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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: 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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  2. 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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  3. 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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  4. 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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  5. 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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  6. 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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  7. 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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  8. 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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  9. 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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  10. 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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  11. 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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  12. 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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  13. 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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  14. 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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  15. 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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  16. 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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  17. 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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  18. 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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  19. 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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  20. 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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  21. Content type: Research article

    Tanzania is experiencing a severe shortage of human resources for health, which poses a serious threat to the quality of health care services particularly in rural areas. Task shifting has been considered a wa...

    Authors: Edith A. M. Tarimo, Gustav Moyo, Happy Masenga, Paul Magesa and Dafroza Mzava

    Citation: BMC Health Services Research 2018 18:277

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  22. Content type: Research article

    Drug resistance is a growing challenge to tuberculosis (TB) control worldwide, but particularly salient to countries such as Myanmar, where the health system is fragmented across the public and private sector....

    Authors: Sucitro Dwijayana Sidharta, Jason Dean-Chen Yin, Joanne Su-Yin Yoong and Mishal Sameer Khan

    Citation: BMC Health Services Research 2018 18:276

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  23. 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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  24. Content type: Research article

    Tuberculosis (TB) infection control at primary healthcare (PHC) level remains problematic, especially in South Africa. Improvements are significantly dependent on healthcare workers’ (HCWs) behaviours, underwr...

    Authors: Farirai Zinatsa, Michelle Engelbrecht, André Janse van Rensburg and Gladys Kigozi

    Citation: BMC Health Services Research 2018 18:269

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  25. Content type: Research article

    Retention of Human Resources for Health (HRH), particularly doctors at district level is a big challenge facing the decentralized health systems in poorly resourced countries. Tanzania, with 75% of its populat...

    Authors: Nathanael Sirili, Gasto Frumence, Angwara Kiwara, Mughwira Mwangu, Amani Anaeli, Tumaini Nyamhanga, Isabel Goicolea and Anna-Karin Hurtig

    Citation: BMC Health Services Research 2018 18:260

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  26. Content type: Research article

    Early identification and management of mental illness in childhood and adolescence helps to avert debilitating mental illness in adulthood but the attention given to Child and Adolescent Mental Health (CAMH) h...

    Authors: Angela Akol, Karen Marie Moland, Juliet N. Babirye and Ingunn Marie S. Engebretsen

    Citation: BMC Health Services Research 2018 18:258

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  27. Content type: Research article

    The Integrated Disease Surveillance and Response (IDSR) strategy was introduced in Madagascar in 2007. Information was collected by Healthcare structures (HS) on paper forms and transferred to the central leve...

    Authors: Rado Randriamiarana, Grégoire Raminosoa, Nikaria Vonjitsara, Rivo Randrianasolo, Harena Rasamoelina, Harimahefa Razafimandimby, Arthur Lamina Rakotonjanabelo, Richard Lepec, Loïc Flachet and Ariane Halm

    Citation: BMC Health Services Research 2018 18:265

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  28. Content type: Research article

    There is uncertainty about how directly observed treatment (DOT) support for tuberculosis (TB) can be delivered most effectively and how DOT support can simultaneously be used to strengthen human immunodeficie...

    Authors: Embry M. Howell, N. Gladys Kigozi and J. Christo Heunis

    Citation: BMC Health Services Research 2018 18:255

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  29. Content type: Research article

    Clinicians have difficulty accurately assessing medication non-adherence within chronic disease care settings. Health information technology (HIT) could offer novel tools to assess medication adherence in dive...

    Authors: Neda Ratanawongsa, Judy Quan, Margaret A. Handley, Urmimala Sarkar and Dean Schillinger

    Citation: BMC Health Services Research 2018 18:254

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  30. Content type: Research article

    Significant knowledge gaps exist in the functioning of institutional designs and organisational practices in purchasing within free healthcare schemes in low resource countries. The study provides evidence of ...

    Authors: Daniel Chukwuemeka Ogbuabor and Obinna Emmanuel Onwujekwe

    Citation: BMC Health Services Research 2018 18:245

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  31. Content type: Research article

    The 2014 Ebola Virus Disease epidemic evolved in alarming ways in Sierra Leone spreading to all districts. The country struggled to control it against a backdrop of a health system that was already over-burden...

    Authors: Joanna Raven, Haja Wurie and Sophie Witter

    Citation: BMC Health Services Research 2018 18:251

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  32. Content type: Research article

    Delivery of quality healthcare in resource-limited settings is an important, understudied public health priority. Thirty-day (early) hospital readmission is often avoidable and an important indicator of health...

    Authors: Kashmira Satish Chawla, Nora E. Rosenberg, Christopher Stanley, Mitch Matoga, Alice Maluwa, Cecilia Kanyama, Jonathan Ngoma and Mina C. Hosseinipour

    Citation: BMC Health Services Research 2018 18:225

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  33. Content type: Research article

    This study aimed to examine the availability, use, and affordability of medicines in urban China following the 2009 Health Care System Reform that included implementation of universal health coverage (UHC).

    Authors: Yunyu Huang, Youfen Jiang, Luying Zhang, Wenhui Mao, Job F. M. van Boven, Maarten J. Postma and Wen Chen

    Citation: BMC Health Services Research 2018 18:218

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  34. Content type: Research article

    In most health systems, Community Health Workers (CHWs) identify and screen for severe acute malnutrition (SAM) in the community. This study aimed to investigate the potential of integrating SAM identification...

