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Health systems and services in low and middle income settings

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.

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  1. Nigeria faces an increase in the burden of non-communicable diseases (NCDs), including cardiovascular diseases (CVDs), leading to an estimated 29% of all deaths in the country. Nigeria has an estimated hyperte...

    Authors: Ikechukwu A. Orji, Abigail S. Baldridge, Kasarachi Omitiran, Mainzhao Guo, Whenayon Simeon Ajisegiri, Tunde M. Ojo, Gabriel Shedul, Namratha R. Kandula, Lisa R. Hirschhorn, Mark D. Huffman and Dike B. Ojji

    Citation: BMC Health Services Research 2021 21:322

    Content type: Research article

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  2. Correctional facilities are an underutilized venue for reaching young adults who have not vaccinated for human papillomavirus (HPV). The objective of this study was to identify factors that are associated with...

    Authors: Amanda Emerson, Molly Allison, Lisa Saldana, Patricia J. Kelly and Megha Ramaswamy

    Citation: BMC Health Services Research 2021 21:309

    Content type: Research article

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  3. Rapid spread of COVID-19 forced the public to turn to community pharmacies as the most accessible points of primary healthcare, overloading pharmacy services. The objectives of this research were to detect and...

    Authors: Jelena Jovičić-Bata, Nebojša Pavlović, Nataša Milošević, Neda Gavarić, Svetlana Goločorbin-Kon, Nemanja Todorović and Mladena Lalić-Popović

    Citation: BMC Health Services Research 2021 21:304

    Content type: Research article

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  4. Although donor transitions from HIV programs are more frequent, little research exists seeking to understand the perceptions of patients and providers on this process. Between 2015 and 2017, PEPFAR implemented...

    Authors: Henry Zakumumpa, Ligia Paina, Jess Wilhelm, Freddie Ssengooba, Eric Ssegujja, Moses Mukuru and Sara Bennett

    Citation: BMC Health Services Research 2021 21:302

    Content type: Research article

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  5. Blackpool is one of the most deprived Local Authority (LA) areas in England; in April 2015 the Blackpool Better Start (BBS) Partnership was allocated £45 million over 10 years from the Big Lottery Fund (BLF) a...

    Authors: C. F. Mills, E. Lowrie, K. Kinloch and E. Hall

    Citation: BMC Health Services Research 2021 21:283

    Content type: Research article

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  6. The aim of this study was to identify the range of ways that safety net hospitals (SNHs) have been empirically operationalized in the literature and determine the extent to which patterns could be identified i...

    Authors: Jennifer L. Hefner, Tory Harper Hogan, William Opoku-Agyeman and Nir Menachemi

    Citation: BMC Health Services Research 2021 21:278

    Content type: Research article

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  7. Tanzania’s primary healthcare system suffers from a scarcity of financial and human resources that impedes its effectiveness to deliver dependable and uniform quality healthcare. Adherence to standard treatmen...

    Authors: Karin Wiedenmayer, Eva Ombaka, Baraka Kabudi, Robert Canavan, Sarah Rajkumar, Fiona Chilunda, Selemani Sungi and Manfred Stoermer

    Citation: BMC Health Services Research 2021 21:272

    Content type: Research article

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  8. Studies focusing on the Integrated Management of Childhood Illness (IMCI) program in the Philippines are limited, and perspectives of frontline health care workers (HCWs) are largely absent in relation to the ...

    Authors: Mark Donald C. Reñosa, Kate Bärnighausen, Sarah L. Dalglish, Veronica L. Tallo, Jhoys Landicho-Guevarra, Maria Paz Demonteverde, Carol Malacad, Thea Andrea Bravo, Mary Lorraine Mationg, Socorro Lupisan and Shannon A. McMahon

    Citation: BMC Health Services Research 2021 21:270

    Content type: Research article

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  9. Improving access to radiotherapy services in low and middle-income countries (LMICs) is challenging. Many LMICs’ radiotherapy initiatives fail because of multi-faceted barriers leading to significant wastage o...

    Authors: Andrew Donkor, Tim Luckett, Sanchia Aranda, Verna Vanderpuye and Jane L. Phillips

    Citation: BMC Health Services Research 2021 21:268

    Content type: Research article

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  10. In this study, we sought to assess healthcare professionals’ acceptance of and satisfaction with a shared decision making (SDM) educational workshop, its impact on their intention to use SDM, and their perceiv...

