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Health systems and services in low and middle income settings

Section edited by Dina Balabanova, Hengjin Dong, David Hotchkiss and Kaspar Wyss 

This section aims to publish research on health systems and services with a focus on research relevant to low and middle income settings as defined by The World Bank.

Page 1 of 18

  1. Content type: Study protocol

    Uganda is experiencing a shift in major causes of death with cases of stroke, heart attack, and heart failure reportedly on the rise. In a study in Mukono and Buikwe in Uganda, more than one in four adults wer...

    Authors: Geofrey Musinguzi, Rhoda K. Wanyenze, Rawlance Ndejjo, Isaac Ssinabulya, Harm van Marwijk, Isaac Ddumba, Hilde Bastiaens and Fred Nuwaha

    Citation: BMC Health Services Research 2019 19:253

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  2. Content type: Research article

    How people respond to febrile illness is critical to malaria prevention, control, and ultimately elimination. This article explores factors affecting treatment-seeking behaviour for febrile illnesses in a remo...

    Authors: Bipin Adhikari, Koukeo Phommasone, Tiengkham Pongvongsa, Palingnaphone Koummarasy, Xayaphone Soundala, Gisela Henriques, Pasathorn Sirithiranont, Daniel M. Parker, Lorenz von Seidlein, Nicholas J. White, Nicholas P. J. Day, Arjen M. Dondorp, Paul N. Newton, Phaik Yeong Cheah, Christopher Pell and Mayfong Mayxay

    Citation: BMC Health Services Research 2019 19:252

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  3. Content type: Research article

    Health Research Priority Setting (HRPS) in the Ministry of Health (MOH) Malaysia was initiated more than a decade ago to drive effort toward research for informed decision and policy-making. This study assesse...

    Authors: Weng Hong Fun, Sondi Sararaks, Ee Hong Tan, Kar Foong Tang, Diane Woei Quan Chong, Lee Lan Low, Roslinda Abu Sapian, S. Asmaliza Ismail, Suresh Kumar Govind, Siti Haniza Mahmud and Shahnaz Murad

    Citation: BMC Health Services Research 2019 19:248

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  4. Content type: Research article

    The mass scale-up of antiretroviral therapy (ART) in Zambia has taken place in the context of limited infrastructure and human resources resulting in many operational side-effects. In this study, we aimed to e...

    Authors: Radhika P. Tampi, Taniya Tembo, Mpande Mukumba-Mwenechanya, Anjali Sharma, David W. Dowdy, Charles B. Holmes, Carolyn Bolton-Moore, Izukanji Sikazwe, Austin Tucker and Hojoon Sohn

    Citation: BMC Health Services Research 2019 19:244

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  5. Content type: Research article

    Shortage of specialized healthcare volunteers is a major challenge during disasters and one solution could be pre-identified healthcare volunteers. This study aimed to develop a conceptual model of managing Ir...

    Authors: Ibrahim Salmani, Hesam Seyedin, Ali Ardalan and Tahmineh Farajkhoda

    Citation: BMC Health Services Research 2019 19:241

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  6. Content type: Research article

    Clinical decisions depend on timely laboratory result reporting. The timeliness is commonly expressed in turnaround time and serves as a quality improvement tool to assess the effectiveness and efficiency of t...

    Authors: Melashu Balew Shiferaw and Gizachew Yismaw

    Citation: BMC Health Services Research 2019 19:240

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  7. Content type: Research article

    No established strategy for household tuberculosis (TB) contact investigation (HTCI) exists in Ethiopia. We implemented integrated, active HTCI model into two hospitals and surrounding community health service...

    Authors: Fana Tefera, Gena Barnabee, Anjali Sharma, Beniam Feleke, Daniel Atnafu, Negasi Haymanot, Gabrielle O’Malley and Getachew Feleke

    Citation: BMC Health Services Research 2019 19:234

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  8. Content type: Research article

    Maternal and neonatal mortality remain high in southern Tanzania despite an increasing number of births occurring in health facilities. In search for reasons for the persistently high mortality rates, we explo...

