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The free healthcare initiative in Sierra Leone: Evaluating a health system reform, 2010‐2015 
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下载免费PDF全文 Sophie Witter Nouria Brikci Tim Harris Richard Williams Sarah Keen Ana Mujica Alex Jones Alex Murray‐Zmijewski Barbara Bale Bailah Leigh Ade Renner 《The International journal of health planning and management》2018,33(2):434-448
This article presents the findings of a theory‐based evaluation of the Sierra Leone Free Health Care Initiative (FHCI), using mixed methods. Analytical approaches included time‐series analysis of national survey data to examine mortality and morbidity trends, as well as modelling of impact using the Lives Saved Tool and expenditure trend analysis. We find that the FHCI responded to a clear need in Sierra Leone, was well designed to bring about needed changes in the health system to deliver services to the target beneficiaries, and did indeed bring funds and momentum to produce important systemic reforms. However, its ambition was also a risk, and weaknesses in implementation have been evident in a number of core areas, such as drugs supply. We conclude that the FHCI was one important factor contributing to improvements in coverage and equity of coverage of essential services for mothers and children. Modelled cost‐effectiveness is high—in the region of US$ 420 to US$ 444 per life year saved. The findings suggest that even—or perhaps especially—in a weak health system, a reform‐like fee removal, if tackled in a systematic way, can bring about important health system gains that benefit vulnerable groups in particular. 相似文献
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Nicolas Bonhoure Ashlee Byrnes Robyn D. Moir Wassim Hodroj Frédéric Preitner Viviane Praz Genevieve Marcelin Streamson C. Chua Jr. Nuria Martinez-Lopez Rajat Singh Norman Moullan Johan Auwerx Gilles Willemin Hardik Shah Kirsten Hartil Bhavapriya Vaitheesvaran Irwin Kurland Nouria Hernandez Ian M. Willis 《Genes & development》2015,29(9):934-947
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Youssouf Kachekouche Madjda Dali-Sahi Djamel Benmansour Nouria Dennouni-Medjati 《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2018,12(3):309-312
Background
Hematological changes affecting blood cells and the coagulation factors are shown to be associated with diabetes mellitus. We investigated some of the hematological risk factors implicated in the development of type 2 diabetes mellitus.Methods
The study conducted in western Algeria on a sample of 1852 subjects, 1059 with type 2 diabetes and 793 witnesses, were evaluated for peripheral blood parameters using hematology analyzer. All the informations related to the disease were collected from the patients and recorded using predesigned questionnaire.Results
The logistic model retained, the mean corpuscular hemoglobin concentration reveals that subjects with concentration over the normal ratio (>36?g/dl) have an exposure risk six and half times higher than subjects with normal concentration (OR?=?6.59; 95% CI?=?2.51–17.31, P?=?0.000). As regards to the platelets blood ratio, subjects with a ratio lower are five times more exposed to type 2 diabetes compared to subjects with a normal ratio (OR?=?5.01; 95% CI?=?1.78–14.13, P?<?0.002). Our logistic model also retained basophils ratio (OR?=?2.18; 95% CI?=?1.35–3.53, P?<?0.001) and sedimentation rate at one hour (OR?=?7.83; 95% CI?=?3.39–18.06, P?=?0.000).Conclusions
Hematological profile associated with type 2 diabetes mellitus retained the mean corpuscular hemoglobin concentration over the normal ratio, lower platelets blood ratio, basophils ratio and sedimentation rate at one hour. 相似文献10.