Linking the Community Health Fund with Accredited Drug Dispensing Outlets in Tanzania: exploring potentials, pitfalls, and modalities

Background: In low- and middle-income countries, too, public-private partnerships in health insurance schemes are crucial for improving access to health services. Problems in the public supply chain of medicines often lead to medicine stock-outs which then negatively influence enrolment in and satisfaction with health insurance schemes. To address this challenge, the government of Tanzania embarked on a redesign of the Community Health Fund (CHF) and established a Prime Vendor System (Jazia PVS). Informal and rural population groups, however, rely heavily on another public-private partnership, the Accredited Drug Dispensing Outlets (ADDOs). This study takes up this public demand and explores the potentials, pitfalls, and modalities for linking the improved CHF (iCHF) with ADDOs. Methods: This was a qualitative exploratory study employing different methods of data collection: in-depth interviews, focus group discussions, and document reviews. Results: Study participants saw a great potential for linking ADDOs with iCHF, following continuous community complaints about medicine stock-out challenges at public health facilities, a situation that also affects the healthcare staff's working environment. The Jazia PVS was said to have improved the situation of medicine availability at public health facilities, although not fully measuring up to the challenge. Study participants thought linking ADDOs with the iCHF would not only improve access to medicine but also increase member enrolment in the scheme. The main pitfalls that may threaten this linkage include the high price of medicines at ADDOs that cannot be accommodated within the iCHF payment model and inadequate digital skills relevant for communication between iCHF and ADDOs. Participants recommended linking ADDOs with the iCHF by piloting the connection with a few ADDOs meeting the selected criteria, while applying similar modalities for linking private retail outlets with the National Health Insurance Fund (NHIF). Conclusions: As the government of Tanzania is moving toward the Single National Health Insurance Fund, there is a great opportunity to link the iCHF with ADDOs, building on established connections between the NHIF and ADDOs and the lessons learnt from the Jazia PVS. This study provides insights into the relevance of expanding public-private partnership in health insurance schemes in low- and middle-income countries

Savings Groups for Social Health Protection: A Social Resilience Study in Rural Tanzania

Global health experts use a health system perspective for research on social health protection. This article argues for a complementary actor perspective, informed by the social resilience framework. It presents a Saving4Health initiative with women groups in rural Tanzania. The participatory qualitative research design yielded new insights into the lived experience of social health protection. The study shows how participation in saving groups increased women's collective and individual capacities to access, combine and transform four capitals. The groups offered a mechanism to save for the annual insurance premium and to obtain health loans for costs not covered by insurance (economic capital). The groups organized around aspirations of mutual support and protection, fostered social responsibility and widened women's interaction arena to peers, government and NGO representatives (social capital). The groups expanded women's horizon by exposing them to new ways of managing financial health risk (cultural capital). The groups strengthened women's social recognition in their family, community and beyond and enabled them to initiate transformative change through advocacy for health insurance (symbolic capital). Savings groups shape the evolving field of social health protection in interaction with governmental and other powerful actors and have further potential for mobilization and transformative change

Soft Resummation of Quark Anomalous Dimensions and Coefficient Functions in MS-bar Factorization

The asymptotic behaviour at large N of the MS-bar quark anomalous dimensions is derived to all orders assuming only MS-bar factorization and standard results for the exponentiation of soft logarithms in the quark initiated bare cross sections for deep inelastic scattering and Drell-Yan. The result is then used to write the MS-bar quark coefficient functions in a form in which all terms of $O(\ln^m N)$ are resummed.Comment: 12 page

La gestión pedagógica y la actualización docente en las instituciones educativas de la red N° 02, Santa Anita, UGEL N° 06 - Ate Vitarte, Lima - 2012

