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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 18

  1. 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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  2. 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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  3. 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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  4. 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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  5. 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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  6. 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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  7. 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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  8. 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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  9. 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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  10. 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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  11. 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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  12. 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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  13. 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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  14. 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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  15. 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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  16. 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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  17. 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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  18. 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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  19. 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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  20. 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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  21. 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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  22. Content type: Research article

    How people respond to febrile illness is critical to malaria prevention, control, and ultimately elimination. This article explores factors affecting treatment-seeking behaviour for febrile illnesses in a remo...

    Authors: Bipin Adhikari, Koukeo Phommasone, Tiengkham Pongvongsa, Palingnaphone Koummarasy, Xayaphone Soundala, Gisela Henriques, Pasathorn Sirithiranont, Daniel M. Parker, Lorenz von Seidlein, Nicholas J. White, Nicholas P. J. Day, Arjen M. Dondorp, Paul N. Newton, Phaik Yeong Cheah, Christopher Pell and Mayfong Mayxay

    Citation: BMC Health Services Research 2019 19:252

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  23. Content type: Research article

    Health Research Priority Setting (HRPS) in the Ministry of Health (MOH) Malaysia was initiated more than a decade ago to drive effort toward research for informed decision and policy-making. This study assesse...

    Authors: Weng Hong Fun, Sondi Sararaks, Ee Hong Tan, Kar Foong Tang, Diane Woei Quan Chong, Lee Lan Low, Roslinda Abu Sapian, S. Asmaliza Ismail, Suresh Kumar Govind, Siti Haniza Mahmud and Shahnaz Murad

    Citation: BMC Health Services Research 2019 19:248

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  24. 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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  25. 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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  26. 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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  27. Content type: Research article

    No established strategy for household tuberculosis (TB) contact investigation (HTCI) exists in Ethiopia. We implemented integrated, active HTCI model into two hospitals and surrounding community health service...

    Authors: Fana Tefera, Gena Barnabee, Anjali Sharma, Beniam Feleke, Daniel Atnafu, Negasi Haymanot, Gabrielle O’Malley and Getachew Feleke

    Citation: BMC Health Services Research 2019 19:234

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  28. Content type: Research article

    Maternal and neonatal mortality remain high in southern Tanzania despite an increasing number of births occurring in health facilities. In search for reasons for the persistently high mortality rates, we explo...

    Authors: Donat Shamba, Tara Tancred, Claudia Hanson, Juddy Wachira and Fatuma Manzi

    Citation: BMC Health Services Research 2019 19:225

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  29. Content type: Study protocol

    In South Africa, rates of exclusive breastfeeding remain low and breastfeeding promotion is a national health priority. Mobile health and narrative entertainment-education are recognized strategies for health ...

    Authors: Maya Adam, Mark Tomlinson, Ingrid Le Roux, Amnesty E LeFevre, Shannon A McMahon, Jamie Johnston, Angela Kirton, Nokwanele Mbewu, Stacy-Leigh Strydom, Charles Prober and Till Bärnighausen

    Citation: BMC Health Services Research 2019 19:211

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  30. Content type: Research article

    Prevention of mother-to-child transmission (PMTCT) across sub-Saharan Africa has rapidly shifted towards Option B+, an approach in which all HIV+ pregnant and breastfeeding women initiate lifelong antiretrovir...

    Authors: Abby L. DiCarlo, Averie Baird Gachuhi, Simangele Mthethwa-Hleta, Siphesihle Shongwe, Thabo Hlophe, Zachary J. Peters, Allison Zerbe, Landon Myer, Nontokozo Langwenya, Velephi Okello, Ruben Sahabo, Harriet Nuwagaba-Biribonwoha and Elaine J. Abrams

    Citation: BMC Health Services Research 2019 19:210

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  31. Content type: Research article

    The by-pass of the primary level of care to the referral facilities has continued to raise concerns for the healthcare delivery system. About 60–90% of patients in Nigeria are reported to self-refer to a refer...

    Authors: Francis Koce, Gurch Randhawa and Bertha Ochieng

    Citation: BMC Health Services Research 2019 19:209

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  32. Content type: Research article

    Low modern contraceptive prevalence rate and high unmet need in Pakistan aggravates the vulnerabilities of unintended pregnancies and births contributing to maternal morbidity and mortality. This research aims...

    Authors: Moazzam Ali, Syed Khurram Azmat, Hasan Bin Hamza, Md. Mizanur Rahman and Waqas Hameed

    Citation: BMC Health Services Research 2019 19:200

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  33. Content type: Research article

    Ghana’s National Health Insurance Scheme (NHIS) has witnessed an upsurge in enrollment since its inception in 2003, with over 40% of the Ghanaian population actively enrolled in the scheme. While the scheme st...

    Authors: Edward Nketiah-Amponsah, Robert Kaba Alhassan, Samuel Ampaw and Aaron Abuosi

    Citation: BMC Health Services Research 2019 19:196

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  34. Content type: Research article

    We use the ‘candidacy framework’ to describe adolescents’ and young people’s (AYP) experiences of health services in a rural KwaZulu-Natal district, South Africa.

