Equity of Inpatient Health Care in Rural Tanzania:\ud A Population- and Facility-Based Survey

To explore the equity of utilization of inpatient health care at rural Tanzanian health centers through the use of a short wealth questionnaire.Methods: Patients admitted to four rural health centers in the Kigoma Region of Tanzania from May 2008 to May 2009 were surveyed about their illness, asset ownership and demographics. Principal component analysis was used to compare the wealth of the inpatients to the wealth of the region’s general population, using data from a previous population-based survey. Among inpatients, 15.3% were characterized as the most poor, 19.6% were characterized as very poor, 16.5% were characterized as poor, 18.9% were characterized as less poor, and 29.7% were characterized as the least poor. The wealth distribution of all inpatients (p < 0.0001), obstetric inpatients (p < 0.0001), other inpatients (p < 0.0001), and fee-exempt inpatients (p < 0.001) were significantly different than the wealth distribution in the community population, with poorer patients underrepresented among inpatients. The wealth distribution of pediatric inpatients (p = 0.2242) did not significantly differ from the population at large. The findings indicated that while current Tanzanian health financing policies may have improved access to health care for children under five, additional policies are needed to further close the equity gap, especially for obstetric inpatients.\u

Separatism in Belgium and Possible Variants of Its Development

Розглядається проблема сепаратизму в Бельгії. Аналізуються історичні моменти зародження конфлікту, сучасний стан, а також пропонуються можливі варіанти розвитку конфлікту. Kruk A. P. Separatism in Belgium and Possible Variants of Its Development. We consider the problem of separatism in Belgium. Historical inception of the conflict, the current status is analyzed. Possible variants development of conflict is offered

Separatism as a Threat to the National Security of Belgium

В статті розкрито зміст поняття «сепаратизм», з’ясовано історичні передумови прояву сепаратистських рухів у Бельгії. Проаналізовано сучасний стан сепаратизму як загрози національній безпеці Бельгії.The paper addresses the problem of separatism in Belgium. The concept of «separatism» is defined, clarified the historical background of the manifestation of separatist movements in the country. The current state of the problem

HUT observations of carbon monoxide in the coma of Comet Levy (1990c)

Observations of comet Levy (1990c) were made with the Hopkins Ultraviolet Telescope during the Astro-1 Space Shuttle mission on 10 Dec. 1990. The spectrum, covering the wavelength range 415 to 1850 A at a spectral emission of 3 A (in first order), shows the presence of carbon monoxide and atomic hydrogen, carbon, and sulfur in the coma. Aside from H I Lyman-beta, no cometary features are detected below 1200 A, although cometary O I and O II would be masked by the same emissions present in the day airglow spectrum. The 9.4 x 116 arcsec aperture corresponds to 12,000 x 148,000 km at the comet. The derived production rate of CO relative to water, 0.13 + or - 0.02, compared with the same ratio derived from IUE observations (made in Sep. 1990) which sample a much smaller region of the coma, 0.04 + or - 0.01, suggests the presence of an extended source of CO, as was found in comet Halley. Upper limits on Ne and Ar abundance are within an order of magnitude or solar abundances

FUSE observations of G226-29: First detection of the H_2 quasi-molecular satellite at 1150A

We present new FUV observations of the pulsating DA white dwarf G226-29 obtained with the Far Ultraviolet Spectroscopic Explorer (FUSE). This ZZ Ceti star is the brightest one of its class and the coolest white dwarf observed by FUSE. We report the first detection of the broad quasi-molecular collision-induced satellite of Ly-beta at 1150 A, an absorption feature that is due to transitions which take place during close collisions of hydrogen atoms. The physical interpretation of this feature is based on recent progress of the line broadening theory of the far wing of Ly-beta. This predicted feature had never been observed before, even in laboratory spectra.Comment: Accepted for publication in ApJ Letters; 6 pages, 3 figure

The Belarus Economy: The Challenges of Stalled Reforms. wiiw Research Report No.413

Twenty-five years after the dissolution of the Soviet Union, Belarus stands out as a special case in transition blending, on the one hand, signs of relative prosperity, socially oriented policies and sprouts of entrepreneurships and, on the other hand, remnants of the communist past. The core of the Belarusian economic model throughout most of this period was a combination of external rents and soft budget constraints on the state-owned part of the economy backed by a strong system of administrative control. In periods of favourable external conditions this mix provided for relatively high rates of economic growth and allowed the authorities to maintain a ‘social contract’ with the population targeting close to full employment. But this model also led to the persistent accumulation of a quasi-fiscal deficit which time and again came to the surface, and its subsequent monetisation provoked macroeconomic and currency turmoil. At present, Belarus’ economic model has run up against its limits and policy changes seem inevitable

