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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 19

  1. Content type: Research article

    As lower-income countries look to develop a mature healthcare workforce and to improve quality and reduce costs, they are increasingly turning to quality improvement (QI), a widely-used strategy in higher-inco...

    Authors: Jordan A. Albritton, Bruce Fried, Kavita Singh, Bryan J. Weiner, Bryce Reeve and Jeffrey R. Edwards

    Citation: BMC Health Services Research 2019 19:385

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  2. Content type: Research article

    Infection in healthcare facilities is a major public health problem in most developing countries like Ethiopia. Currently the overall incidence of health care associated infection has been increased and burden...

    Authors: Abera Beyamo, Terefe Dodicho and Wolde Facha

    Citation: BMC Health Services Research 2019 19:381

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  3. Content type: Research article

    Past studies have identified that inconvenient access to health clinics is one of the important barriers to health service utilization and health outcomes. However, establishing the link between the lack of ac...

    Authors: Ryoko Sato

    Citation: BMC Health Services Research 2019 19:377

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  4. Content type: Research article

    Hypertension remains one of the leading causes of death in Nigeria. Appropriate and cost-effective treatment of the disease is necessary to reduce mortality. This study evaluates (i) the prescription patterns ...

    Authors: Onyinye Onyeka Akunne and Aduragbenro Deborah A. Adedapo

    Citation: BMC Health Services Research 2019 19:373

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  5. Content type: Research article

    Hospital accreditation is widely adopted as a visible measure of an organisation’s quality and safety management standards compliance. There is still inconsistent evidence regarding the influence of hospital a...

    Authors: Viera Wardhani, Jitse Pieter van Dijk and Adi Utarini

    Citation: BMC Health Services Research 2019 19:372

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  6. Content type: Research article

    Elder people aged ≥45 years often have more healthcare needs than the younger. But the Chinese elderly are less likely to see a doctor when ill. In this article, this phenomenon is abbreviated as “not see a do...

    Authors: Shangren Qin and Ye Ding

    Citation: BMC Health Services Research 2019 19:365

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  7. Content type: Research article

    Health systems worldwide rely on health professionals to deliver services and provide framework structures. Considering their opinions about their work environment, the public policies that regulate their work...

    Authors: Esteban Ortiz-Prado, Marta Fors, Aquiles R. Henriquez-Trujillo, Gabriel H. Cevallos-Sierra, Alejandra Barreto-Grimaldos, Katherine Simbaña-Rivera, Lenin Gomez-Barreno, Eduardo Vasconez and Alex Lister

    Citation: BMC Health Services Research 2019 19:363

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  8. Content type: Research article

    High medical expenditures serve as a major obstacle for many people trying to access healthcare. Our goals are to provide an updated and comprehensive description of each category of medical expenditure in inp...

    Authors: Chenjin Ma, Yan Jiang, Yang Li, Yuming Zhang, Xiaojun Wang, Shuangge Ma and Yu Wang

    Citation: BMC Health Services Research 2019 19:360

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  9. Content type: Research article

    Homeless women are a highly vulnerable group for risks of pregnancy and childbirth-related complications. They may also face multiple challenges to access and utilize maternity healthcare services. This study ...

    Authors: Hailay Gebreyesus, Abebe Mamo, Mebrahtu Teweldemedhin, Berihu Gidey, Znabu Hdush and Zewdie Birhanu

    Citation: BMC Health Services Research 2019 19:359

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  10. Content type: Research article

    The Republic of Moldova is faced with a high prevalence of non-communicable diseases (NCDs) related to lifestyle and health behavioural factors. Within the frame of the decentralisation reform, the primary hea...

    Authors: Carolyn Blake, Leah F. Bohle, Cristina Rotaru, Natalia Zarbailov, Valeriu Sava, Florence Sécula, Helen Prytherch and Ala Curteanu

    Citation: BMC Health Services Research 2019 19:353

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  11. Content type: Research article

    As a result of financial barriers to the utilization of Maternal and Child Health (MCH) services, the Government of Sierra Leone launched the Free Health Care Initiative (FHCI) in 2010. This study aimed to exa...

    Authors: Mohamed Boie Jalloh, Abdulai Jawo Bah, Peter Bai James, Steven Sevalie, Katrina Hann and Amir Shmueli

    Citation: BMC Health Services Research 2019 19:352

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  12. Content type: Research article

    Expansion of provider-initiated testing and counselling (PITC) is one strategy to increase accessibility of HIV testing services. Insufficient human resources was identified as a primary barrier to increasing ...