    Authors: Busisiwe Nkosi, Janet Seeley, Nothando Ngwenya, S. Lerato Mchunu, Dumile Gumede, Jane Ferguson and Aoife M. Doyle

    Citation: BMC Health Services Research 2019 19:195

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  35. Content type: Research article

    Despite malaria prevention initiatives, malaria remains a major health problem in Malawi, especially for pregnant mothers and children under the age of five. To reduce the malaria burden, Malawi established it...

    Authors: Chikondi A. Mwendera, Christiaan de Jager, Herbert Longwe, Save Kumwenda, Charles Hongoro, Kamija Phiri and Clifford M. Mutero

    Citation: BMC Health Services Research 2019 19:194

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  36. Content type: Research article

    The shortage of benzathine penicillin G (BPG) worldwide presents a major challenge in the treatment of syphilis. Its availability for syphilis treatment has not been adequately evaluated in China.

    Authors: Xinlong Chen, Guigang Li, Yanling Gan, Tongsheng Chu and Dianchang Liu

    Citation: BMC Health Services Research 2019 19:188

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  37. Content type: Research article

    Trust is regarded as the cornerstone of the doctor-patient relationship in the world of medicine; it determines the decisions patients make when choosing doctors and influences patients’ compliance with recomm...

    Authors: Linni Gu, Jianjun Deng, Huiwen Xu, Shengfa Zhang, Min Gao, Zhiyong Qu, Weijun Zhang and Donghua Tian

    Citation: BMC Health Services Research 2019 19:187

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  38. Content type: Research article

    Access to safe abortion is a globally contested policy and social justice issue – contested because of its religious and moral dimensions regarding the right to life and personhood of a foetus vs. the rights o...

    Authors: Patience Aniteye and Susannah H. Mayhew

    Citation: BMC Health Services Research 2019 19:185

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  39. Content type: Research article

    Family-centered care (FCC), based on collaborative participation of the family along with a team of health care providers, is found to increase the well-being of sick infants in neonatal critical care units. O...

    Authors: Enisha Sarin and Arti Maria

    Citation: BMC Health Services Research 2019 19:184

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  40. Content type: Research article

    Evidence-based clinical algorithms (EBCA) are knowledge tools to promote evidence use by codifying evidence into action plans to facilitate appropriate care. However, their impact on process and outcomes of ca...

    Authors: Lisa M. Puchalski Ritchie, Finot Debebe and Aklilu Azazh

    Citation: BMC Health Services Research 2019 19:181

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  41. Content type: Research article

    The use of maternal health services can markedly promote the maternal health and safety, but there has been a low utilization rate in the ethnic rural areas of western China. Furthermore, the correlated factor...

    Authors: Yuju Wu, Huan Zhou, Qingzhi Wang, Min Cao, Alexis Medina and Scott Rozelle

    Citation: BMC Health Services Research 2019 19:179

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  42. Content type: Research article

    Surgical instrument processing is important for improving the safety of surgical care in hospitals. However, it has been rarely studied to date. Errors in surgical instrument processing may increase operative ...

    Authors: Xiaolian Zhu, Lan Yuan, Tianyi Li and Ping Cheng

    Citation: BMC Health Services Research 2019 19:176

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  43. Content type: Research article

    Health management information system (HMIS) is a system whereby health data are recorded, stored, retrieved and processed to improve decision-making. HMIS data quality should be monitored routinely as producti...

    Authors: Misganu Endriyas, Abraham Alano, Emebet Mekonnen, Sinafikish Ayele, Temesgen Kelaye, Mekonnen Shiferaw, Tebeje Misganaw, Teka Samuel, Tesfahun Hailemariam and Samuel Hailu

    Citation: BMC Health Services Research 2019 19:175

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  44. Content type: Research article

    Evidence from the context of local health ecosystems is highly relevant for research and policymaking to understand geographical variations in outcomes of health care delivery. In mental health systems, the an...

    Authors: Mary Anne Furst, Coralie Gandré, Cristina Romero López-Alberca and Luis Salvador-Carulla

    Citation: BMC Health Services Research 2019 19:173

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  45. Content type: Research article

    Growing understanding of the influence of social determinants of health (SDH) on healthcare costs and outcomes for low income populations is leading State Medicaid agencies to consider incorporating SDH into t...

    Authors: Deena J. Chisolm, Daniel L. Brook, Mary S. Applegate and Kelly J. Kelleher

    Citation: BMC Health Services Research 2019 19:167

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  46. Content type: Research article

    Nepal formulated a range of policies related to maternal and neonatal survival, especially after the year 2000. Nevertheless, Nepal’s perinatal mortality remains high, particularly in disadvantaged regions. Po...

    Authors: Mohan Paudel, Sara Javanparast, Gouranga Dasvarma and Lareen Newman

    Citation: BMC Health Services Research 2019 19:166

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  47. Content type: Research article

    Low- and middle-income countries often lack the fiscal, infrastructural and human resources to conduct evidence-based research; similar constraints may also hinder the application of good clinical practice gui...

    Authors: Ockert Coetzee, Leslie Swartz, Charlotte Capri and Colleen Adnams

    Citation: BMC Health Services Research 2019 19:162

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  48. Content type: Research article

    Tanzania remains among the countries with the highest burden of infectious diseases (notably HIV, Malaria and Tuberculosis) during pregnancy. In response, the country adopted World Health Organization’s (WHO) ...

    Authors: Emmanuel Nene Odjidja, Ghislaine Gatasi and Predrag Duric

    Citation: BMC Health Services Research 2019 19:153

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