    Authors: J. L. Alvarez Morán, G. B. Franck Alé, P. Charle, N. Sessions, S. Doumbia and S. Guerrero

    Citation: BMC Health Services Research 2018 18:207

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  35. Content type: Research article

    Although depression and alcohol use disorder (AUD) are expected to be common among patients presenting to primary health care setting, there is limited research on prevalence of depression and AUD among people...

    Authors: Nagendra P. Luitel, Emily C. Baron, Brandon A. Kohrt, Ivan H. Komproe and Mark J. D. Jordans

    Citation: BMC Health Services Research 2018 18:215

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  36. Content type: Research article

    Perinatal depression is common in low and middle income countries (LAMICs). Task sharing interventions have been implemented to treat perinatal depression in these settings, as a way of dealing with staff shor...

    Authors: Memory Munodawafa, Sumaya Mall, Crick Lund and Marguerite Schneider

    Citation: BMC Health Services Research 2018 18:205

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  37. Content type: Correspondence

    The purpose of this correspondence is to describe how the positive-deviance approach can be used to translate evidence into practice, based on successive studies conducted in Ethiopia. In earlier studies, it w...

    Authors: Yibeltal Assefa, Peter S. Hill, Helmut Kloos, Gorik Ooms and Wim Van Damme

    Citation: BMC Health Services Research 2018 18:193

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  38. Content type: Research article

    Three-quarters of sub-Saharan Africa’s urban population currently live under slum conditions making them susceptible to ill health and diseases. Ghana characterizes the situation in many developing countries w...

    Authors: Adanna Uloaku Nwameme, Philip Teg-Nefaah Tabong and Philip Baba Adongo

    Citation: BMC Health Services Research 2018 18:186

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  39. Content type: Research article

    Maternal morbidity and mortality is most prevalent in resource-poor settings such as sub-Saharan Africa and southern Asia. In sub-Saharan Africa, Ghana is one of the countries still facing particular challenge...

    Authors: Minerva Kyei-Onanjiri, Mary Carolan-Olah, John Koku Awoonor-Williams and Terence V. McCann

    Citation: BMC Health Services Research 2018 18:184

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  40. Content type: Research article

    The burden of cervical cancer and shortage of screening services in Tanzania confers an urgent need for human papillomavirus (HPV) vaccination. However, the sustainability and impact of another new vaccine cam...

    Authors: Katherine E. Gallagher, Tusajigwe Erio, Kathy Baisley, Shelley Lees and Deborah Watson-Jones

    Citation: BMC Health Services Research 2018 18:173

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  41. Content type: Research article

    Since 2003 Tanzania has upgraded its approximately 7000 drug stores to Accredited Drug Dispensing Outlets (ADDOs), involving dispenser training, introduction of record keeping and enhanced regulation. Prior to...

    Authors: Rebecca Thomson, Boniface Johanes, Charles Festo, Admirabilis Kalolella, Mark Taylor, Sarah Tougher, Yazoume Ye, Andrea Mann, Ruilin Ren, Katia Bruxvoort, Barbara Willey, Fred Arnold, Kara Hanson and Catherine Goodman

    Citation: BMC Health Services Research 2018 18:169

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  42. Content type: Research article

    Substance use is a potentially modifiable risk factor for suicidal behaviour. Little is known about the epidemiology of substance use among self-harm patients in South Africa. This study set out to collect epi...

    Authors: Elsie Breet, Jason Bantjes and Ian Lewis

    Citation: BMC Health Services Research 2018 18:157

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  43. Content type: Research article

    Research has shown that community mobilization is a useful strategy in promoting maternal care of HIV negative women in resource poor settings; however, similar evidence for women living with HIV is missing. T...

    Authors: Choolwe Muzyamba, Wim Groot, Sonila Tomini and Milena Pavlova

    Citation: BMC Health Services Research 2018 18:155

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  44. Content type: Research article

    The first month of life is the period with the highest risk of dying. Despite knowledge of effective interventions, newborn mortality is high and utilization of health care services remains low in Ethiopia. In...

    Authors: Onarheim Kristine Husøy, Sisay Mitike Molla, Gizaw Muluken, Moland Karen Marie, Norheim Ole Frithof and Miljeteig Ingrid

    Citation: BMC Health Services Research 2018 18:153

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  45. Content type: Research article

    Delays in receiving adequate care for children suffering from pneumonia can be life threatening and have been described associated with parents’ limited education and their difficulties in recognizing the seve...

    Authors: Mónica J. Pajuelo, Cynthia Anticona Huaynate, Malena Correa, Holger Mayta Malpartida, Cesar Ramal Asayag, Juan R. Seminario, Robert H. Gilman, Laura Murphy, Richard A. Oberhelman and Valerie A. Paz-Soldan

    Citation: BMC Health Services Research 2018 18:149

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  46. Content type: Research article

    Inadequate antenatal care (ANC) can lead to missed diagnosis of danger signs or delayed referral to emergency obstetrical care, contributing to maternal mortality. In developing countries, ANC quality is often...

    Authors: Anatole Manzi, Laetitia Nyirazinyoye, Joseph Ntaganira, Hema Magge, Evariste Bigirimana, Leoncie Mukanzabikeshimana, Lisa R. Hirschhorn and Bethany Hedt-Gauthier

    Citation: BMC Health Services Research 2018 18:136

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  47. Content type: Research article

    Throughput might be partially responsible for sub-optimum organisational and medical outcomes. The present study examined throughput and the challenges to ensuring optimum throughput in hospitals, and determin...

    Authors: Mandreker Bahall

    Citation: BMC Health Services Research 2018 18:129

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