Countries are seeking to diversify sources of revenue for Universal Health Coverage (UHC), and strategies vary among countries at different stages on the road to UHC. The study tends to document these trade-offs by fa...Countries are seeking to diversify sources of revenue for Universal Health Coverage (UHC), and strategies vary among countries at different stages on the road to UHC. The study tends to document these trade-offs by factoring successful economies across the globe. A review of peer-reviewed literature retrieved country-wise on the basis of successful UHC economies to establish the major factor associated with development of UHC. Political will has been recognized as one of the critical factors. Overcoming barriers associated with development of an adequate and sustainable financing mechanism and selecting the right package of services are other essential determinants. Reaching vulnerable groups and efficient use of resources were other factors that contributed to UHC development in Mexico and south-east Asian countries. UHC development is at threshold where nations should learn from one another, especially from those systems which appear to be doing better, and are more prepared to innovate, test and evaluate new approaches.展开更多
Introduction: Prematurity continues to stand as a major public health issue worldwide and more particularly for low incomes countries like Burkina Faso. Indeed, it is the main cause of high death rate and infant morbi...Introduction: Prematurity continues to stand as a major public health issue worldwide and more particularly for low incomes countries like Burkina Faso. Indeed, it is the main cause of high death rate and infant morbidity, neurologic deficiencies being one of them. Objective: From March 1st to September 30th, 2020, evaluate the fetal neuroprotection protocol using sulfate magnesium during births before thirty-three (33) weeks of amenorrhea at the University Health Centers (UHC) of Yalgado Ouedraogo and Bogodogo in Ouagadougou, Burkina Faso. Patients and Methods: It was a prospective cohort survey, exposed or unexposed. The exposed ones are from the UHC of Yalgado Ouedraogo, while the unexposed ones are from the UHC of Bogodogo. Analysis of the results showed 87 newborns from the exposed and 180 from the unexposed. The mortality rate, as well as neonatal neurologic complications, was higher with unexposed than with exposed. Although antenatal exposure to magnesium sulfate was not statistically associated with mortality and morbidity in newborns at a threshold of 0.05%, it has shown an overall good neurological prognosis in newborns exposed. Conclusion: A survey of a large sample of the population would be relevant in order to better assess the determinants of this influence. Proposition: In light of the results, the use of magnesium sulfate for neuroprotective purposes could be considered in our countries.展开更多
<b>Title:</b> Assessment of haemostasis in anaesthesia for surgery at the Sylvanus Olympio University Hospital Center in Lomé. <b>Objectives:</b> Evaluate the prescription of the preoperat...<b>Title:</b> Assessment of haemostasis in anaesthesia for surgery at the Sylvanus Olympio University Hospital Center in Lomé. <b>Objectives:</b> Evaluate the prescription of the preoperative haemostasis assessment. <b>Methodology:</b> This was a prospective descriptive and observational study which had taken place in the central operating room and in the operating room of the ENT department at UHC SO of Lomé from January 1 to June 31, 2016. It had concerned all patients who had anaesthesia for scheduled surgery after pre-anesthetic consultation and the haemostasis assessment carried out according to the anaesthesia technique and the type of surgery. <b>Results:</b> Two hundred and sixty (260) patients underwent anaesthesia during the study period. The male sex predominated (60%), the age group 18 - 40 years predominated (50.4%). GA was more practiced (62.7%) followed by spinal anaesthesia (30.3%). Minor ENT surgery was more performed (28%). ASA1 patients predominated (48.5%). The pre-anesthetic haemostasis assessment including platelet count, prothrombin rate, activated partial thromboplastin time and bleeding time was almost always done. The platelet count was achieved in all patients followed by the activated partial thromboplastin time (94%). No haemorrhagic complication related to a haemostasis disorder was observed in the perioperative period in anaesthesia than in surgery. <b>Conclusion:</b> The prescription of the pre-anesthetic haemostasis assessment should not be systematic. It must take into account the clinical history, the patient’s bleeding history during the anaesthesia consultation, the type of anaesthesia, the surgery planned and the age.展开更多
Background: Myanmar’s National Health Plan 2017-2021 set out concrete steps to strengthen the health system on the way to achieving the goal of universal health coverage by 2030. Ensuring these steps include the 7.7 ...Background: Myanmar’s National Health Plan 2017-2021 set out concrete steps to strengthen the health system on the way to achieving the goal of universal health coverage by 2030. Ensuring these steps include the 7.7 million older adults in Myanmar’s population by 2030 will require novel strategies that improve health and reduce financial burden of health expenditures. An examination of the relationship between social networks and selected health outcomes was undertaken to determine whether these networks can safeguard older adults’ continued contributions to family, society and their own health. Methods: Secondary analysis of a nationally representative study of adults aged 60 years and older. Ordered logistic regression analyses with weighted data were used to examine the relationship between a social network variable and a number of health outcomes. Findings: Stronger social networks were associated with better health outcomes like better memory (OR 1.2), lower reported walking difficulties (OR 0.58), better self-reported health (R 1.15). People with higher social ties were also more like to receive regular assistance and provide care for other household members. Interpretation: Social networks play a role in mediating health outcomes and interactions with the health care systems. Social network interventions should be explored as part of policy mechanisms to ensure universal health coverage for older adults in Myanmar.展开更多
文摘Countries are seeking to diversify sources of revenue for Universal Health Coverage (UHC), and strategies vary among countries at different stages on the road to UHC. The study tends to document these trade-offs by factoring successful economies across the globe. A review of peer-reviewed literature retrieved country-wise on the basis of successful UHC economies to establish the major factor associated with development of UHC. Political will has been recognized as one of the critical factors. Overcoming barriers associated with development of an adequate and sustainable financing mechanism and selecting the right package of services are other essential determinants. Reaching vulnerable groups and efficient use of resources were other factors that contributed to UHC development in Mexico and south-east Asian countries. UHC development is at threshold where nations should learn from one another, especially from those systems which appear to be doing better, and are more prepared to innovate, test and evaluate new approaches.