    Authors: Aaron F. Bochner, Beth A. Tippett Barr, Batsirai Makunike, Gloria Gonese, Blessing Wazara, Richard Mashapa, Elizabeth Meacham, Ponesai Nyika, Gertrude Ncube, Shirish Balachandra, Ruth Levine, Frances Petracca, Tsitsi Apollo, Ann Downer and Stefan Z. Wiktor

    Citation: BMC Health Services Research 2019 19:351

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  13. Content type: Research article

    Promotion of healthy lifestyle is an important strategy. This study was conducted to determine the effects of counselling on health-promoting lifestyle and quality of life in middle-aged women.

    Authors: Vahideh Karimlou, Sakineh Mohammad-Alizadeh Charandabi, Jamileh Malakouti and Mojgan Mirghafourvand

    Citation: BMC Health Services Research 2019 19:350

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  14. Content type: Research article

    In life time, nearly each person succumbs to some sort of chronic disease and many develop complicated chronic diseases. It is critical to focus on preventive services with a relatively high health impact and ...

    Authors: Netsanet Fetene Wendimagegn and Marthie Bezuidenhout

    Citation: BMC Health Services Research 2019 19:347

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  15. Content type: Research article

    Patient satisfaction is an important factor for both assessing the quality of healthcare and predicting positive health outcomes. This study assesses the influence of HIV/AIDS patients’ perception of the quali...

    Authors: Carlued Leon, Tamar Koosed, Bryn Philibert, Cristina Raposo and Adele Schwartz Benzaken

    Citation: BMC Health Services Research 2019 19:344

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  16. Content type: Research article

    Adherence to antiretroviral therapy (ART) may be influenced by knowledge, perception and perception regarding ART. The purpose of this study was to assess knowledge, attitude/perception and practice regarding ...

    Authors: Mihaja Raberahona, Zinara Lidamahasolo, Johary Andriamamonjisoa, Volatiana Andriananja, Radonirina Lazasoa Andrianasolo, Rivonirina Andry Rakotoarivelo and Mamy Jean de Dieu Randria

    Citation: BMC Health Services Research 2019 19:341

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  17. Content type: Research article

    Nursing and midwifery research activity is an important indicator of the quality of healthcare services and the status of nursing profession. The main aim of this study was to assess the research activity in n...

    Authors: Waleed M. Sweileh, Huda Abu-Saad Huijer, Samah W. Al-Jabi, Sa’ed H. Zyoud and Ansam F. Sawalha

    Citation: BMC Health Services Research 2019 19:340

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  18. Content type: Research article

    Health service and health outcome data collection across many low- and middle-income countries (LMICs) is, to date largely paper-based. With the development and increased availability of reliable technology, e...

    Authors: Fiona M. Dickinson, Mary McCauley, Barbara Madaj and Nynke van den Broek

    Citation: BMC Health Services Research 2019 19:336

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  19. Content type: Research article

    This study aimed to assess on-the-ground barriers to the provision of oxygen therapy for paediatric patients in three government-funded Eastern Ugandan district general hospitals (DGHs).

    Authors: Jonathan W. Dauncey, Peter Olupot-Olupot and Kathryn Maitland

    Citation: BMC Health Services Research 2019 19:335

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  20. Content type: Research article

    Early readmission amongst older safety-net hospitalized adults is costly. Interventions to prevent early readmission have had mixed success. The role of perceived social support is unclear. We examined the ass...

    Authors: Brian Chan, L. Elizabeth Goldman, Urmimala Sarkar, David Guzman, Jeff Critchfield, Somnath Saha and Margot Kushel

    Citation: BMC Health Services Research 2019 19:334

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  21. Content type: Research article

    The overuse of tertiary hospitals and underuse of primary care facilities has been one of the key reasons leading to fast health expenditure increase and health service utilization inequity in China. Recent he...

    Authors: Linxin Liu, Chaojie Liu, Zhanqi Duan, Jingping Pan and Min Yang

    Citation: BMC Health Services Research 2019 19:329

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  22. Content type: Research article

    Prescription connects physician, patient and community pharmacy personnel who can help in understanding prescribing pattern. The present study was aimed to get an insight of viewpoints of all members involved ...

    Authors: Syed Zia Husnain, Nadeem Irfan Bukhari, Khalid Hussain, Zaheer-Ud-Din Babar, Furqan Khurshid Hashmi, Zikria Saleem, Muhammad Salman and Louise Curley

    Citation: BMC Health Services Research 2019 19:328

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  23. Content type: Research article

    Health management information systems (HMIS) are instrumental in addressing health delivery problems and strengthening health sectors by generating credible evidence about the health status of clients. There i...

