Right to health in developing countries

Introduction. Maternal health care suffers from sub-optimal performance, client extortion and low quality of care in Bangladesh. Supply side barriers with a synergistic effect on demand side constraints make services inaccessible for poor women living in rural, remote areas.
Theoretical focus. Inspired by Pay-for-performance (P4P) that ties performance with financial incentives, the government implemented two P4P models- Strategy-I incentivized both providers and clients, and Strategy-II only the providers.
Methods. With a quasi-experimental design, interviews with 2,124 exit clients and 473 providers were conducted; monthly service statistics, quarterly quality assurance visit measurements, and auditor’s validation reports were collected for evaluation.
Findings. Institutional deliveries and quality of care score were increased significantly. Overall client satisfaction was highest in strategy-I for providing free medicines and not requiring extra payment. Cost per service unit was US$8. Although overall client satisfaction increased, staff behavior was not improved. Targets could not be set for complications services. Facilities not having minimal staff tend to fail.
Conclusions. The study tested a team based incentive mechanism. Design adjustments are to be made to make providers accountable for their behaviors.

Changes in population dynamics presents new challenges in healthcare of the Latin American population. The region's countries have implemented various policies to improve public health outcomes, especially primary care, lower infant mortality and causes of maternal mortality and largely preventable diseases. In addition to efforts to achieve this, we found several factors associated to political activity, that is, the implementation of programs that can easily translate into visible results and citizen satisfaction with government actions. These efforts to maintain the equilibrium in social cohesion have, in some Countries of Latin America, interesting paradoxes in terms of the expected effects on the results. This essay addresses some of the factors that affect infant and maternal mortality in the region, through principal components and cluster analysis, as well as some aspects related to the perception of the population health services. We developed an index of availability of services and risk factors for health. Also, we make a comparison with the ranking made by PAHO which discusses some of the advances in health policies based on access and other variables that allow us to get closer to understanding the fundamental social factors of health.

The present study investigates the mental health needs of refugee women who survived politically motivated torture and identified barriers to professional counseling services in a community located in Southwestern Ontario, Canada. This community-based pilot study (N = 20) adopted both quantitative and qualitative research components to enhance the validity and coherence of the information generated. The results showed that the torture survivors currently experienced clinically significant symptoms of anxiety, depression, and Post Traumatic Stress Disorders (PTSD) based on the DSM-IV criteria. In addition, the torture survivors identified (a) lasting and harmful effects of torture on their daily lives, (b) socio-economic-cultural barriers to mental health services, and (c) detrimental effects of torture on family relationships. The alternative treatment approach was further discussed of the recommendations for practice and policy.

How effective the floating population of basic medical protection, which is the research aiming to.According to the definition of factors ,this paper set the evaluation dimensions of the medical insurance as satisfaction, identity, Primary health care institutions and policy, expecting to demonstrate the current situation and basic connotation of medical insurance of floating people:the 4 dimensions, namely satisfaction, identity, Primary health care institutions and policy, are used as the first-class index of the evaluation system.
In this article, construct three models about the influencing factors on the level of migrant medical social insurance, gradually taking into consideration of the personal characteristic variables, the participate of basic social insurance as well as utilization of community clinic variables. There are difference between willingness and behavior in floating people.
In floating population there is a willingness to enjoy primary health services in urban areas, and there are different needs depending on the different income. There are difference between willingness and behavior in floating people.Floating population lack medical coverage in basic health protection.

The contentious issue of induced abortion has been a major stumbling block in the promotion of women's reproductive and sexual health and rights around the world. In Islamic societies the debates about the secular and religious dimensions of pregnancy termination have referenced a number of schools of Islamic law and teachings. In this paper we compare Iran, the largest Shi'ite society, and Indonesia, the largest Sunni society and largest national population of Muslims in the world, to identify the dimensions and dynamics of the debates over abortion. Both countries display differences of opinion among clerics and some confusion about the place of secular law in regulating the medical practice of abortion. It is difficult to analyze the demographic dimensions of abortions rates, ratios and trends, without valid and reliable data and many of the parliamentary and religious debates are thus riven with misinformation. Demographic techniques to calculate numbers of abortions in each country have failed to achieve valid or reliable estimates. It appears that the main determinants of local policies arise from a general sense of propriety and morality rather than any specific religious doctrines specific to the two streams of Islam. Women's rights are constrained by primordial culture entwined with Islamic legal arguments.

