‘I know my rights, but am I better off?’: institutions and disability in Uganda

Uganda is internationally recognised for both its legal and constitutional provisions for people with disabilities, and the presence of disabled persons’ organisations that provide informal advocacy and support. Using a unique dataset of 579 Ugandans with physical disabilities, we develop a conceptual framework on social capital to investigate the factors correlated with knowledge of formal institutions that target disability. In examining whether this knowledge results in higher incomes we find that gender matters. A woman’s education and membership of external networks are correlates of knowledge; higher levels of this knowledge are associated with substantially higher levels of income

Challenges of future multimedia QoE monitoring for internet service providers

The ever-increasing network traffic and user expectations at reduced cost make the delivery of high Quality of Experience (QoE) for multimedia services more vital than ever in the eyes of Internet Service Providers (ISPs). Real-time quality monitoring, with a focus on the user, has become essential as the first step in cost-effective provisioning of high quality services. With the recent changes in the perception of user privacy, the rising level of application-layer encryption and the introduction and deployment of virtualized networks, QoE monitoring solutions need to be adapted to the fast changing Internet landscape. In this contribution, we provide an overview of state-of-the-art quality monitoring models and probing technologies, and highlight the major challenges ISPs have to face when they want to ensure high service quality for their customers

Increasing Access to Surgical Services in Sub-Saharan Africa: Priorities for National and International Agencies Recommended by the Bellagio Essential Surgery Group

In this Policy Forum, the Bellagio Essential Surgery Group, which was formed to advocate for increased access to surgery in Africa, recommends four priority areas for national and international agencies to target in order to address the surgical burden of disease in sub-Saharan Africa

Multimorbidity-associated emergency hospital admissions: a “screen and link” strategy to improve outcomes for high-risk patients in sub-Saharan Africa: a prospective multicentre cohort study protocol

Background The prevalence of multimorbidity (the presence of two or more chronic health conditions) is rapidly increasing in sub–Saharan Africa. Hospital care pathways that focus on single presenting complaints do not address this pressing problem. This has the potential to precipitate frequent hospital readmissions, increase health system and out-of-pocket expenses, and may lead to premature disability and death. We aim to present a description of inpatient multimorbidity in a multicentre prospective cohort study in Malawi and Tanzania. Primary objectives Clinical: Determine prevalence of multimorbid disease among adult medical admissions and measure patient outcomes. Health Economic: Measure economic costs incurred and changes in health-related quality of life (HRQoL) at 90 days post-admission. Situation analysis: Qualitatively describe pathways of patients with multimorbidity through the health system. Secondary objectives Clinical: Determine hospital readmission free survival and markers of disease control 90 days after admission. Health Economic: Present economic costs from patient and health system perspective, sub-analyse costs and HRQoL according to presence of different diseases. Situation analysis: Understand health literacy related to their own diseases and experience of care for patients with multimorbidity and their caregivers. Methods This is a prospective longitudinal cohort study of adult (≥18 years) acute medical hospital admissions with nested health economic and situation analysis in four hospitals: 1) Queen Elizabeth Central Hospital, Blantyre, Malawi; 2) Chiradzulu District Hospital, Malawi; 3) Hai District Hospital, Boma Ng’ombe, Tanzania; 4) Muhimbili National Hospital, Dar-es-Salaam, Tanzania. Follow-up duration will be 90 days from hospital admission. We will use consecutive recruitment within 24 hours of emergency presentation and stratified recruitment across four sites. We will use point-of-care tests to refine estimates of disease pathology. We will conduct qualitative interviews with patients, caregivers, healthcare providers and policymakers; focus group discussions with patients and caregivers, and observations of hospital care pathways

Inequalities creating economic barriers to owning mobile phones in India

In India, men own around 70% of mobile phones, creating a gender digital divide for the most widely owned information and communication technology (ICT) in the world. This study investigates the factors responsible for the inability of 245 female slum-dwellers in India earning less than $2 a day to own a mobile phone. Open, axial and selective coding of survey responses shows that socio-cultural, economic, demographic, psychological, communication-related, and health related inequalities in the lives of the respondents create eight economic barriers precluding respondents from owning some of the least expensive mobile phones worth$15 or so on installments of $1 a month