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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.

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  1. Content type: Study protocol

    There is a global drive to promote facility deliveries but unless coupled with concurrent improvement in care quality, it might not translate into mortality reduction for mothers and babies. The World Health O...

    Authors: Alexander Manu, Shams Arifeen, John Williams, Edward Mwasanya, Nabila Zaka, Beth Anne Plowman, Debra Jackson, Priscilla Wobil and Kim Dickson

    Citation: BMC Health Services Research 2018 18:531

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  2. Content type: Research article

    Retail drug shops play a significant role in managing pediatric fevers in rural areas in Uganda. Targeted interventions to improve drug seller practices require understanding of the retail drug shop market and...

    Authors: Chrispus Mayora, Freddy Eric Kitutu, Ngianga-Bakwin Kandala, Elizabeth Ekirapa-Kiracho, Stefan Swartling Peterson and Henry Wamani

    Citation: BMC Health Services Research 2018 18:532

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  3. Content type: Research article

    Irrational use of medicines is widespread in the South-East Asia Region (SEAR), where policy implementation to encourage quality use of medicines (QUM) is often low. The aim was to determine whether public-sec...

    Authors: Kathleen Anne Holloway, Anita Kotwani, Gitanjali Batmanabane, Budiono Santoso, Sauwakon Ratanawijitrasin and David Henry

    Citation: BMC Health Services Research 2018 18:526

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  4. Content type: Research article

    Non-communicable diseases (NCDs) are medical conditions or diseases that are non-transmissible. As NCDs are becoming one of major public health problem, providing local description of diseases and injuries is ...

    Authors: Misganu Endriyas, Emebet Mekonnen, Tadele Dana, Kassa Daka, Tebeje Misganaw, Sinafikish Ayele, Mekonnen Shiferaw, Tigist Tessema and Tewodros Getachew

    Citation: BMC Health Services Research 2018 18:520

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  5. Content type: Study protocol

    Maternal mortality in Nigeria is one of the highest in the world. Access to antenatal care is limited and the quality of services is poor in much of the country. Previous research in Bauchi State found associa...

    Authors: Anne Cockcroft, Khalid Omer, Yagana Gidado, Adamu Ibrahim Gamawa and Neil Andersson

    Citation: BMC Health Services Research 2018 18:510

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  6. Content type: Study protocol

    A large proportion of patients encounter barriers to access and navigation in complex healthcare systems. They are unable to obtain information and services and to take appropriate action to improve their heal...

    Authors: Christine Loignon, Sophie Dupéré, Martin Fortin, Vivian R. Ramsden and Karoline Truchon

    Citation: BMC Health Services Research 2018 18:505

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  7. Content type: Study protocol

    Reduction in neonatal deaths has been a major challenge globally. To prevent neonatal deaths, improvements in newborn care have been promoted worldwide. The World Health Organization Western Pacific Regional O...

    Authors: Sayaka Horiuchi, Sommana Rattana, Bounnack Saysanasongkham, Outhevanh Kounnavongsa, Shogo Kubota, Julie Cayrol, Kenzo Takahashi, Mariko Inoue, Asuka Nemoto and Kazue Yamaoka

    Citation: BMC Health Services Research 2018 18:489

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  8. Content type: Research article

    The length of time between symptom onset and reperfusion therapy in patients with ST-segment elevation acute myocardial infarction (STEMI) is a key determinant of mortality. Information on this delay is scarce...

    Authors: Cézar E. Mesas, Ricardo J. Rodrigues, Arthur E. Mesas, Vivian B. R. Feijó, Lucas M. C. Paraiso, Gabriela F. G. A. Bragatto, Viviane Moron, Marcos H. Bergonso, Laercio Uemura and Cintia Magalhães Carvalho Grion

    Citation: BMC Health Services Research 2018 18:490

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  9. Content type: Research article

    Severe underutilization of healthcare facilities and lack of timely, affordable and effective access to healthcare services in resource-constrained, bottom of pyramid (BoP) settings are well-known issues, whic...