    Authors: Samira Abbasgholizadeh Rahimi, Charo Rodriguez, Jordie Croteau, Alireza Sadeghpour, Amir-Mohammad Navali and France Légaré

    Citation: BMC Health Services Research 2021 21:225

    Content type: Research article

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  11. To improve care for patients with chronic diseases, a recent policy initiative in Thailand focused on strengthening primary care based on the concept of Chronic Care Model (CCM). This study aimed to assess the...

    Authors: Wichai Aekplakorn, Paibul Suriyawongpaisal, Samrit Srithamrongsawadi and Phanuwich Kaewkamjonchai

    Citation: BMC Health Services Research 2021 21:223

    Content type: Research article

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  12. The shortage of healthcare professionals (HCP) negatively affects health services in rural areas in many parts of the world, as is the case in South Africa. Innovative programs designed to improve the recruitm...

    Authors: Dumsani M. Gumede, Myra Taylor and Jane D. Kvalsvig

    Citation: BMC Health Services Research 2021 21:220

    Content type: Research article

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  13. Delays in care-seeking for childhood illness may lead to more severe outcomes. We evaluated whether community distance from a primary healthcare facility was associated with decreased healthcare utilization in...

    Authors: Catherine E. Oldenburg, Ali Sié, Mamadou Ouattara, Mamadou Bountogo, Valentin Boudo, Idrissa Kouanda, Elodie Lebas, Jessica M. Brogdon, Ying Lin, Fanice Nyatigo, Benjamin F. Arnold and Thomas M. Lietman

    Citation: BMC Health Services Research 2021 21:212

    Content type: Research article

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  14. Social enterprises are organizations created to address social problems that use business models to sustain themselves financially. Social enterprises can help increase access to primary health care in low res...

    Authors: Lutfi Lokman and Teresa Chahine

    Citation: BMC Health Services Research 2021 21:211

    Content type: Research article

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  15. Research capacity strengthening could be an indirect outcome of implementing a research project. The objective of this study was to explore the ability of the global maternal sepsis study (GLOSS), implemented ...

    Authors: Rachidatou Compaoré, Vanessa Brizuela, Anne M. Khisa, Alejandra López Gómez, Adama Baguiya, Mercedes Bonet, Anna Thorson, Evelyn Gitau and Seni Kouanda

    Citation: BMC Health Services Research 2021 21:208

    Content type: Research article

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  16. Poor reproductive, maternal, newborn, child, and adolescent health outcomes in Nigeria can be attributed to several factors, not limited to low health service coverage, a lack of quality care, and gender inequ...

    Authors: Chioma Oduenyi, Joya Banerjee, Oniyire Adetiloye, Barbara Rawlins, Ugo Okoli, Bright Orji, Emmanuel Ugwa, Gbenga Ishola and Myra Betron

    Citation: BMC Health Services Research 2021 21:198

    Content type: Research article

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  17. People living with diabetes have an increased risk of developing mental health issues. Mexico has observed a high prevalence of people living with diabetes suffering from mental health issues, such as anxiety ...

    Authors: Benjamín Aceves, Manuel Ruiz, Maia Ingram, Catalina Denman, David O. Garcia, Purnima Madhivanan and Cecilia Rosales

    Citation: BMC Health Services Research 2021 21:177

    Content type: Research article

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  18. The COVID-19 pandemic has posed unprecedented challenges and threats to the health care system, particularly affecting the effective delivery of essential health services in resource-poor countries such as Nep...

    Authors: Devendra Raj Singh, Dev Ram Sunuwar, Sunil Kumar Shah, Kshitij Karki, Lalita Kumari Sah, Bipin Adhikari and Rajeeb Kumar Sah

    Citation: BMC Health Services Research 2021 21:174

    Content type: Research article

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  19. While the nexus of migration and health outcomes is well acknowledged, the effect of rural–urban migration on the use of sexual and reproductive health (SRH) services has received less attention. We assessed t...

    Authors: Mulekya F. Bwambale, Paul Bukuluki, Cheryl A. Moyer and Bart H. W. Van den Borne

    Citation: BMC Health Services Research 2021 21:169

    Content type: Research article

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  20. Several countries including Tanzania, have established voluntary non-profit insurance schemes, commonly known as community-based health insurance schemes (CBHIs), that typically target rural populations and th...