    Authors: Stephen Ojiambo Wandera, Betty Kwagala, Olivia Nankinga, Patricia Ndugga, Allen Kabagenyi, Bridgit Adamou and Benjamin Kachero

    Citation: BMC Health Services Research 2019 19:327

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  24. Content type: Research article

    Technological advances in health care currently provide better care conditions and have increased survival rates of premature infants, along with increasing the life expectancy of chronically ill children. In ...

    Authors: Antônio José Lana de Carvalho, Hyster Martins Ferreira, Eliza Fernanda Borges, Laerte Honorato Borges Junior, Ana Laura Teodoro de Paula, Wallisen Tadashi Hattori and e Vivian Mara Gonçalves de Oliveira Azevedo

    Citation: BMC Health Services Research 2019 19:324

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  25. Content type: Research article

    Overcrowding of high-level health facilities is a major concern in a Vietnamese health system. This may increase an economic burden to the households since health insurance is still insufficient in providing f...

    Authors: Hwa-Young Lee, Juhwan Oh, Van Minh Hoang, J. Robin Moon and S. V. Subramanian

    Citation: BMC Health Services Research 2019 19:318

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  26. Content type: Research article

    According to the 2016–2017 Tanzania HIV Impact Survey, 55% of men diagnosed with HIV during the survey self-reported that they were unaware of their HIV status. As a response, the Government of Tanzania launch...

    Authors: Donaldson F. Conserve, Jumanne Issango, Andrew M. Kilale, Bernard Njau, Patrick Nhigula, Peter Memiah, Gaspar Mbita, Augustine T. Choko, Akeen Hamilton and Gary King

    Citation: BMC Health Services Research 2019 19:317

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  27. Content type: Research article

    The early initiation of antiretroviral therapy (ART) for people living with HIV (PLWH) benefits both individuals and societies. However, little is known about the intention to initiate ART among PLWH in China ...

    Authors: Qiangsheng He, Xuan Du, Huifang Xu, Lirui Fan, Remina Maimaitijiang, Yanan Wu, Chun Hao, Jinghua Li, Yuantao Hao and Jing Gu

    Citation: BMC Health Services Research 2019 19:314

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  28. Content type: Research article

    Despite the increasing frequency of ARV medicines stock-outs in Sub-Saharan Africa, there is little research inquiring into the mitigation strategies devised by frontline health facilities. Many previous studi...

    Authors: Henry Zakumumpa, Flavia Matovu Kiweewa, Felix Khuluza and Freddy Eric Kitutu

    Citation: BMC Health Services Research 2019 19:312

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  29. Content type: Research article

    Clinical guidelines are systematically proven statements that help physicians to make healthcare decisions for specific medical conditions. Non-adherence to clinical guidelines is believed to contribute signif...

    Authors: Hiba Salah Abdelgadir, Maisa Mustafa Elfadul, Nisreen Haider Hamid and Mounkaila Noma

    Citation: BMC Health Services Research 2019 19:309

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  30. Content type: Research article

    Intra-household dynamics play crucial roles in utilisation of healthcare services for children. We investigated the influence of household relationships on healthcare seeking behaviour for common childhood ill...

    Authors: Joshua O. Akinyemi, Pamela Banda, Nicole De Wet, Adenike E. Akosile and Clifford O. Odimegwu

    Citation: BMC Health Services Research 2019 19:308

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  31. Content type: Research article

    Patients in Yemen commonly visit community pharmacies to obtain consultation or treatment for common ailments. Community pharmacists have an opportunity to optimize medication use and improve patient outcomes....

    Authors: Seena A. Yousuf, Mohammed Alshakka, Wafa F. S. Badulla, Heyam Saad Ali, P. Ravi Shankar and Mohamed Izham Mohamed Ibrahim

    Citation: BMC Health Services Research 2019 19:304

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  32. Content type: Research article

    In general, medical regimens and treatments are more likely to be effective if patients follow their physicians’ advice. However, limited studies have focused on the relationship between regulatory focus and p...

    Authors: Runtong Zhang, Xinyi Lu, Wen Wu and Xiaopu Shang

    Citation: BMC Health Services Research 2019 19:301

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  33. Content type: Research article

    Health literacy is a strong predictor of health status. This study develops and tests a structural equation model to explore the factors that are associated with the health literacy level of rural residents in...

    Authors: Yaofei Xie, Mengdi Ma, Ya’nan Zhang and Xiaodong Tan

    Citation: BMC Health Services Research 2019 19:300

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  34. Content type: Research article

    A variety of antenatal care models have been implemented in low and middle-income countries over the past decades, as proposed by the World Health Organisation (WHO). One such model is the 2001 Focused Antenat...