Equity of inpatient health care in rural Tanzania: a population- and facility-based survey

Abstract Objective To explore the equity of utilization of inpatient health care at rural Tanzanian health centers through the use of a short wealth questionnaire. Methods Patients admitted to four rural health centers in the Kigoma Region of Tanzania from May 2008 to May 2009 were surveyed about their illness, asset ownership and demographics. Principal component analysis was used to compare the wealth of the inpatients to the wealth of the region's general population, using data from a previous population-based survey. Results Among inpatients, 15.3% were characterized as the most poor, 19.6% were characterized as very poor, 16.5% were characterized as poor, 18.9% were characterized as less poor, and 29.7% were characterized as the least poor. The wealth distribution of all inpatients (p < 0.0001), obstetric inpatients (p < 0.0001), other inpatients (p < 0.0001), and fee-exempt inpatients (p < 0.001) were significantly different than the wealth distribution in the community population, with poorer patients underrepresented among inpatients. The wealth distribution of pediatric inpatients (p = 0.2242) did not significantly differ from the population at large. Conclusion The findings indicated that while current Tanzanian health financing policies may have improved access to health care for children under five, additional policies are needed to further close the equity gap, especially for obstetric inpatients.http://deepblue.lib.umich.edu/bitstream/2027.42/112633/1/12939_2011_Article_251.pd

Health service quality in 2929 facilities in six low-income and middle-income countries: a positive deviance analysis

BACKGROUND: Primary care is of insufficient quality in many low-income and middle-income countries. Some health facilities perform better than others despite operating in similar contexts, although the factors that characterise best performance are not well known. Existing best-performance analyses are concentrated in high-income countries and focus on hospitals. We used the positive deviance approach to identify the factors that differentiate best from worst primary care performance among health facilities across six low-resource health systems. METHODS: This positive deviance analysis used nationally representative samples of public and private health facilities from Service Provision Assessments of the Democratic Republic of the Congo, Haiti, Malawi, Nepal, Senegal, and Tanzania. Data were collected starting June 11, 2013, in Malawi and ending Feb 28, 2020, in Senegal. We assessed facility performance through completion of the Good Medical Practice Index (GMPI) of essential clinical actions (eg, taking a thorough history, conducting an adequate physical examination) according to clinical guidelines and measured with direct observations of care. We identified hospitals and clinics in the top decile of performance (defined as best performers) and conducted a quantitative, cross-national positive deviance analysis to compare them with facilities performing below the median (defined as worst performers) and identify facility-level factors that explain the gap between best and worst performance. FINDINGS: We identified 132 best-performing and 664 worst-performing hospitals, and 355 best-performing and 1778 worst-performing clinics based on clinical performance across countries. The mean GMPI score was 0.81 (SD 0.07) for the best-performing hospitals and 0.44 (0.09) for the worst-performing hospitals. Among clinics, mean GMPI scores were 0.75 (0.07) for the best performers and 0.34 (0.10) for the worst performers. High-quality governance, management, and community engagement were associated with best performance compared with worst performance. Private facilities out-performed government-owned hospitals and clinics. INTERPRETATION: Our findings suggest that best-performing health facilities are characterised by good management and leaders who can engage staff and community members. Governments should look to best performers to identify scalable practices and conditions for success that can improve primary care quality overall and decrease quality gaps between health facilities. FUNDING: Bill & Melinda Gates Foundation

CalFUSE v3: A Data-Reduction Pipeline for the Far Ultraviolet Spectroscopic Explorer

Since its launch in 1999, the Far Ultraviolet Spectroscopic Explorer (FUSE) has made over 4600 observations of some 2500 individual targets. The data are reduced by the Principal Investigator team at the Johns Hopkins University and archived at the Multimission Archive at Space Telescope (MAST). The data-reduction software package, called CalFUSE, has evolved considerably over the lifetime of the mission. The entire FUSE data set has recently been reprocessed with CalFUSE v3.2, the latest version of this software. This paper describes CalFUSE v3.2, the instrument calibrations upon which it is based, and the format of the resulting calibrated data files.Comment: To appear in PASP; 29 pages, 13 figures, uses aastex, emulateap