    Authors: Alphoncina Kagaigai, Amani Anaeli, Amani Thomas Mori and Sverre Grepperud

    Citation: BMC Health Services Research 2021 21:162

    Content type: Research article

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  21. Despite health centres being the first point of contact of care, there are challenges faced in providing care to patients at this level. In Malawi, service provision barriers reported at this level included lo...

    Authors: Mtisunge Joshua Gondwe, Marc Y. R. Henrion, Thomasena O’Byrne, Clemens Masesa, Norman Lufesi, Queen Dube, Maureen D. Majamanda, Martha Makwero, David G. Lalloo and Nicola Desmond

    Citation: BMC Health Services Research 2021 21:150

    Content type: Research article

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  22. This paper aims to describe the profile of oral cancer (OC) patients, their risk classification and identify the time between screening and treatment initiation in Rio de Janeiro Municipality.

    Authors: Manoela Garcia Dias da Conceição, Isabel Cristina Martins Emmerick, Ana Claudia Figueiró and Vera Lucia Luiza

    Citation: BMC Health Services Research 2021 21:145

    Content type: Research article

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  23. Solving inequality of health human resource (HHR) is one of the motives of Pakistan health policies, however, there is still exists a massive quantity of HHR inequality in almost every district of Pakistan. Th...

    Authors: Rashed Nawaz, Zhongliang Zhou, Neelum Khalid, Dan Cao, Guanping Liu, Yangling Ren, Dantong Zhao, Yaxin Zhao and Yaru Chen

    Citation: BMC Health Services Research 2021 21:142

    Content type: Research article

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  24. Cardiovascular disease (CVD) is the largest contributor to the non-communicable diseases (NCD) burden in Cameroon, but data on its economic burden is lacking.

    Authors: Leopold Ndemnge Aminde, Anastase Dzudie, Yacouba N. Mapoure, Jacques Cabral Tantchou and J. Lennert Veerman

    Citation: BMC Health Services Research 2021 21:140

    Content type: Research article

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  25. Patients’ non-adherence with medical orders of physicians in outpatient clinics can lead to reduced clinical effectiveness, inadequate treatment, and increased medical care expenses. This study was conducted t...

    Authors: Vahid Yazdi-Feyzabadi, Nouzar Nakhaee, Mohammad Hossein Mehrolhassani, Soheila Naghavi and Enayatollah Homaie Rad

    Citation: BMC Health Services Research 2021 21:136

    Content type: Research article

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  26. Patient satisfaction is one proxy indicator of the health care quality; however, enhancing patient satisfaction in low-income settings is very challenging due to the inadequacy of resources as well as low heal...

    Authors: Mukesh Adhikari, Narendra Raj Paudel, Shiva Raj Mishra, Archana Shrestha and Dipak Prasad Upadhyaya

    Citation: BMC Health Services Research 2021 21:135

    Content type: Research article

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  27. This study aimed to estimate both direct medical and indirect costs of treating the Coronavirus disease 2019 (COVID-19) from a societal perspective in the patients at a referral hospital in Fars province as we...

    Authors: Mohsen Ghaffari Darab, Khosro Keshavarz, Elnaz Sadeghi, Javad Shahmohamadi and Zahra Kavosi

    Citation: BMC Health Services Research 2021 21:132

    Content type: Research article

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  28. In Peru, a majority of individuals bypass primary care facilities even for routine services. Efforts to strengthen primary care must be informed by understanding of current practice. We conducted a time motion...

    Authors: Hannah H. Leslie, Denisse Laos, Cesar Cárcamo, Ricardo Pérez-Cuevas and Patricia J. García

    Citation: BMC Health Services Research 2021 21:123

    Content type: Research article

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  29. Surgery can correct congenital heart defects, but disease management in low- and middle-income countries can be challenging and complex due to a lack of referral system, financial resources, human resources, a...

    Authors: Sugy Choi, Heesu Shin, Jongho Heo, Etsegenet Gedlu, Berhanu Nega, Tamirat Moges, Abebe Bezabih, Jayoung Park and Woong-Han Kim

    Citation: BMC Health Services Research 2021 21:110

    Content type: Research article

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  30. While community care services have been developing rapidly as a new way to meet the growing demands of elderly individuals in China, their health benefits are virtually unknown. Thus, the aim of this study was...

    Authors: Liu Yang, Lijian Wang and Xiuliang Dai

    Citation: BMC Health Services Research 2021 21:106

    Content type: Research article

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  31. Access to health care facilities is a key requirement to enhance safety for mothers and newborns during labour and delivery. Haydom Lutheran Hospital (HLH) is a regional hospital in rural Tanzania with a catch...