    Authors: Martina Mchenga, Ronelle Burger and Dieter von Fintel

    Citation: BMC Health Services Research 2019 19:295

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  35. Content type: Research article

    In 2014, Indonesia launched a mandatory national health insurance system called Jaminan Kesehatan Nasional (JKN). The reform introduced new conditions for primary care physicians (PCPs) that could influence th...

    Authors: Chatila Maharani, Desie Frihandini Afief, Dorothea Weber, Michael Marx and Svetla Loukanova

    Citation: BMC Health Services Research 2019 19:290

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  36. Content type: Research article

    In Malawi, as in many low-and middle-income countries, health facility committees (HFCs) are involved in the governance of health services. Little is known about the approaches they use and the challenges they...

    Authors: Elsbet Lodenstein, Joyce M. Molenaar, Christine Ingemann, Kondwani Botha, Jenipher Jere Mkandawire, Loan Liem, Jacqueline E. W. Broerse and Marjolein Dieleman

    Citation: BMC Health Services Research 2019 19:279

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  37. Content type: Research article

    Patient experience with primary health care services can vary markedly between different types of health care facilities, even within the same country setting. Given known benefits of high quality primary heal...

    Authors: Nguyen Thi Hoa, Nguyen Minh Tam, Anselme Derese, Jeffrey F. Markuns and Wim Peersman

    Citation: BMC Health Services Research 2019 19:275

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  38. Content type: Research article

    In order to elicit the knowledge, experience, and attitudes of individuals involved in disaster response with regard to evidence-based best practices, Evidence Aid and its institutional partners, Georgetown Un...

    Authors: Irene Anne Jillson, Michael Clarke, Claire Allen, Stephen Waller, Tracey Koehlmoos, William Mumford, Jeroen Jansen, Keith McKay and Alexandra Trant

    Citation: BMC Health Services Research 2019 19:274

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  39. Content type: Research article

    Quick scaling-up of innovative and promising interventions in health systems of low and middle-income countries to rapidly achieve population level benefits is a key challenge. While there is consensus on the ...

    Authors: Somesh Kumar, Priti Dave, Ashish Srivastava, Jelle Stekelenburg, Dinesh Baswal, Deepti Singh, Bulbul Sood and Vikas Yadav

    Citation: BMC Health Services Research 2019 19:273

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  40. Content type: Research article

    The child health record booklet (CHRB) is a powerful tool for screening children under five and for education of caregivers by health workers. The objective of the present study was to assess the knowledge and...

    Authors: Issahaku Sulley, Abdul-Razak Abizari, Zakari Ali, Wisdom Peprah, Hamshawu Gombilla Yakubu, Wilfred W. Forfoe and Mahama Saaka

    Citation: BMC Health Services Research 2019 19:267

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  41. Content type: Research article

    In developing countries like Uganda, there are shortages of health workers especially medical specialists. The referral process is frustrating to both patients and health workers (HWs). This is due to delays i...

    Authors: Vincent Micheal Kiberu, Richard E. Scott and Maurice Mars

    Citation: BMC Health Services Research 2019 19:266

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  42. Content type: Research article

    Effective referral systems from the community to the health care facility are essential to save lives and ensure quality and a continuum of care. The effectiveness of referral systems in Mozambique depends on ...

    Authors: Celso Give, Sozinho Ndima, Rosalind Steege, Hermen Ormel, Rosalind McCollum, Sally Theobald, Miriam Taegtmeyer, Maryse Kok and Mohsin Sidat

    Citation: BMC Health Services Research 2019 19:263

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  43. Content type: Research article

    There is mounting evidence supporting the effectiveness of task-shifted mental health interventions in low- and middle-income countries (LMIC). However, there has been limited systematic scale-up or sustainabi...

    Authors: E. E. Haroz, P. Bolton, A. J. Nguyen, C. Lee, S. Bogdanov, J. Bass, N. S. Singh, S. B. Doty and L. Murray

    Citation: BMC Health Services Research 2019 19:262

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  44. Content type: Research article

    Good inventory management practices in the health facilities are one of the critical aspects that influence the availability of essential medicines (EMs). This study aimed to assess EMs availability and invent...

    Authors: Adane Teshome Kefale and Hafiza Hayredin Shebo

    Citation: BMC Health Services Research 2019 19:254

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  45. 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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  46. 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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  47. 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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    The Correction to this article has been published in BMC Health Services Research 2019 19:330

  48. 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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