Health Policy Research Group, University of Nigeria Nsukka, Nsukka, Nigeria
| | - Benjamin Uzochukwu
- Department of Health Administration and Management, University of Nigeria Enugu campus, Nsukka, Nigeria
- Department of Community Medicine, University of Nigeria Enugu campus, Nsukka, Nigeria
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Arsyad M, Pulubuhu DAT, Kawamura Y, Maria IL, Dirpan A, Unde AA, Nuddin A, Yusuf S. The role of public health services (PHS) in agricultural poverty alleviation. ENFERMERIA CLINICA 2020. [DOI: 10.1016/j.enfcli.2019.07.076] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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