Universal Health Coverage: A burning need for developing countries

The term of universal health coverage (UHC) are getting popularity among the countries who have not yet attained it. Majority of the developing countries are planning to implement the UHC to protect the vulnerable citizen who cannot afford to buy the health services. Poor people living in developing countries, where there is no UHC, are bereft of getting equal health care. They have to bear a significant amount of health cost in buying different services which often causes catastrophic expenditures for an individual and a family. If a country can provide UHC, it will be possible to bring all the citizens under provision of equal and quality care. However, implementation of a UHC is not an easy phenomenon, rather it needs proper design of a good health insurance system by integrating both the public and private health care providers. The influence of good governance and a sustainable health financing system is fundamental to establish UHC in the developing countries

Impact of Improved Cooking Stove on Maternal Health in Rural Bangladesh: A Quasi-Experimental Study

Introduction: Two-thirds of all households in developing countries depend on unprocessed biomass fuel for cooking. Traditional stoves have poor combustion capacity which produce heavy smoke and numerous  harmful pollutants. Switching to Improved Cooking Stove (ICS), a well-designed earthen made stove equipped with a chimney could be beneficial for health. The aim of this study was to assess the efficacy of ICS on maternal health in rural areas of Bangladesh. Methods: A quasi-experimental design was adopted to conduct the study. This study selected 150 Households from 5 villages (intervention) and 150 Households from 2 villages (control) from the Manikgonj District of Bangladesh during January 1, 2012 to July 30, 2012. Differences between control and intervention group were examined by applying t-test or one-way analysis of variance (ANOVA). The conventional cut-off value of 0.05 was taken as statistical significance. Stata (version 13) was used to do the analysis. Results: Most of the respondents (62%) were less than 30 years of age. About 94% participants resided in tin-shaded houses, and 51% kitchens were small. After the intervention period, the measured mean concentrations of Particulate Matter (PM2.5) for the intervention and control group was 259 µg/m3 and 1285 µg/m3, respectively (p<0.05). However, lung function test (LFT) did not reveal significant differences between the two groups (p>0.05). Conclusion: ICS reduced the incidence of respiratory illness among the intervention group, however, did not demonstrate significant changes in LFT during the six months of the follow-up period. Therefore, this study found ICS might have the potential to be used to improve the maternal health in rural Bangladesh. However, more longitudinal investigations are expected to demonstrate the efficacy and impact of ICS on maternal health to support the statement

Encrypted Color Image Transmission in LDPC Encoded MIMO Wireless Communication System with implementation of MP-WFRFT based

This paper emphasizes on comprehensive study for the performance evaluation of LDPC encoded MIMO wireless communication system under implementation of MP-WFRFT based physical layer security scheme. The 4 5F4; multi antenna configured simulated system under investigation incorporates LDPC channel coding scheme and various types of modulation (QPSK, DQPSK, and 4-QAM) and signal detection (ZF, MMSE, ZF-SIC and MMSE-SIC) techniques. On considering transmission of encrypted color image in a hostile fading channel, it is noticeable from MATLAB based simulation study that the LDPC channel encoded system is very much robust and effective in retrieving color image under utilization of MMSE-SIC signal detection and 4-QAM digital modulation techniques

Contexts and Opportunities of e-Health Technology in Medical Care

Keeping up with a sound health is a fundamental right for the human beings. It also acts as an indicator of the socio-economic development of a country. However, nowadays keeping sound health is challenging because of rapidly increasing non-communicable diseases. Concurrently, we are on the edge of very fast technological advancement which includes usage of cellular technology, high-speed internet and wireless communications. These technologies and their unique applications are creating lots of new dimensions in health care system which is known as e-Health. The medical call centers, emergency toll-free telephone services are being used in all over the world. The newly developed electronic health system can play a vital role in the remote regions of emerging and developing countries although sometimes it seems difficult due to the lack of communication infrastructure. E-Health can be a promising aspect for providing public health benefits if it integrates with the conventional medical system. More strategic approaches are necessary for the planning, development, and evaluation of e-Health. This article is written to depict the existing and future opportunities of e-Health in health support system

Prevalence of cervical intraepithelial neoplasia and cervical carcinoma in a tertiary care hospital at Rajshahi