    Authors: Vilius Černauskas, Federica Angeli, Anand Kumar Jaiswal and Milena Pavlova

    Citation: BMC Health Services Research 2018 18:473

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  10. Content type: Research article

    Hypertension is a major risk factor for the global burden of disease, particularly in countries that are not economically developed. This study aimed to evaluate risk factors associated with self-reported hype...

    Authors: Maolin Du, Shaohua Yin, Peiyu Wang, Xuemei Wang, Jing Wu, Mingming Xue, Huiqiu Zheng, Yajun Zhang, Danyan Liang, Ruiqi Wang, Dan Liu, Wei Shu, Xiaoqian Xu, Ruiqi Hao and Shiyuan Li

    Citation: BMC Health Services Research 2018 18:475

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  11. Content type: Research article

    Successful pre-referral treatment with rectal artesunate (RA) for suspected severe malaria requires operational linkages between community health workers (CHWs) and referral facilities, acceptance of pre-refer...

    Authors: C. E. Strachan, A. Nuwa, D. Muhangi, A. P. Okui, M. E. H. Helinski and J. K. Tibenderana

    Citation: BMC Health Services Research 2018 18:470

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  12. Content type: Research article

    Healthcare-associated infections are a major global public health agenda. Health care workers are front line of protecting themselves and clients from infection. This study examined the knowledge and practice ...

    Authors: Melaku Desta, Temesgen Ayenew, Nega Sitotaw, Nibretie Tegegne, Muluken Dires and Mulualem Getie

    Citation: BMC Health Services Research 2018 18:465

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  13. Content type: Research Article

    Employing malaria operational research (MOR) findings in planning national malaria control programmes is gaining increased attention. The malaria control foci are diverse, resources are limited; therefore, agr...

    Authors: Olufemi Ajumobi, Perpetua Uhomoibhi, Pamela Onyiah, Obafemi Babalola, Salami Sharafadeen, Maduka D. Ughasoro, Al-Mukhtar Y. Adamu, Oluwaseun Odeyinka, Taiwo Orimogunje, Ibrahim Maikore, Emmanuel Shekarau, Akintayo Ogunwale, Rotimi Afolabi, Sylvester Udeh, Akpuh Ndubuisi, Ntiense Umoette…

    Citation: BMC Health Services Research 2018 18:459

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  14. Content type: Research article

    Many hospitals in China experience large volumes of emergency department (ED) radiology patients, thereby lengthening the wait times for non-emergency radiology patients. We examine whether an emergency reserv...

    Authors: Li Luo, Yumeng Zhang, Fang Qing, Hongwei Ding, Yingkang Shi and Huili Guo

    Citation: BMC Health Services Research 2018 18:452

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  15. Content type: Research article

    HIV-related stigma among people living with HIV/AIDS (PLWHA) has been associated with many negative consequences, including poor adherence to therapy and undue psychological stress. However, the relative influ...

    Authors: Zhen Li, Jamie P. Morano, Kaveh Khoshnood, Evelyn Hsieh and Yu Sheng

    Citation: BMC Health Services Research 2018 18:453

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  16. Content type: Study protocol

    Postpartum family planning (PPFP) information and services can prevent maternal and child morbidity and mortality in low-resource countries, where high unmet need for PPFP remains despite opportunities offered...

    Authors: Nguyen Toan Tran, Mary Eluned Gaffield, Armando Seuc, Sihem Landoulsi, Wambi Maurice E. Yamaego, Asa Cuzin-Kihl, Seni Kouanda, Blandine Thieba, Désiré Mashinda, Rachel Yodi, James Kiarie and Suzanne Reier

    Citation: BMC Health Services Research 2018 18:439

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  17. Content type: Research article

    Poor communication of medicines information to patients may cause medication errors. We assessed the completeness and readability of dosing instructions provided by pharmacists on dispensing labels and knowled...

