BMC Health Services Research
(Accessed 29 August 2015)
Perspectives of health care providers on the provision of intermittent preventive treatment in pregnancy in health facilities in Malawi
P. Yoder, Xavier Nsabagasani, Erin Eckert, Allisyn Moran, Yazoumé Yé
BMC Health Services Research 2015, 15:354 (29 August 2015)
Estimating the cost of referral and willingness to pay for referral to higher-level health facilities: a case series study from an integrated community case management programme in Uganda
Agnes Nanyonjo, Benson Bagorogoza, Frida Kasteng, Godfrey Ayebale, Fredrick Makumbi, Göran Tomson, Karin Källander, for the inSCALE study group
BMC Health Services Research 2015, 15:347 (28 August 2015)
Risk factors for delay in age-appropriate vaccinations among Gambian children
Aderonke Odutola, Muhammed Afolabi, Ezra Ogundare, Yamu Lowe-Jallow, Archibald Worwui, Joseph Okebe, Martin Ota
BMC Health Services Research 2015, 15:346 (28 August 2015)
Vaccination has been shown to reduce mortality and morbidity due to vaccine-preventable diseases. However, these diseases are still responsible for majority of childhood deaths worldwide especially in the developing countries. This may be due to low vaccine coverage or delay in receipt of age-appropriate vaccines. We studied the timeliness of routine vaccinations among children aged 12–59 months attending infant welfare clinics in semi-urban areas of The Gambia, a country with high vaccine coverage.
A cross-sectional survey was conducted in four health centres in the Western Region of the Gambia. Vaccination dates were obtained from health cards and timeliness assessed based on the recommended age ranges for BCG (birth–8 weeks), Diphtheria-Pertussis–Tetanus (6 weeks–4 months; 10 weeks–5 months; 14 weeks–6 months) and measles vaccines (38 weeks–12 months). Risk factors for delay in age-appropriate vaccinations were determined using logistic regression. Analysis was limited to BCG, third dose of Diphtheria-Pertussis -Tetanus (DPT3) and measles vaccines.
Vaccination records of 1154 children were studied. Overall, 63.3 % (95 % CI 60.6–66.1 %) of the children had a delay in the recommended time to receiving at least one of the studied vaccines. The proportion of children with delayed vaccinations increased from BCG [5.8 % (95 % CI 4.5–7.0 %)] to DPT3 [60.4 % (95 % CI 57.9 %-63.0 %)] but was comparatively low for the measles vaccine [10.8 % (95 % CI 9.1 %–12.5 %)]. Mothers of affected children gave reasons for the delay, and their profile correlated with type of occupation, place of birth and mode of transportation to the health facilities.
Despite high vaccination coverage reported in The Gambia, a significant proportion of the children’s vaccines were delayed for reasons related to health services as well as profile of mothers. These findings are likely to obtain in several countries and should be addressed by programme managers in order to improve and optimize the impact of the immunization coverage rates.
A survey of the availability, prices and affordability of essential medicines in Jiangsu Province, China
Xiaoyu Xi, Weixia Li, Jun Li, Xuan Zhu, Cong Fu, Xu Wei, Shuzhen Chu
BMC Health Services Research 2015, 15:345 (27 August 2015)
Field surveys conducted in China before the implementation of the essential medicine policy showed that Chinese individuals faced less access to essential medicines. This paper aims to evaluate the availability, prices and affordability of essential medicines in Jiangsu Province, China after the implementation of the policy in 2009.
A cross-sectional survey was conducted in Jiangsu in 2013 using the World Health Organization/Health Action International (WHO/HAI) methodology. Data on the availability and prices of 50 essential medicines were collected from the public and private healthcare sectors.
The mean availabilities of innovator brands and lowest priced generics (LPGs) were 11.5 % and 100 % in primary healthcare facilities, 36.8 % and 32.6 % in the secondary and tertiary sectors, and 18.7 % and 42.9 % in the private sector, respectively. The median price ratios (MPRs) were 1.26 to 2.05 for generics and 3.76 to 27.22 for innovator brands. Treating ten common diseases with LPGs was generally affordable, whereas treatment with IBs was less affordable.
The high availability of LPGs at primary healthcare facilities reflects the success of the essential medicine policy, while the low availability in secondary and tertiary levels and in private pharmacies reflects a failure to implement the policy in these levels. The health policy should be fully developed and enforced at the secondary and tertiary levels and in the private sector to ensure equitable access to health services.
Community-level effect of the reproductive health vouchers program on out-of-pocket spending on family planning and safe motherhood services in Kenya
Francis Obare, Charlotte Warren, Lucy Kanya, Timothy Abuya, Ben Bellows
BMC Health Services Research 2015, 15:343 (25 August 2015)