Background: Cervical intraepithelial neoplasia (CIN) is a precancerous cervical condition with the potential to develop into cervical carcinoma if untreated. While research on CIN and cervical carcinoma exists in various regions, the Rajshahi area lacks such investigations. Examining the prevalence of CIN and cervical carcinoma in this region is essential. This study aimed to assess the prevalence of CIN and cervical carcinoma in a tertiary care hospital at Rajshahi in Bangladesh. Methods: This cross-sectional descriptive study was conducted at the department of pathology, Rajshahi medical college, and the department of gynaecology and obstetrics, Rajshahi medical college hospital, Rajshahi, Bangladesh from July 2019 to June 2022. A total of 1000 VIA test-positive cases of cervical lesions were enrolled as study subjects purposively. Data were processed and analyzed by the MS office tools. Results: Cervical carcinoma was identified through cytological analysis in 4.6% of cases, with 7.6% exhibiting high-grade squamous intraepithelial lesions (HSIL) and 13.1% showing low-grade squamous intraepithelial lesions (LSIL). Through histopathological analysis, cervical carcinoma found in 5.3% of cases, CIN-grade III (CIN-III) in 7.1%, and CIN-II and CIN-I in 2.2%, 16.4% of cases, respectively. Human papillomavirus (HPV) vaccination rate was 0.70%. Conclusions: The prevalence of CIN and cervical carcinoma in the Rajshahi region of Bangladesh is alarmingly high. These findings underscore the pressing need for the immediate implementation of a comprehensive vaccination and awareness development program for cervical carcinoma

Informality, Poverty and Politics in Urban Bangladesh: An Empirical Study of Dhaka City

Urbanization is one of the inevitable feature in the process of development, but rapid expansion of the urban process in Dhaka city has brought with it incredible transformation of lifestyle. Quality of urban life in Dhaka city has become major aspect of urban political economy. The paper aims at studing to explain the situation of informal sector’s worker’s life condition; explore the relation with the creation of slum because of the rising of informal sector, politics are the cause of the rising of urban chaos and there poverty condition. Most of them settle in slum where extreme poverty exists. They have lack of access to fundamental social service and they are being used by political leader. This study tries to explore the relationship among them. The study has been conducted in Dhaka city which is experiencing rapid urbanization and informalization in recent decades. The study is based on both qualitative and quantitative methodologies. Urban ethnography has been used to conducted informal activities. Keywords: Informality, Poverty, Marginality,Politics, Urban,Bangladesh

An Association of Total Health Expenditure with GDP and Life Expectancy

Introduction: Gradual  total health expenditure (THE) has become a major concern. It is not only the increased THE, but also its unequal growth in  overall economy, found among the developing countries. If increased life expectancy is considered as a leverage for an individual’s investment in health services, it can be  expected that as the life expectancy increases, tendency of health care investment will also experience a boost up. Objective: The aim of the present study was to explore and identify the association of healthcare expenditure with the life expectancy and Gross Domestic Product (GDP) in developing countries, especially that of Bangladesh. Methodology: Data were retrospectively collected from “Health Bulletin 2011” and “Sample Vital Registration System 2010” of Bangladesh considering the fiscal year 1996 to fiscal year 2006. Using STATA, multivariable logistic regression was performed to find out the association of total health expenditure with GDP and life expectancy. Results: A direct relationship between GDP and total health expenditure was found through analysing the data. At the individual level, income  had a direct influence on health spending. However, there was no significant relationship between total health expenditure with increased life expectancy. Conclusion: The present study did not find any association between life expectancy and total health expenditure. However, our analysis found out that total health expenditure is more sensitive to gross domestic product rather than life expectancy

Current status of gonococcal antimicrobial susceptibility with special reference to Azithromycin and Ceftriaxone: report from a tertiary care hospital in Bangladesh