    Authors: M. G. C. A. Manchanayake, G. R. W. S. K. Bandara and N. R. Samaranayake

    Citation: BMC Health Services Research 2018 18:425

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  18. Content type: Research article

    There is a paucity of data on the pattern of oral and maxillofacial surgeries done in Nigeria. Despite the rising prominence of oral and maxillofacial surgery as a specialty in our immediate environment, no pu...

    Authors: Adebayo Aremu Ibikunle, Abdurrazaq Olanrewaju Taiwo and Ramat Oyebunmi Braimah

    Citation: BMC Health Services Research 2018 18:416

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  19. Content type: Research article

    While focused antenatal care (ANC) has served as an entry point in the continuum of care for both mothers and children, fewer than a third of pregnant women in the most remote and poorest communities of Zambia...

    Authors: Choolwe Jacobs, Charles Michelo and Mosa Moshabela

    Citation: BMC Health Services Research 2018 18:409

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  20. Content type: Research article

    The African Health Professions Regulatory Collaborative (ARC) was launched in 2011 to support countries in East, Central, and Southern Africa to safely and sustainably expand HIV service delivery by nurses and...

    Authors: Jessica M. Gross, Carey F. McCarthy, Andre R. Verani, Jill Iliffe, Maureen A. Kelley, Kenneth W. Hepburn, Melinda K. Higgins, Alphonce T. Kalula, Agnes N. Waudo and Patricia L. Riley

    Citation: BMC Health Services Research 2018 18:406

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  21. Content type: Research article

    Primary health care plays an important role in addressing the burden of non-communicable diseases (NCDs) in low- and middle-income countries. In light of the rapid urbanization of Vietnam, this study aims to e...

    Authors: Vu Duy Kien, Hoang Van Minh, Kim Bao Giang, Nawi Ng, Viet Nguyen, Le Thanh Tuan and Malin Eriksson

    Citation: BMC Health Services Research 2018 18:392

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  22. Content type: Research article

    Unmet need for contraception results in several health challenges such as unintended pregnancies, unwanted births and unsafe abortions. Most interventions have been unable to successfully address this unmet ne...

    Authors: Adam Silumbwe, Theresa Nkole, Margarate Nzala Munakampe, Cecilia Milford, Joanna Paula Cordero, Yolandie Kriel, Joseph Mumba Zulu and Petrus S. Steyn

    Citation: BMC Health Services Research 2018 18:390

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  23. Content type: Research article

    The World Health Organization (WHO) called for new clinical diagnostic for settings with limited access to laboratory services. Access to diagnostic testing may not be uniform in rural settings, which may resu...

    Authors: T. P. Mashamba-Thompson, B. Sartorius and P. K. Drain

    Citation: BMC Health Services Research 2018 18:380

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  24. Content type: Research article

    While health needs and expenditure in the Occupied Palestinian Territories (OPT) are growing, the international donations are declining and the economic situation is worsening. The purpose of this paper is two...

    Authors: Wasim I. M. Sultan and José Crispim

    Citation: BMC Health Services Research 2018 18:381

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  25. Content type: Research article

    Cervical cancer is the most frequent neoplasm among Kenyan women, with 4800 diagnoses and 2400 deaths per year. One reason is an extremely low rate of screening through pap smears, at 13.8% in 2014. Knowing th...

    Authors: Jennifer Shen, Easter Olwanda, James G. Kahn and Megan J. Huchko

    Citation: BMC Health Services Research 2018 18:378

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  26. Content type: Research article

    Since the late 1990s, contracting has been employed in Cambodia in an attempt to accelerate rural health system recovery and improve health service delivery. Special Operating Agencies (SOA), a form of ‘intern...

    Authors: Sreytouch Vong, Joanna Raven and David Newlands

    Citation: BMC Health Services Research 2018 18:375

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  27. Content type: Research article

    In order to tackle the considerable treatment gap for epilepsy in many low- and middle-income countries (LMICs), a task sharing model is recommended whereby care is integrated into primary health services. How...

