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Rethinking Strategies to Address inequity in Immunization Services towards Achieving Universal Immunization Coverage (UIC) in Karachi, Pakistan

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World Journal of Vaccines 2021年第4期11卷 39-49页

作者： Iqbal Hossain Tariq Masood Akram Sultan Rana Safdar Hamidreza Setayesh Lora Shimp Soofia Younus Immunization Center JSI Arlington VA USA JSI Karachi Pakistan EPI Karachi Pakistan EPI Islamabad Pakistan Gavi Geneva Switzerland

Karachi, the largest city in Pakistan, having high population growth and a complex health care environment, has highest density of unimmunized (zero dose) and under-immunized children. The main reasons of low immunization coverage in Karachi were lack of governance and accountability in a duplicative and fragmented health management structure, weak and inequitable immunization services, and lack of demand and trust among people for immunization services. The Expanded Programme on Immunization (EPI), Ministry of Health (MOH) in Sindh Province spearheaded a structured and collaborative process to develop strategies for addressing inequity in immunization services towards achieving Universal Immunization Coverage (UIC) in Karachi. The process included a situation analysis with gathering quantitative and qualitative information on the root causes of zero-dose and inequity of the immunization services. The strategies and interventions were developed with multi-layer input and feedback of the stakeholders and partners, and focusing primarily to address gaps in three program areas: governance, leadership and accountability;immunization service delivery;and building demand and trust among the people. The interventions were further prioritized for high-risk areas;identified based on maximum number zero-dose children, presence of large slum areas, measles outbreak and on-going circulation of wild poliovirus. Finally, costing for the Roadmap activities was done through consultation with partners and aligning domestic and external (donor) resources. In this paper, we have highlighted the unique process the Sindh Government undertook in collaboration with the stakeholders and partners to develop strategies and interventions for addressing inequity in urban immunization services in Karachi towards achieving Universal Immunization Coverage (UIC). Similar processes can be adapted, as a potential model, for developing strategies to achieve universal health coverage in the cities of

关键词： Urban Immunization inequity Strategies Roadmap Universal Immunization Coverage

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Knowledge of Tuberculosis, Services of TB Control Programme and Associated Socio-Demographic inequity among Rural Participants of Jaipur, Rajasthan, India: A Cross Sectional Study

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Journal of Tuberculosis Research 2023年第2期11卷 49-61页

作者： Praveen Kumar Anand Vikas Dhikav Swarn Lata Monika Rathore Gurudayal Singh Toteja Bhawar Manohar Singh Chet Ram Meena Murli Lal Mathur Indian Council of Medical Research National Institute for Implementation Research on Non Communicable Diseases New Pali Road Jodhpur India Department of Pathology Dr. Sampoornanand Medical College Jodhpur Rajasthan Department of Preventive & Social Medicine Sawai Man Singh Medical College & Associated Hospitals Jaipur India Jodhpur City Knowledge & Innovation Foundation Indian Institute of Technology Jodhpur India Model Rural Health Research Unit Department of Health Research Government of India Bhanpur Kalan Jaipur India

Background: Tuberculosis (TB) is one of the top 10 causes of death worldwide. India is still the highest TB burden country. There is a scarcity of data on TB knowledge from Rajasthan state of India. Objective: The objective of this study was to estimate the prevalence of knowledge about TB and services of TB control programme and to determine its correlates among rural population of Jaipur, Rajasthan. Methods: Cross-sectional community based study was carried out at Model Rural Health Research Unit, Jaipur, a unit of Department of Health Research, Ministry of Health & Family Welfare, Government of India. Results: Study reports the result from 1993 adult participants from 10 villages of 2 sub-districts of district Jaipur. About 88.9% of studied participants knew that TB is an infectious disease and it spreads from TB patient to healthy person in close contact. Only 22.3% of participants knew “DOTS is the treatment for TB”. While, only 58.9% knew “sputum is used for diagnosis of TB” at health centers. Scheduled castes, scheduled tribes and backward classes social groups knew less than the mainstream “General” social group. The observed difference was statistically significant (p 0.05). Logistic regression analysis estimated the relative contribution to knowledge status. Conclusion: The knowledge of study participants on transmission of tuberculosis was similar to knowledge of population in country wide study. They poorly knew sputum is used for diagnosing tuberculosis disease;socio-demographic inequity exists in this knowledge too. People from older age groups, underprivileged social groups and minority need extra educational activities.