    Authors: Donat Shamba, Tara Tancred, Claudia Hanson, Juddy Wachira and Fatuma Manzi

    Citation: BMC Health Services Research 2019 19:225

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  9. Content type: Study protocol

    In South Africa, rates of exclusive breastfeeding remain low and breastfeeding promotion is a national health priority. Mobile health and narrative entertainment-education are recognized strategies for health ...

    Authors: Maya Adam, Mark Tomlinson, Ingrid Le Roux, Amnesty E LeFevre, Shannon A McMahon, Jamie Johnston, Angela Kirton, Nokwanele Mbewu, Stacy-Leigh Strydom, Charles Prober and Till Bärnighausen

    Citation: BMC Health Services Research 2019 19:211

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  10. Content type: Research article

    Prevention of mother-to-child transmission (PMTCT) across sub-Saharan Africa has rapidly shifted towards Option B+, an approach in which all HIV+ pregnant and breastfeeding women initiate lifelong antiretrovir...

    Authors: Abby L. DiCarlo, Averie Baird Gachuhi, Simangele Mthethwa-Hleta, Siphesihle Shongwe, Thabo Hlophe, Zachary J. Peters, Allison Zerbe, Landon Myer, Nontokozo Langwenya, Velephi Okello, Ruben Sahabo, Harriet Nuwagaba-Biribonwoha and Elaine J. Abrams

    Citation: BMC Health Services Research 2019 19:210

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  11. Content type: Research article

    The by-pass of the primary level of care to the referral facilities has continued to raise concerns for the healthcare delivery system. About 60–90% of patients in Nigeria are reported to self-refer to a refer...

    Authors: Francis Koce, Gurch Randhawa and Bertha Ochieng

    Citation: BMC Health Services Research 2019 19:209

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  12. Content type: Research article

    Low modern contraceptive prevalence rate and high unmet need in Pakistan aggravates the vulnerabilities of unintended pregnancies and births contributing to maternal morbidity and mortality. This research aims...

    Authors: Moazzam Ali, Syed Khurram Azmat, Hasan Bin Hamza, Md. Mizanur Rahman and Waqas Hameed

    Citation: BMC Health Services Research 2019 19:200

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  13. Content type: Research article

    Ghana’s National Health Insurance Scheme (NHIS) has witnessed an upsurge in enrollment since its inception in 2003, with over 40% of the Ghanaian population actively enrolled in the scheme. While the scheme st...

    Authors: Edward Nketiah-Amponsah, Robert Kaba Alhassan, Samuel Ampaw and Aaron Abuosi

    Citation: BMC Health Services Research 2019 19:196

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  14. Content type: Research article

    We use the ‘candidacy framework’ to describe adolescents’ and young people’s (AYP) experiences of health services in a rural KwaZulu-Natal district, South Africa.

    Authors: Busisiwe Nkosi, Janet Seeley, Nothando Ngwenya, S. Lerato Mchunu, Dumile Gumede, Jane Ferguson and Aoife M. Doyle

    Citation: BMC Health Services Research 2019 19:195

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  15. Content type: Research article

    Despite malaria prevention initiatives, malaria remains a major health problem in Malawi, especially for pregnant mothers and children under the age of five. To reduce the malaria burden, Malawi established it...

    Authors: Chikondi A. Mwendera, Christiaan de Jager, Herbert Longwe, Save Kumwenda, Charles Hongoro, Kamija Phiri and Clifford M. Mutero

    Citation: BMC Health Services Research 2019 19:194

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  16. Content type: Research article

    The shortage of benzathine penicillin G (BPG) worldwide presents a major challenge in the treatment of syphilis. Its availability for syphilis treatment has not been adequately evaluated in China.

    Authors: Xinlong Chen, Guigang Li, Yanling Gan, Tongsheng Chu and Dianchang Liu

    Citation: BMC Health Services Research 2019 19:188

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  17. Content type: Research article

    Trust is regarded as the cornerstone of the doctor-patient relationship in the world of medicine; it determines the decisions patients make when choosing doctors and influences patients’ compliance with recomm...

    Authors: Linni Gu, Jianjun Deng, Huiwen Xu, Shengfa Zhang, Min Gao, Zhiyong Qu, Weijun Zhang and Donghua Tian

    Citation: BMC Health Services Research 2019 19:187

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  18. Content type: Research article

    Access to safe abortion is a globally contested policy and social justice issue – contested because of its religious and moral dimensions regarding the right to life and personhood of a foetus vs. the rights o...