    Authors: Raquel Catalao, Tigist Eshetu, Ruth Tsigebrhan, Girmay Medhin, Abebaw Fekadu and Charlotte Hanlon

    Citation: BMC Health Services Research 2018 18:372

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  28. Content type: Research article

    Low use of maternal health services, as well as poor quality care, contribute to the high maternal mortality in sub-Saharan Africa (SSA). In particular, poor person-centered maternity care (PCMC), which captur...

    Authors: Patience A. Afulani, Takudzwa S. Sayi and Dominic Montagu

    Citation: BMC Health Services Research 2018 18:360

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  29. Content type: Research article

    Workplace violence is worrisome in the mental health sector. Little is understood about it in sub-Saharan Africa. Consequently, we decided to investigate the prevalence, related factors, and the available sour...

    Authors: Anthony A. Olashore, Oluyemi O. Akanni and Radiance M. Ogundipe

    Citation: BMC Health Services Research 2018 18:362

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  30. Content type: Research article

    Women with a prior gestational diabetes have an increased lifetime risk of developing type 2 diabetes. Although post-partum follow-up for GDM women is essential to prevent progression to type 2 diabetes, it is...

    Authors: Lorrein Shamiso Muhwava, Katherine Murphy, Christina Zarowsky and Naomi Levitt

    Citation: BMC Health Services Research 2018 18:349

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  31. Content type: Research article

    To explore the nature of the relationship between and factors associated with productivity and performance among the community health volunteer (CHV) cadre (Village Health Teams, VHT) in Busia District, Easter...

    Authors: Naoko Kozuki and Tana Wuliji

    Citation: BMC Health Services Research 2018 18:340

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  32. Content type: Research article

    Chronic disease management (CDM) is an approach to health care that keeps people as healthy as possible through the prevention, early detection and management of chronic diseases. The aim of this study was to ...

    Authors: Eric Maimela, Marianne Alberts, Hilde Bastiaens, Jesicca Fraeyman, Herman Meulemans, Johan Wens and Jeane Pierre Van Geertruyden

    Citation: BMC Health Services Research 2018 18:331

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  33. Content type: Research article

    This project aims to study the use of antibiotics in three clinical wards in the largest tertiary teaching hospital in Ethiopia for a period of 1 year. The specific aims were to assess the prevalence of patien...

    Authors: Girma Gutema, Helle Håkonsen, Ephrem Engidawork and Else-Lydia Toverud

    Citation: BMC Health Services Research 2018 18:326

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  34. Content type: Research article

    Hypertension is a major risk factor for cardiovascular disease, a leading cause of premature death and disability in India. Since access to health services is poor in rural India and Accredited Social Health A...

    Authors: Marwa Abdel-All, Amanda Gay Thrift, Michaela Riddell, Kavumpurathu Raman Thankappan Thankappan, Gomathyamma Krishnakurup Mini, Clara K. Chow, Pallab Kumar Maulik, Ajay Mahal, Rama Guggilla, Kartik Kalyanram, Kamakshi Kartik, Oduru Suresh, Roger George Evans, Brian Oldenburg, Nihal Thomas and Rohina Joshi

    Citation: BMC Health Services Research 2018 18:320

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  35. Content type: Research article

    In contexts with severe physician shortages, the World Health Organization advocates task shifting to cadres with shorter training. To investigate the effects of task shifting at scale in primary health care, ...

    Authors: Manuela Villar Uribe, Olakunle O. Alonge, David M. Bishai and Sara Bennett

    Citation: BMC Health Services Research 2018 18:308

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  36. Content type: Research article

    Zambia is experiencing high prevalence of childhood cancer. However, very few children access and complete treatment for cancer. This study aimed to document the challenges for health care providers, parents a...

    Authors: Mulima Walubita, Bornwell Sikateyo and Joseph M. Zulu

    Citation: BMC Health Services Research 2018 18:314

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  37. Content type: Research article

    There is a paucity of evidence on access to services for mental health and psychosocial support for conflict-affected populations in low- and middle-income countries. In the Republic of Georgia, rates of utili...