The need to integrate TB and HIV control programmes has become critical due to their interface at the clinical level and the need for optimal use of resources. In developing countries such as Ghana where public health interventions depend on donor funds, such calls have become more urgent than ever. But, its implementation depends on attitudes of implementers. This paper explores the views of stakeholders on tuberculosis and HIV integration in Ghana. Using a qualitative data collection approach, respondents were purposively selected from four regions with the highest reported tuberculosis cases. Two general views emerged: support for and opposition to integration. Supporters argued on shared clinical and social constructions and reducing financial and functional duplications. Those opposed cited increased workload, clinical complications, leadership crisis, and “smaller the better” arguments. Although a policy for TB/HIV integration exists, lack of clarity of direction and unwillingness of some programme managers to collaborate have resulted in disjointed health care for co-infected patients. Underlying the debate is an unspoken unwillingness of implementers to cede some or all-institutional “autonomy” for active, broad-based planning, implementation, monitoring and evaluation of programmatic goals.

Female circumcision is a practice which dated as far back as ancient Egypt and which is still rampant nowadays. The reasons given to justify this are numerous. The preservation of the virginity of the woman until marriage and the respect of the religions and customs of peoples are some of the reasons which make this practice common. This study has allowed us to highlight two key factors in the practice of female circumcision. These are religion and ethnicity. These two factors are also correlated. The Muslim religion has emerged as one in which the proportion of circumcised women is the highest which is not the case among Christians and animists. In the Southern Mande ethnic group, female circumcision is very common. These people are also very much in favor of female circumcision. On the other hand, the Akan people who are predominantly Christian are less likely to circumcise their daughters and have a low prevalence of circumcised females. Although there is a link between religion and the practice of circumcision, the search for reasons to justify this practice has proven otherwise. Thus, circumcision is not tied to religion, but rather to traditions that persist within different ethnic groups.

Client satisfaction occupies an intermediate step in establishing healthy culture for evaluation of an ongoing programme on HIV/AIDS. However, in India (one of the country where world’s highest number of persons living with HIV/AIDS resides) information on HIV/AIDS client satisfaction is almost non-existent. A qualitative study was carried out to explore issues of client satisfaction in relation to HIV/AIDS counselling services. In-depth interviews were carried out among the (22) counsellors and seven FGDs were carried out among the HIV positive group of male, female and transgender population. The study finds a clear distinction between the clients’ need according to their gender role. Female clients used to seem more satisfied after receiving the counselling services than other. The need for information on HIV/AIDS among the clients was universal among all the clients. All male clients felt satisfied, when counsellors used to clear their doubts and confusion about HIV/AIDS. Maintaining privacy was crucial for making male clients satisfied. Female clients were keen for receiving emotional support and medical treatment. Social acceptance was given highest priority by the transgender clients. The study suggests that to meet the HIV/AIDS clients’ expectations and needs gender specific counselling needs to be practiced.

Despite Nigeria’s abundant physical and human resource endowments, the economic growth rate has been as slow (0.1 %, 1965-1996). This is due in part to the improper harmonization of demographic characteristics of the population and the physical resources. For instance high fertility rate can lead to rapid population growth and high proportion of the youth in a population. Resource allocations for the different sectors of the economic become limited and thus slow the rate of economic development. Apparently, controlling population growth rate, as echoed by the United Nation, is necessary for any economy to development.
Investing in the human resource particularly adolescent reproductive health needs is not only a right but crucial for any meaningful economic development.
Information from sources like the Nigerian Demographic and Health Survey and other sources revealed that adolescents are now giving birth before the age of 18 years thus contributing to an annual population growth rate of 3.2%. This scenario imposes an unsustainable burden on the health care There is a need to demystify sex education and include it in school based programmes. This will help to discourage unprotected sex, lower fertility and eventual slowing the rapid population growth delivery and slow economic development.

While the number of parents migrating to seek jobs elsewhere leaving young children in the care of others has been common, little is known about the positive or negative consequences for children. This study uses both bivariate and multivariate analyses to examine the impact of parental out-migration on the health of children left behind. Data were derived from “Migration and Health, Kanchanaburi Demographic Surveillance System (KDSS), 2007, Thailand”. A total of 11,241 children were the study population.

The study found that 14.5% of children had either one or both migrant parents in the Kanchanaburi study area. One out of four children (25%) had an incidence of illness. A significantly higher percentage of children whose mother, father or both had migrated had an illness compared to those whose parent(s) were not migrants. Several individual, household, and community factors were significantly associated with children’s health. Multivariate analysis suggests that parental out-migration in poor households is independently associated with a higher likelihood of an illness. The findings also suggest that strategies to alleviate the negative impact of parental migration as well as to maintain and enhance the well-being of families, especially among the children left behind in poor households, are warranted.