How efficient are New Zealand's District Health Boards at producing life expectancy gains for Māori and Europeans?

As an open access journal, all articles in ANZJPH will be freely available to read, download and share immediately on publication[EN] Objective: Use data envelopment analysis (DEA) to measure the efficiency of New Zealand’s District Health Boards (DHBs) at achieving gains in Māori and European life expectancy (LE). Methods: Using life tables for 2006 and 2013, a two-output DEA model established the production possibility frontier for Māori and European LE gain. Confidence limits were generated from a 10,000 replicate Monte Carlo simulation. Results: Results support the use of LE change as an indicator of DHB efficiency. DHB mean income and education were related to initial LE but not to its rate of change. LE gains were unrelated to either the initial level of life expectancy or to the proportion of Māori in the population. DHB efficiency ranged from 79% to 100%. Efficiency was significantly correlated with DHB financial performance. Conclusion: Changes in LE did not depend on the social characteristics of the DHB. The statistically significant association between efficiency and financial performance supports its use as an indicator of managerial effectiveness. Implications for Public Health: Efficient health systems achieve better population health outcomes. DEA can be used to measure the relative efficiency of sub-national health authorities at achieving health gain and equity outcomes.Sandiford, P.; Vivas Consuelo, DJJ.; Rouse, P. (2017). How efficient are New Zealand's District Health Boards at producing life expectancy gains for Māori and Europeans?. Australian and New Zealand Journal of Public Health. 41(2):125-129. doi:10.1111/1753-6405.12618S12512941

Corruption Kills: Estimating the Global Impact of Corruption on Children Deaths

BACKGROUND: Information on the global risk factors of children mortality is crucial to guide global efforts to improve survival. Corruption has been previously shown to significantly impact on child mortality. However no recent quantification of its current impact is available. METHODS: The impact of corruption was assessed through crude Pearson's correlation, univariate and multivariate linear models coupling national under-five mortality rates in 2008 to the national "perceived level of corruption" (CPI) and a large set of adjustment variables measured during the same period. FINDINGS: The final multivariable model (adjusted R(2)= 0.89) included the following significant variables: percentage of people with improved sanitation (p.value<0.001), logarithm of total health expenditure (p.value = 0.006), Corruption Perception Index (p.value<0.001), presence of an arid climate on the national territory (p = 0.006), and the dependency ratio (p.value<0.001). A decrease in CPI of one point (i.e. a more important perceived corruption) was associated with an increase in the log of national under-five mortality rate of 0.0644. According to this result, it could be roughly hypothesized that more than 140000 annual children deaths could be indirectly attributed to corruption. INTERPRETATIONS: Global response to children mortality must involve a necessary increase in funds available to develop water and sanitation access and purchase new methods for prevention, management, and treatment of major diseases drawing the global pattern of children deaths. However without paying regard to the anti-corruption mechanisms needed to ensure their proper use, it will also provide further opportunity for corruption. Policies and interventions supported by governments and donors must integrate initiatives that recognise how they are inter-related

Stigma Toward Persons with Intellectual Disability in South America: A Narrative Review

People with intellectual disability (ID) form one of the most underserved/stigmatized groups in society. Published data have documented stigma toward this population group in different countries. However, this phenomenon has received scant attention in South American countries. The aim of this work is to conduct a systematic search of published and gray literature in the area of stigma toward persons with ID within the 12 countries of the region to explore expression of stigma toward people with ID in the region. Systematic research of published data and gray literature, based on a previous published protocol, was run in this work. The search strategy included terms related to IDs being combined with stigma, prejudice, attitudes and stereotypes, and with the names of all the South American countries. Due to the known relationship between ID and Autism Spectrum Disorder, this term was included in the search. The search was conducted in English, Spanish, and Portuguese. A narrative approach to results is presented. Available information is organized by stakeholder groups, including persons with ID, families, caregivers, and mental health workers. The quality of the studies was analyzed based on the Mixed Method Appraisal Tool Version 2018, and results are variable. The results of the narrative review are indicative of the limited scientific study of stigma toward people with ID in South American countries and the clear sense that people with ID living in those countries report experience of stigmatizing attitudes. Future research, at population level, is needed in the region to ensure improvements in the quality of life and in the civil participation of people with ID