    Authors: Adrianna Murphy, Ivdity Chikovani, Maia Uchaneishvili, Nino Makhashvili and Bayard Roberts

    Citation: BMC Health Services Research 2018 18:306

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  38. Content type: Research article

    Patient reported outcomes (PRO) measure the quality of care from the patient’s perspective. PROs are an important measure of surgical outcome and can be used to calculate health gains after surgical treatment....

    Authors: Michelle C. White, Kirsten Randall, Dennis Alcorn, Rachel Greenland, Christine Glasgo and Mark G. Shrime

    Citation: BMC Health Services Research 2018 18:305

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  39. Content type: Research article

    The intertwined relation between public and private care in Brazil is reshaping the medical profession, possibly affecting the distribution and profile of the country’s medical workforce. Physicians’ simultane...

    Authors: Bruno Alonso Miotto, Aline Gil Alves Guilloux, Alex Jones Flores Cassenote, Giulia Marcelino Mainardi, Giuliano Russo and Mário César Scheffer

    Citation: BMC Health Services Research 2018 18:299

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  40. Content type: Research article

    The Missed Opportunities in Maternal and Infant Health (MOMI) project aimed at reducing maternal and newborn mortality and morbidity within the year after childbirth in four sub-Saharan African countries. MOMI in...

    Authors: Danielle Yugbaré Belemsaga, Anne Goujon, Halima Tougri, Abou Coulibaly, Olivier Degomme, Els Duysburgh, Marleen Temmerman and Seni Kouanda

    Citation: BMC Health Services Research 2018 18:298

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  41. Content type: Research article

    The Nigerian Midwives Service Scheme (MSS) increased use of antenatal services at rural public sector clinics. However, it is unclear if women who would not have otherwise sought care, or those who would have ...

    Authors: Daniel O. Erim, Harrison E. Offiong, Christine Kim, Folasade A. Bello, Jeremy Moulton, Stephanie B. Wheeler and Harsha Thirumurthy

    Citation: BMC Health Services Research 2018 18:295

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  42. Content type: Research article

    Out-of-hospital emergency care (OHEC), also known as prehospital care, has been shown to reduce morbidity and mortality from serious illness. We sought to summarize literature for low and low-middle income cou...

    Authors: Antony Gatebe Kironji, Peter Hodkinson, Sarah Stewart de Ramirez, Trisha Anest, Lee Wallis, Junaid Razzak, Alexander Jenson and Bhakti Hansoti

    Citation: BMC Health Services Research 2018 18:291

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  43. Content type: Research article

    Free clinics are volunteer based organizations that provide health care services to low-income individuals for free or minimal cost. Communities served by a free clinic can provide ambulatory care services for...

    Authors: Jenny Hutchison, Michael E. Thompson, Jennifer Troyer, Christine Elnitsky, Maren J. Coffman and M. Lori Thomas

    Citation: BMC Health Services Research 2018 18:280

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  44. Content type: Research article

    Maternal anaemia prevalence in Bihar, India remains high despite government mandated iron supplementation targeting pregnant women. Inadequate supply has been identified as a potential barrier to iron and foli...

    Authors: Amanda S. Wendt, Rob Stephenson, Melissa F. Young, Pankaj Verma, Sridhar Srikantiah, Amy Webb-Girard, Carol J. Hogue, Usha Ramakrishnan and Reynaldo Martorell

    Citation: BMC Health Services Research 2018 18:281

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  45. Content type: Research article

    Neonatal male circumcision (NMC) is an alternative approach to adult male circumcision for HIV prevention. Recent studies found that NMC was rarely performed in Thailand and that most Thai health professionals...

    Authors: Kriengkrai Srithanaviboonchai, Namtip Srirak, Boonlure Pruenglampoo, Kanittha Thaikla, Jiraporn Suwanteerangkul, Jiraporn Khorana, Vipa Danthamrongkul, Suchada Paileeklee, Uraiwan Pattanasattayavong, Deanna E. Grimes and Richard M. Grimes

    Citation: BMC Health Services Research 2018 18:275

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