    Authors: Patience Aniteye and Susannah H. Mayhew

    Citation: BMC Health Services Research 2019 19:185

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  19. Content type: Research article

    Family-centered care (FCC), based on collaborative participation of the family along with a team of health care providers, is found to increase the well-being of sick infants in neonatal critical care units. O...

    Authors: Enisha Sarin and Arti Maria

    Citation: BMC Health Services Research 2019 19:184

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  20. Content type: Research article

    Evidence-based clinical algorithms (EBCA) are knowledge tools to promote evidence use by codifying evidence into action plans to facilitate appropriate care. However, their impact on process and outcomes of ca...

    Authors: Lisa M. Puchalski Ritchie, Finot Debebe and Aklilu Azazh

    Citation: BMC Health Services Research 2019 19:181

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  21. Content type: Research article

    The use of maternal health services can markedly promote the maternal health and safety, but there has been a low utilization rate in the ethnic rural areas of western China. Furthermore, the correlated factor...

    Authors: Yuju Wu, Huan Zhou, Qingzhi Wang, Min Cao, Alexis Medina and Scott Rozelle

    Citation: BMC Health Services Research 2019 19:179

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  22. Content type: Research article

    Surgical instrument processing is important for improving the safety of surgical care in hospitals. However, it has been rarely studied to date. Errors in surgical instrument processing may increase operative ...

    Authors: Xiaolian Zhu, Lan Yuan, Tianyi Li and Ping Cheng

    Citation: BMC Health Services Research 2019 19:176

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  23. Content type: Research article

    Health management information system (HMIS) is a system whereby health data are recorded, stored, retrieved and processed to improve decision-making. HMIS data quality should be monitored routinely as producti...

    Authors: Misganu Endriyas, Abraham Alano, Emebet Mekonnen, Sinafikish Ayele, Temesgen Kelaye, Mekonnen Shiferaw, Tebeje Misganaw, Teka Samuel, Tesfahun Hailemariam and Samuel Hailu

    Citation: BMC Health Services Research 2019 19:175

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  24. Content type: Research article

    Evidence from the context of local health ecosystems is highly relevant for research and policymaking to understand geographical variations in outcomes of health care delivery. In mental health systems, the an...

    Authors: Mary Anne Furst, Coralie Gandré, Cristina Romero López-Alberca and Luis Salvador-Carulla

    Citation: BMC Health Services Research 2019 19:173

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  25. Content type: Research article

    Growing understanding of the influence of social determinants of health (SDH) on healthcare costs and outcomes for low income populations is leading State Medicaid agencies to consider incorporating SDH into t...

    Authors: Deena J. Chisolm, Daniel L. Brook, Mary S. Applegate and Kelly J. Kelleher

    Citation: BMC Health Services Research 2019 19:167

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  26. Content type: Research article

    Nepal formulated a range of policies related to maternal and neonatal survival, especially after the year 2000. Nevertheless, Nepal’s perinatal mortality remains high, particularly in disadvantaged regions. Po...

    Authors: Mohan Paudel, Sara Javanparast, Gouranga Dasvarma and Lareen Newman

    Citation: BMC Health Services Research 2019 19:166

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  27. Content type: Research article

    Low- and middle-income countries often lack the fiscal, infrastructural and human resources to conduct evidence-based research; similar constraints may also hinder the application of good clinical practice gui...

    Authors: Ockert Coetzee, Leslie Swartz, Charlotte Capri and Colleen Adnams

    Citation: BMC Health Services Research 2019 19:162

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  28. Content type: Research article

    Tanzania remains among the countries with the highest burden of infectious diseases (notably HIV, Malaria and Tuberculosis) during pregnancy. In response, the country adopted World Health Organization’s (WHO) ...

    Authors: Emmanuel Nene Odjidja, Ghislaine Gatasi and Predrag Duric

    Citation: BMC Health Services Research 2019 19:153

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  29. Content type: Research article

    Of the estimated 130,000 children living with HIV in Uganda, 47% are receiving ART. Only 39.3% have suppressed HIV-1 viral load to levels below 50 copies per ml. Caregivers are key drivers of adherence to achi...