关键词： India inequity Knowledge Tuberculosis

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Side Effects of Large-Scale Assessments in Education

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ECNU Review of Education 2019年第3期2卷 279-296页

作者： Trina E.Emler Yong Zhao Jiayi Deng Danqing Yin Yurou Wang University of Kansas The University of Alabama

Purpose:In line with a recent call for side effects research in education,this article aims to synthesize the major concerns that have been raised in the literature concerning large-scale assessments(LSAs)in ***/Approach/Methods:The researchers endeavored to complete a deep review of the literature on LSAs to synthesize the reported side *** review was synthesized thematically to understand and report the consequences of the ongoing push for the use of LSA in ***:Thematic analysis indicated overarching side effects of LSA in *** discuss why negative side effects exist and present evidence of the most commonly observed side effects of LSA in education,including distorting education,exacerbating inequity and injustice,demoralization of professionals,ethical corruption,and stifling of innovation in ***/Value:While concerns about the use and misuse of LSA in education are not new and have been discussed widely in the literature,rarely have they been discussed as inherent qualities and consequences of LSAs that can do harm to education.

关键词： inequity large-scale assessments side effects

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Management and risk factor control of coronary artery disease in elderly versus nonelderly： a multicenter registry

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Journal of Geriatric Cardiology 2016年第12期13卷 954-959页

作者： Arintaya Phrommimikul Rungroj Krittayaphong Wanwarang Wongcharoen Smonpom Boonyaratavej Chaiyasith Wongvipaporn Worapom Tiyanon Pakaphan Dinchuthai Rapeephon Kunjara-Na-Ayudhya Pyatat Tatsanavivat Piyamitr Sritara Department of Internal Medicine Faculty of Medicine Chiang Mai University Chiang Mai Thailand Department of Medicine Faculty of Medicine Siriraj Hospital Mahidol University Bangkok Thailand Department of Medicine Faculty of Medicine Chulalongkorn University Bangkok Thailand Department of Medicine Faculty of Medicine Khon Kaen University Khon Kaen Thailand Department of Medicine Phramongkutklao College of Medicine Bangkok Thailand Faculty of Medicine Burapha University Chonburi Thailand Vichaiyut Hospital and Medical Center Bangkok Thailand Department of Medicine Faculty of Medicine Ramathibodi Hospital Mahidol University Bangkok Thailand

Background Coronary artery disease （CAD） is a leading cause of death in elderly because aging is the important non-modifiable risk factors of atherosclerosis and also a predictor of poor outcomes. Underuse of guideline directed therapy may contribute to suboptimal risk factor control and worse outcomes in the elderly. We aimed to explore the management of CAD, risk factors control as well as goal attain- ment in elderly compared to nonelderly CAD patients. Methods The CORE-Thailand is an ongoing multicenter, prospective, observational registry of patients with high atherosclerotic risk in Thailand. The data of 4120 CAD patients enrolled in this cohort was analyzed comparing between the elderly （age ≥ 65 years） vs. nonelderly （age 〈 65 years）. Results There were 2172 elderly and 1948 nonelderly patients. The elderly CAD patients had higher prevalence of hypertension, dyslipidemia, atrial fibrillation and chronic kidney disease. The proportion of patients who received coronary revascularization was not different between the elderly and nonelderly CAD patients. Antiplatelets were prescribed less in the elderly while statin was prescribed in the similar proportion. Goal attainments of risk factor control of glycemic control, low density lipoprotein cholesterol, and smoking cessation except the blood pressure goal were higher in the elderly CAD patients. Conclusions The CORE-Thailand registry showed the equity in the treatment of CAD between elderly and non-elderly. Elderly CAD patients had higher rate of goal attainment in risk factor control except blood pressure goal. The effects of goal attainment on cardiovascular outcomes will be demonstrated from ongoing cohort.