Objectives: Successful treatment of gonorrhea has always been jeopardized by the emergence of resistance to antibiotics recommended as first-line therapies. The present investigation was carried out to demonstrate the current status of antimicrobial susceptibility of N. gonorrhoeae with a special reference to azithromycin and ceftriaxone. Methods: Microscopical detection in Gram-stained smear and isolation by culture in Thayer-Martin medium were done for 60 clinically suspected gonorrhea patients using urethral discharge or prostatic secretion for male and endocervical secretion for female. Isolates of N. gonorrhoeae were subjected to antimicrobial susceptibility testing by modified Kirby Bauer disk diffusion method against eight antimicrobial drugs including azithromycin and ceftriaxone. Results: Culture yielded a total of 25(42%) isolates of N. gonorrhoeae from 60 clinically suspected patients of both sexes; 21 from male (17 from urethral discharge and 04 from prostatic secretion) and 04 from female (endocervical secretion). Isolates of N. gonorrhoeae showed moderate to high resistance (60 to 88%) to penicillin, tetracycline, cotrimoxazole, erythromycin, ciprofloxacin and cefixime. While resistance to azithromycin and ceftriaxone was 60% and 48% respectively, which was also moderate. Conclusion: Our findings indicate moderate to the high resistance of N. gonorrhoeae to conventional antibiotics. It also showed moderate resistance to azithromycin and ceftriaxone, current dual therapy recommended by the WHO for the treatment of genital gonorrhea, which is alarming

Measuring the availability of human resources for health and its relationship to universal health coverage for 204 countries and territories from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: Human resources for health (HRH) include a range of occupations that aim to promote or improve human health. The UN Sustainable Development Goals (SDGs) and the WHO Health Workforce 2030 strategy have drawn attention to the importance of HRH for achieving policy priorities such as universal health coverage (UHC). Although previous research has found substantial global disparities in HRH, the absence of comparable cross-national estimates of existing workforces has hindered efforts to quantify workforce requirements to meet health system goals. We aimed to use comparable and standardised data sources to estimate HRH densities globally, and to examine the relationship between a subset of HRH cadres and UHC effective coverage performance. Methods: Through the International Labour Organization and Global Health Data Exchange databases, we identified 1404 country-years of data from labour force surveys and 69 country-years of census data, with detailed microdata on health-related employment. From the WHO National Health Workforce Accounts, we identified 2950 country-years of data. We mapped data from all occupational coding systems to the International Standard Classification of Occupations 1988 (ISCO-88), allowing for standardised estimation of densities for 16 categories of health workers across the full time series. Using data from 1990 to 2019 for 196 of 204 countries and territories, covering seven Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) super-regions and 21 regions, we applied spatiotemporal Gaussian process regression (ST-GPR) to model HRH densities from 1990 to 2019 for all countries and territories. We used stochastic frontier meta-regression to model the relationship between the UHC effective coverage index and densities for the four categories of health workers enumerated in SDG indicator 3.c.1 pertaining to HRH: physicians, nurses and midwives, dentistry personnel, and pharmaceutical personnel. We identified minimum workforce density thresholds required to meet a specified target of 80 out of 100 on the UHC effective coverage index, and quantified national shortages with respect to those minimum thresholds. Findings: We estimated that, in 2019, the world had 104·0 million (95% uncertainty interval 83·5–128·0) health workers, including 12·8 million (9·7–16·6) physicians, 29·8 million (23·3–37·7) nurses and midwives, 4·6 million (3·6–6·0) dentistry personnel, and 5·2 million (4·0–6·7) pharmaceutical personnel. We calculated a global physician density of 16·7 (12·6–21·6) per 10 000 population, and a nurse and midwife density of 38·6 (30·1–48·8) per 10 000 population. We found the GBD super-regions of sub-Saharan Africa, south Asia, and north Africa and the Middle East had the lowest HRH densities. To reach 80 out of 100 on the UHC effective coverage index, we estimated that, per 10 000 population, at least 20·7 physicians, 70·6 nurses and midwives, 8·2 dentistry personnel, and 9·4 pharmaceutical personnel would be needed. In total, the 2019 national health workforces fell short of these minimum thresholds by 6·4 million physicians, 30·6 million nurses and midwives, 3·3 million dentistry personnel, and 2·9 million pharmaceutical personnel. Interpretation: Considerable expansion of the world's health workforce is needed to achieve high levels of UHC effective coverage. The largest shortages are in low-income settings, highlighting the need for increased financing and coordination to train, employ, and retain human resources in the health sector. Actual HRH shortages might be larger than estimated because minimum thresholds for each cadre of health workers are benchmarked on health systems that most efficiently translate human resources into UHC attainment