文摘Introduction: Prematurity continues to stand as a major public health issue worldwide and more particularly for low incomes countries like Burkina Faso. Indeed, it is the main cause of high death rate and infant morbidity, neurologic deficiencies being one of them. Objective: From March 1st to September 30th, 2020, evaluate the fetal neuroprotection protocol using sulfate magnesium during births before thirty-three (33) weeks of amenorrhea at the University Health Centers (UHC) of Yalgado Ouedraogo and Bogodogo in Ouagadougou, Burkina Faso. Patients and Methods: It was a prospective cohort survey, exposed or unexposed. The exposed ones are from the UHC of Yalgado Ouedraogo, while the unexposed ones are from the UHC of Bogodogo. Analysis of the results showed 87 newborns from the exposed and 180 from the unexposed. The mortality rate, as well as neonatal neurologic complications, was higher with unexposed than with exposed. Although antenatal exposure to magnesium sulfate was not statistically associated with mortality and morbidity in newborns at a threshold of 0.05%, it has shown an overall good neurological prognosis in newborns exposed. Conclusion: A survey of a large sample of the population would be relevant in order to better assess the determinants of this influence. Proposition: In light of the results, the use of magnesium sulfate for neuroprotective purposes could be considered in our countries.
文摘<b>Title:</b> Assessment of haemostasis in anaesthesia for surgery at the Sylvanus Olympio University Hospital Center in Lomé. <b>Objectives:</b> Evaluate the prescription of the preoperative haemostasis assessment. <b>Methodology:</b> This was a prospective descriptive and observational study which had taken place in the central operating room and in the operating room of the ENT department at UHC SO of Lomé from January 1 to June 31, 2016. It had concerned all patients who had anaesthesia for scheduled surgery after pre-anesthetic consultation and the haemostasis assessment carried out according to the anaesthesia technique and the type of surgery. <b>Results:</b> Two hundred and sixty (260) patients underwent anaesthesia during the study period. The male sex predominated (60%), the age group 18 - 40 years predominated (50.4%). GA was more practiced (62.7%) followed by spinal anaesthesia (30.3%). Minor ENT surgery was more performed (28%). ASA1 patients predominated (48.5%). The pre-anesthetic haemostasis assessment including platelet count, prothrombin rate, activated partial thromboplastin time and bleeding time was almost always done. The platelet count was achieved in all patients followed by the activated partial thromboplastin time (94%). No haemorrhagic complication related to a haemostasis disorder was observed in the perioperative period in anaesthesia than in surgery. <b>Conclusion:</b> The prescription of the pre-anesthetic haemostasis assessment should not be systematic. It must take into account the clinical history, the patient’s bleeding history during the anaesthesia consultation, the type of anaesthesia, the surgery planned and the age.
文摘Background: Myanmar’s National Health Plan 2017-2021 set out concrete steps to strengthen the health system on the way to achieving the goal of universal health coverage by 2030. Ensuring these steps include the 7.7 million older adults in Myanmar’s population by 2030 will require novel strategies that improve health and reduce financial burden of health expenditures. An examination of the relationship between social networks and selected health outcomes was undertaken to determine whether these networks can safeguard older adults’ continued contributions to family, society and their own health. Methods: Secondary analysis of a nationally representative study of adults aged 60 years and older. Ordered logistic regression analyses with weighted data were used to examine the relationship between a social network variable and a number of health outcomes. Findings: Stronger social networks were associated with better health outcomes like better memory (OR 1.2), lower reported walking difficulties (OR 0.58), better self-reported health (R 1.15). People with higher social ties were also more like to receive regular assistance and provide care for other household members. Interpretation: Social networks play a role in mediating health outcomes and interactions with the health care systems. Social network interventions should be explored as part of policy mechanisms to ensure universal health coverage for older adults in Myanmar.