Ion Channel-like Crystallographic Signatures in Modified Guanine–Potassium/Sodium Interactions

This communication describes crystallographic details of structures reminiscent of ion channels, formed from regioisomeric N7 and N9 guanine-carboxylate conjugates with potassium/sodium ions and their subsequent STM observations on Au(111) surface. Ion channel-like crystal structures were obtained with the observation of a notable shift in metal ion coordination from carbonyl to carboxylate oxygen. These results are expected to provide insight into competing sites for modified guanine–metal coordination, an entry into guanine-based ion channels and a route toward guanine-functionalized surfaces

Did Equity of Reproductive and Maternal Health Service Coverage Increase during the MDG Era? An Analysis of Trends and Determinants across 74 Low- and Middle-Income Countries

<div><p>Introduction</p><p>Despite widespread gains toward the 5^th Millennium Development Goal (MDG), pro-rich inequalities in reproductive health (RH) and maternal health (MH) are pervasive throughout the world. As countries enter the post-MDG era and strive toward UHC, it will be important to monitor the extent to which countries are achieving equity of RH and MH service coverage. This study explores how equity of service coverage differs across countries, and explores what policy factors are associated with a country’s progress, or lack thereof, toward more equitable RH and MH service coverage.</p><p>Methods</p><p>We used RH and MH service coverage data from Demographic and Health Surveys (DHS) for 74 countries to examine trends in equity between countries and over time from 1990 to 2014. We examined trends in both relative and absolute equity, and measured relative equity using a concentration index of coverage data grouped by wealth quintile. Through multivariate analysis we examined the relative importance of policy factors, such as political commitment to health, governance, and the level of prepayment, in determining countries’ progress toward greater equity in RH and MH service coverage.</p><p>Results</p><p>Relative equity for the coverage of RH and MH services has continually increased across all countries over the past quarter century; however, inequities in coverage persist, in some countries more than others. Multivariate analysis shows that higher education and greater political commitment (measured as the share of government spending allocated to health) were significantly associated with higher equity of service coverage. Neither country income, i.e., GDP per capita, nor better governance were significantly associated with equity.</p><p>Conclusion</p><p>Equity in RH and MH service coverage has improved but varies considerably across countries and over time. Even among the subset of countries that are close to achieving the MDGs, progress made on equity varies considerably across countries. Enduring disparities in access and outcomes underpin mounting support for targeted reforms within the broader context of universal health coverage (UHC).</p></div

Equity of reproductive and maternal health service coverage in Colombia, 1990 to 2010.

<p>CPR = contraceptive prevalence rate. ANC = antenatal care.</p

Distribution of facility delivery coverage in India, by wealth quintile, 1993–2006.

<p>Q1-5 = wealth quintiles from poorest to wealthiest households. CI = concentration index.</p

Maternal mortality ratio vs. equity of facility delivery.

<p>Maternal mortality ratio vs. equity of facility delivery.</p

Distribution of reproductive and maternal health service coverage in Jordan, by wealth quintile, 1990–2012.

<p>(A) Demand met for family planning. (B) Antenatal care. (C) Facility delivery. Q1-5 = wealth quintiles from poorest to wealthiest households. CI = concentration index.</p

Equity of facility delivery coverage in select countries in South and East Asia, 1990–2013.

<p>Equity of facility delivery coverage in select countries in South and East Asia, 1990–2013.</p

Distribution of facility delivery coverage in select countries in Europe and Central Asia, by wealth quintile, 1996–2012.

<p>Q1-5 = wealth quintiles from poorest to wealthiest households. CI = concentration index.</p

Equity of reproductive and maternal health service coverage, full sample of countries, 1990–2013.

<p>Equity of reproductive and maternal health service coverage, full sample of countries, 1990–2013.</p

Equity of facility delivery coverage in Africa, 1990–2013.

<p>Equity of facility delivery coverage in Africa, 1990–2013.</p