    Authors: Esther Nasuuna, Joanita Kigozi, Patience A. Muwanguzi, Joyce Babirye, Laura Kiwala, Alex Muganzi, Nelson Sewankambo and Damalie Nakanjako

    Citation: BMC Health Services Research 2019 19:150

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  30. Content type: Research article

    While local context costing evidence is relevant for healthcare planning, budgeting and cost-effectiveness analysis, it continues to be scarce in Ethiopia. This study assesses the cost of providing a preventio...

    Authors: Elias Asfaw Zegeye, Josue Mbonigaba, Sylvia Kaye and Benjamin Johns

    Citation: BMC Health Services Research 2019 19:148

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  31. Content type: Research article

    Many countries are facing overlapping epidemics of tuberculosis (TB) and diabetes mellitus (DM). Diabetes increases the overall risk of developing Tuberculosis (TB) and contributes to adverse treatment outcome...

    Authors: Mashal S. Basir, Shifa S. Habib, Syed M.A. Zaidi, Saira Khowaja, Hamidah Hussain, Rashida A. Ferrand and Aamir J. Khan

    Citation: BMC Health Services Research 2019 19:147

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  32. Content type: Research article

    Many countries, including China, have identified the primary health care system as a reform priority. The purpose of this study is to compare the perceived service capacity of primary care from the perspective...

    Authors: Wenjuan Tao, Wenqi Zeng, Ling Yan, Huazhen Yang, Jin Wen and Weimin Li

    Citation: BMC Health Services Research 2019 19:143

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  33. Content type: Research article

    Auxiliary Midwives (AMWs) are unpaid volunteer health workers assisting qualified paid midwives in maternal and child health care mainly in hard-to-reach areas of Myanmar. This paper describes the relationship...

    Authors: Kyu Kyu Than, Stanley Luchters, Khaing Nwe Tin, Thazin La, James Beeson and Alison Morgan

    Citation: BMC Health Services Research 2019 19:138

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  34. Content type: Research article

    The government of Mongolia mandates free access to primary healthcare (PHC) for its citizens. However, no evidence is available on the physical presence of PHC services within health facilities. Thus, the pres...

    Authors: Altantuya Jigjidsuren, Tumurbat Byambaa, Enkhjargal Altangerel, Suvd Batbaatar, Yu Mon Saw, Tetsuyoshi Kariya, Eiko Yamamoto and Nobuyuki Hamajima

    Citation: BMC Health Services Research 2019 19:129

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  35. Content type: Research article

    Standards represent benchmarks against which improvements can be measured. In 2016, the Federal Ministry of Health developed and endorsed a set of standards entitled the Ethiopian Health Center Reform Implemen...

    Authors: Mesele Damte Argaw, Binyam Fekadu Desta, Temesgen Ayehu Bele and Abebe Dagnew Ayne

    Citation: BMC Health Services Research 2019 19:127

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  36. Content type: Research article

    The incidence of inappropriate admissions in China has become the shackle of its’ service supply system. This research aims to assess the level of children’s inappropriate admissions to county hospitals in rur...

    Authors: Shi-han Lei, Yan Zhang, Hao-miao Li, Dai Su, Jing-jing Chang, Xiao-mei Hu, Qing Ye, Di Jiang and Ying-chun Chen

    Citation: BMC Health Services Research 2019 19:126

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  37. Content type: Research article

    Accurate measurement of CD4 cell counts remains an important tenet of clinical care for people living with HIV. We assessed an instrument-free point-of-care CD4 test (VISITECT® CD4) based on a lateral flow pri...

    Authors: Fiona Scorgie, Yasmin Mohamed, David Anderson, Suzanne M. Crowe, Stanley Luchters and Matthew F. Chersich

    Citation: BMC Health Services Research 2019 19:123

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  38. Content type: Research article

    Data on nurses’ adherence to standard protocol on nasogastric (NG) tube feeding remain scanty in Ghana even though patients in critical medical conditions are routinely managed using this procedure. This study...