El presente trabajo de investigación tuvo como propósito determinar la relación que existe entre la gestión pedagógica y la actualización docente en las instituciones educativas estatales de la Red educativa N° 02, Santa Anita, UGEL N° 06-Ate Vitarte, Lima. Asimismo, teniendo en cuenta las dimensiones, determinar la relación que existe entre el aspecto metodológico, la planificación curricular y la actividad evaluativa de los aprendizajes con las actualizaciones docentes. La población está conformada por 425 docentes de las instituciones educativas estatales de la Red educativa N° 02, del distrito de Santa Anita, UGEL N° 06, Ate Vitarte, Lima, que laboran durante el 2012. La muestra se obtuvo utilizando la fórmula para variables cualitativas y población conocida, con el cual se determinó el tamaño de la muestra. La muestra es de tipo probabilística aleatoria simple. En la presente investigación se utilizó el método hipotético-deductivo bajo el enfoque cuantitativo. La investigación fue de tipo básica correlacional y comprende un diseño no experimental de corte transversal. Para obtener la información se tomo una muestra de 198 docentes de nueve instituciones educativas, que equivale al 47% de la población y a 425 profesores de las mismas instituciones que constituyen el 100% de la población; como técnica se utilizó la encuesta, con dos cuestionario de 31 y 32 ítems, también hemos utilizado tablas y figuras estadísticos para organizar, presentar e interpretar los resultados obtenidos. Se concluye, los docentes consideran en su mayoría la gestión pedagógica de los directores poco eficiente en cuanto a la actualización docente. Los docentes consideran en su mayoría la planificación curricular, es aspecto metodológico y la actividad evaluativa del aprendizaje poco eficiente. En cuanto la actualización docentes recibidas por gestión del director de la LE donde laboran, respecto a la planificación curricular, el aspecto metodológico y la actividad evaluativa de los aprendizajes en un nivel regular

The impact of the sector of activity and of the region of operation on the competitiveness of the Spanish Agri-Food Industry: a Shift-Share analysis / El impacto del sector de actividad y de la región de actuación sobre la competitividad de la industria agroalimentar española: un analisis Shift-Share

This paper evaluates the potential impact on the competitiveness of the Spanish Agri-Food Industry (AFI) of the economic strength of the two most important territorial factors that impact its development, namely the sector(s) of activity and the region(s) of operation within which each AFI enterprise operates. The importance of studying such topic centers on a two-part rationale, namely (i) the central role played by competitiveness in the survival, growth and profitability of any firm; and (ii) the pivotal position of the AFI within the manufacturing sector, as well as its proximity to the agricultural sector of the economy. The method of analysis adopted for these purposes is based upon the concepts of ? and ? convergence and upon shift-share analysis. As a final conclusion, it may be stated that the territorial development of the AFI does not tend to converge. Hence, it is necessary to study the specific regional and sectorial strategies that have been developed to carry out the competitive position of the AFI.

A cluster randomized controlled cross-over bed net acceptability and preference trial in Solomon Islands: community participation in shaping policy for malaria elimination

Background: A key component of the malaria elimination strategy in Solomon Islands (SI) is widespread coverage of long-lasting insecticidal nets (LLINs). The success of this strategy is dependent on LLIN acceptability and compliance. There has been unresolved debate among policy makers and donors as to which type of LLIN would be most appropriate for large-scale distribution in SI, and anecdotal reports of a lack of acceptability of certain brands of LLINs. A cluster randomized controlled crossover bed net acceptability and preference trial was therefore carried out from July to September, 2008 to inform policy and to facilitate community engagement and participation in the selection of the most appropriate LLIN for use in SI

Strong Coupling Constant from the Photon Structure Function

We extract the value of the strong coupling constant alpha_s from a single-parameter pointlike fit to the photon structure function F_2^gamma at large x and Q^2 and from a first five-parameter full (pointlike and hadronic) fit to the complete F_2^gamma data set taken at PETRA, TRISTAN, and LEP. In next-to-leading order and the MSbar renormalization and factorization schemes, we obtain alpha_s(m_Z)=0.1183 +/- 0.0050(exp.)^+0.0029_-0.0028(theor.) [pointlike] and alpha_s(m_Z)=0.1198 +/- 0.0028(exp.)^+0.0034_-0.0046(theor.) [pointlike and hadronic]. We demonstrate that the data taken at LEP have reduced the experimental error by about a factor of two, so that a competitive determination of alpha_s from F_2^gamma is now possible.Comment: 11 pages, 2 tables, 2 figures. Version accepted for publication by Phys. Rev. Let