    Authors: Corinna Vossius, Estomih Mduma, Robert Moshiro, Paschal Mdoe, Jan Terje Kvaløy, Hussein Kidanto, Sara Lyanga and Hege Ersdal

    Citation: BMC Health Services Research 2021 21:99

    Content type: Research article

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  32. Literature about participation in health and social services suggests that youth, and more specifically Indigenous youth, are difficult to engage within health and social services. Youth are less likely to acc...

    Authors: Sarah Louise Fraser, Louise Moulin, Dominique Gaulin and Jennifer Thompson

    Citation: BMC Health Services Research 2021 21:94

    Content type: Research article

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  33. Non-communicable diseases are leading causes of death and disability across the world. Countries with the highest non-communicable disease (NCD) burden in the WHO European Region are often those that have some...

    Authors: Tiina Laatikainen, Anastasiya Dumcheva, Tetiana Kiriazova, Oleksandr Zeziulin, Laura Inglin, Dylan Collins and Jill Farrington

    Citation: BMC Health Services Research 2021 21:91

    Content type: Research article

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  34. Hand hygiene (HH) among healthcare workers (HCWs) is critical for infection prevention and control (IPC) in healthcare facilities (HCFs). Nonetheless, it remains a challenge in HCFs, largely due to lack of hig...

    Authors: Richard K. Mugambe, Jane Sembuche Mselle, Tonny Ssekamatte, Moses Ntanda, John Bosco Isunju, Solomon T. Wafula, Winnifred K. Kansiime, Prossy Isubikalu, David Ssemwanga, Habib Yakubu and Christine L. Moe

    Citation: BMC Health Services Research 2021 21:88

    Content type: Study protocol

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  35. While millions of women in many African countries have little autonomy in health care decision-making, in most low and middle-income countries, including Ethiopia, it has been poorly studied. Hence, it is impo...

    Authors: Getayeneh Antehunegn Tesema, Yigizie Yeshaw, Ayenew Kasie, Alemneh Mekuriaw Liyew, Achamyeleh Birhanu Teshale and Adugnaw Zeleke Alem

    Citation: BMC Health Services Research 2021 21:74

    Content type: Research article

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  36. Injuries are a major public health problem globally. With sound planning and organization, essential trauma care can be reliably provided with relatively low-cost equipment and supplies. However, availability ...

    Authors: Godfred Boakye, Adam Gyedu, Melissa Stewart, Peter Donkor, Charles Mock and Barclay Stewart

    Citation: BMC Health Services Research 2021 21:66

    Content type: Research article

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  37. Dental care utilization for low income pregnant women is met with challenges in the traditional dentist-centered model of care. County-level measures provide insights for policy and roles for stakeholders that...

    Authors: Mark E. Moss, Andrew Grodner, Ananda P. Dasanayake and Cherry M. Beasley

    Citation: BMC Health Services Research 2021 21:61

    Content type: Research article

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  38. Non-communicable diseases (NCDs) are the dominant cause of global morbidity and mortality, especially in developing countries. Tackling NCDs is central to advancing women’s and child health, and future generat...

    Authors: Firanbon Teshome Gonfa, Yohannes Kebede Lemu and Zewdie Birhanu Koricha

    Citation: BMC Health Services Research 2021 21:56

    Content type: Research article

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  39. Maternal deaths reviews are proposed as one strategy to address high maternal mortality in low and middle-income countries, including Tanzania. Review of maternal deaths relies on comprehensive documentation o...

    Authors: Ali Said, Andrea B. Pembe, Siriel Massawe, Claudia Hanson and Mats Malqvist

    Citation: BMC Health Services Research 2021 21:52

    Content type: Research article

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  40. Accredited Social Health Activists (ASHA) are community health workers responsible for improving the health status of people by facilitating their access to healthcare services. The life skills of ASHA are kno...

    Authors: Shantanu Sharma, Kanishtha Arora, Chandrashekhar, Rajesh Kumar Sinha, Faiyaz Akhtar and Sunil Mehra

    Citation: BMC Health Services Research 2021 21:46

    Content type: Research article

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  41. Inequalities in the use of postnatal care services (PNC) in Ghana have been linked to poor maternal and neonatal health outcomes. This has ignited a genuine concern that PNC interventions with a focus on influ...