    Authors: Robert Kaba Alhassan, Richard Tsikata, Richard Naatu Tizaawaw, Prince Asante Tannor, Perpetual Praba Quaw, Cecilia Aba Ata Awortwi, Martin Amogre Ayanore, Agani Afaya, Solomon Mohammed Salia, Japiong Milipaak and Prudence Portia Mwini-Nyaledzigbor

    Citation: BMC Health Services Research 2019 19:119

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  39. Content type: Research article

    The Integrated Disease Surveillance and Response (IDSR) strategy was adopted as the framework for implementation of International Health Regulation (2005) in the African region of World Health Organisation (WH...

    Authors: Lydia Nakiire, Ben Masiira, Christine Kihembo, Edson Katushabe, Nasan Natseri, Immaculate Nabukenya, Innocent Komakech, Issa Makumbi, Okot Charles, Francis Adatu, Miriam Nanyunja, Peter Nsubuga, Solomon Fisseha Woldetsadik, Patrick Tusiime, Ali Ahmed Yahaya, Ibrahima Socé Fall…

    Citation: BMC Health Services Research 2019 19:117

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  40. Content type: Research article

    Evidence-based decision on drug list or formulary has been applied worldwide. Although the importance of scientific evidence was emphasized, the decision-making procedures for including medicines into the nati...

    Authors: Wenbin Liu, Lizheng Shi, Monika Sawhney, Xiaoli Gu and Yingyao Chen

    Citation: BMC Health Services Research 2019 19:112

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  41. Content type: Research article

    The continuous migration of Human Resources for Health (HRH) compromises the quality of health services in the developing supplying countries. The ability to increase earnings potentially serves as a strong mo...

    Authors: Gavin George, Bruce Rhodes and Christine Laptiste

    Citation: BMC Health Services Research 2019 19:109

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  42. Content type: Research article

    The appropriate use of the Partograph allows early identification of labour related complications and prevents deaths. We, therefore, sought to determine the level of Partograph completion and healthcare worke...

    Authors: John Mukisa, Isha Grant, Jonathan Magala, Andrew S. Ssemata, Patrick Z. Lumala and Josaphat Byamugisha

    Citation: BMC Health Services Research 2019 19:107

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  43. Content type: Research article

    Little is known about operative volume, distribution of cases, or capacity of the public sector to deliver essential surgical services in Uganda.

    Authors: Katherine Albutt, Maria Punchak, Peter Kayima, Didacus B. Namanya and Mark G. Shrime

    Citation: BMC Health Services Research 2019 19:104

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  44. Content type: Research article

    In 2014, the Joint United Nations Program on HIV/AIDS (UNAIDS) set out a treatment target with the objective to help end the AIDS epidemic by 2030. This was supported by the UNAIDS ’90-90-90’ target that by 20...

    Authors: Vincent Adjetey, Dorcas Obiri-Yeboah and Bernard Dornoo

    Citation: BMC Health Services Research 2019 19:95

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  45. Content type: Research article

    Tobacco use and alcohol abuse are associated with higher risk of tuberculosis (TB) infection, progression to active TB and adverse treatment outcomes among patients with TB. Revised National Tuberculosis Contr...

    Authors: Nagendra Navya, Kathiresan Jeyashree, Akshaya Kibballi Madhukeshwar, Tanu Anand, Abhay Subashrao Nirgude, Badarudeen Mohammad Nayarmoole and Petros Isaakidis

    Citation: BMC Health Services Research 2019 19:90

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  46. Content type: Research article

    WhatsApp (WA) is the most recent and attractive applicative among Smartphone users. The use of WA in healthcare environment has been shown of multiple benefices. Mozambique team involved in 2017 bed nets unive...

    Authors: Jorge A. H. Arroz, Baltazar Neves Candrinho, Figueiredo Mussambala, Marta Chande, Chandana Mendis, Sónia Dias and Maria do Rosário O. Martins

    Citation: BMC Health Services Research 2019 19:86

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  47. Content type: Research article

    The increasing cost on healthcare exposes China’s healthcare budgets and system to financial crisis. To control the excessive growth of healthcare expenditure, China’s healthcare reforms emphasize the control ...

    Authors: Jianzhou Yan, Hui-Heng Lin, Dan Zhao, Yuanjia Hu and Rong Shao

    Citation: BMC Health Services Research 2019 19:84

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