关键词： Aging Coronary artery disease Goal attainment inequity The elderly

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National Happiness at a Time of Economic Growth: A Tracking Study Based on CGSS Data

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Social Sciences in China 2013年第4期34卷 20-37页

作者： Liu Junqiang Xiong Moulin Su Yanga School of Insurance Southwestern University of Finance and Economics Law School Southwestern University of Finance and Economics School of Social Sciences University of California Irvine

In order to respond to the ongoing debate over the Chinese people＇s sense of happiness and to assess the effects of macro-economic and policy changes on the life of ordinary people over the past decade, this study employs data from the Chinese General Social Survey （CGSS） to analyze the development and trends in the happiness （or subjective well-being） of the Chinese people over this period. Based on 5 time points and 44,166 samples, the study finds that the Chinese people＇s sense of happiness has risen steadily over the past decade, and that groups with different political affiliations, household registration, age, income, marital status and ethnicity have all witnessed, to varying degrees, a growing sense of happiness. Economic growth may be the crucial driving force here; if the economy contracts, people＇s sense of happiness may also fall. To maintain the coordinated development of the economy and society, more numerous and more detailed follow-up research on happiness needs to be conducted.

关键词： sense of happiness inequity economic growth

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我国医疗保健的城乡分割问题研究

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社会保障制度 2013年第3期

作者：马超顾海李佳佳

本文借鉴国际主流卫生经济学的观点，对我国医疗保健中的“城乡差异”与“城乡分割”这组概念进行了区分。利用CHNS2009年截面数据，采用反事实分析方法，度量出城乡医疗保健差异中的不公平部分，即本文所界定的城乡分割现象。研究表明... 详细信息

本文借鉴国际主流卫生经济学的观点，对我国医疗保健中的“城乡差异”与“城乡分割”这组概念进行了区分。利用CHNS2009年截面数据，采用反事实分析方法，度量出城乡医疗保健差异中的不公平部分，即本文所界定的城乡分割现象。研究表明：城乡医疗差距中的88.1%是不公平的，仅有11.9%的差距可以认为是合理的；并且越是在大额的医疗支出上，城乡分割现象越严重。

关键词：医疗保健不公平城乡分割反事实分析 healthcare inequity rural-urban disparities counterfactual analysis

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京津冀协同发展：挑战与困境

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区域与城市经济 2015年第5期

作者：薄文广陈飞

京津冀协同发展面临着三大关键挑战：三地产业结构差异明显，难以形成产业良性互动；发展差距过大，促使要素单向流动；缺乏协同治理机制，导致“三者共输”。京津冀不平等的政治和经济地位、三地背后各自为战的利益出发点、中央相关制... 详细信息

京津冀协同发展面临着三大关键挑战：三地产业结构差异明显，难以形成产业良性互动；发展差距过大，促使要素单向流动；缺乏协同治理机制，导致“三者共输”。京津冀不平等的政治和经济地位、三地背后各自为战的利益出发点、中央相关制度设计以及非政府力量发展迟缓的共同作用使得京津冀协同发展比较艰难。更为重要的是，在中央无意的“错位”及有意的“缺位”下，在津冀地方政府无法打破“首先为北京(即中央)服务”的政治态势下，在京津冀未能构建利益协调机制下，真正市场意义的京津冀协同发展将是一个长期的宏伟目标。

关键词：京津冀协同发展不平等利益协调机制 Beijing-Tianjin-Hebei coordinated development inequity interests coordinating mechanism

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