    Authors: Emmanuel Dankwah, Cindy Feng, Shelley Kirychuck, Wu Zeng, Rein Lepnurm and Marwa Farag

    Citation: BMC Health Services Research 2021 21:40

    Content type: Research article

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  42. Several factors might contribute to the delay to get cancer care including poor cancer awareness and having barriers to seeking help. This study described these barriers in Gaza and their association with reca...

    Authors: Mohamedraed Elshami, Bettina Bottcher, Mohammed Alkhatib, Iyad Ismail, Khitam Abu-Nemer, Mustafa Hana, Ahmed Qandeel, Ahmed Abdelwahed, Hamza Yazji, Hisham Abuamro, Ghadeer Matar, Ahmed Alsahhar, Ahmed Abolamzi, Obay Baraka, Mahmood Elblbessy, Tahani Samra…

    Citation: BMC Health Services Research 2021 21:28

    Content type: Research article

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  43. Group model building (GMB) is a method to facilitate shared understanding of structures and relationships that determine system behaviors. This project aimed to determine the feasibility of GMB in a resource-l...

    Authors: Fiona Muttalib, Ellis Ballard, Josephine Langton, Sara Malone, Yudy Fonseca, Andreas Hansmann, Kenneth Remy, Peter Hovmand and Allan Doctor

    Citation: BMC Health Services Research 2021 21:26

    Content type: Research article

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  44. In sub-Saharan Africa, there is dearth of trained laboratorians and strengthened laboratory systems to provide adequate and quality laboratory services for enhanced HIV control. In response to this challenge, ...

    Authors: Ritu Shrivastava, Richard Poxon, Erin Rottinghaus, Leyya Essop, Victoria Sanon, Zawadi Chipeta, Elsie van-Schalkwyk, Phuti Sekwadi, Pelagia Murangandi, Shon Nguyen, Josh Devos, Shanna Nesby-Odell, Thomas Stevens, Farouk Umaru, Alex Cox, Andrea Kim…

    Citation: BMC Health Services Research 2021 21:22

    Content type: Research article

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  45. Patients’ participation in decision making regarding their treatment is defined in ethical, legal and human rights standards in the provision of care that concerns health providers and the entire community. Th...

    Authors: Osward Vedasto, Baraka Morris and Francis F. Furia

    Citation: BMC Health Services Research 2021 21:8

    Content type: Research article

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  46. All countries face challenging decisions about healthcare coverage. Malawi has committed to achieving Universal Health Coverage (UHC) by 2030, the timeframe set out by the Sustainable Development Goals (SDGs)....

    Authors: Sarah C. Masefield, Alan Msosa and Jean Grugel

    Citation: BMC Health Services Research 2020 20:1142

    Content type: Research article

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  47. Dispensing errors, known to result in significant patient harm, are preventable if their nature is known and recognized. However, there is a scarcity of such data on dispensing errors particularly in resource ...

    Authors: R. A. N. Dilsha, H. M. I. P. Kularathne, M. T. M. Mujammil, S. M. M. Irshad and N. R. Samaranayake

    Citation: BMC Health Services Research 2020 20:1140

    Content type: Research article

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  48. Training is a common and cost-effective way of trying to improve quality of care in low- and middle-income countries but studies of contextual factors for the successful translation of increased knowledge into...

    Authors: Jesper Kjærgaard, Thomas Nørrelykke Nissen, Elvira Isaeva, Nguyen Nhat Quynh, Susanne Reventlow, Stine Lund, Talant Sooronbaev, Pham Le An, Marianne Stubbe Østergaard, Jim Stout and Anja Poulsen

    Citation: BMC Health Services Research 2020 20:1137

    Content type: Research article

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  49. Despite a recognized need for midwives to provide post abortion care, there exist barriers preventing them from integrating lifesaving skills such as manual vacuum aspiration (MVA) into practice. This collabor...

    Authors: Kirsty M. Bourret, Sylvie Larocque, Amélie Hien, Carol Hogue, Kalum Muray, Aurélie Thethe Lukusa and Abel Minani Ngabo

    Citation: BMC Health Services Research 2020 20:1136

    Content type: Research article

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  50. Chinese government launched a pilot study on public long-term care insurance (LTCI) recently. Guangzhou is one of the fifteen pilot cities, officially started providing LTCI in August 2017. An in-depth analysi...

    Authors: Jialan Wu, Siman Chen, Huangliang Wen, Yayan Yi and Xiaoyan Liao

    Citation: BMC Health Services Research 2020 20:1127

    Content type: Research article

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