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Enhancing Private Healthcare Effectiveness in Lagos State, Nigeria: An Overview of the Effect of Quality Improvement Initiatives and Implications for Sustainable Healthcare Delivery

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Health 2024年第2期16卷 93-104页

作者： Nnenna Mba-Oduwusi Ifesinachi Eze Tochukwu Osuji Maxwell Obubu Tolulope Oyekanmi Oluwatosin Kolade Ozioma Oguguah Jane Martins Nkata Chuku Alozie Ananaba Rodio Diallo Firdausi Umar Sadiq Emmanuella Zamba Abiola Idowu InSiGHt Health Consulting Limited Ikeja Nigeria Health Systems Consult Limited Abuja Nigeria bill & melinda gates foundation Abuja Nigeria Lagos State Health Management Agency (LASHMA) Lagos Nigeria Health Facility Monitoring and Accreditation Agency (HEFAMAA) Ikeja Nigeria

Background: Nigeria, a nation grappling with rapid population growth, economic intricacies, and complex healthcare challenges, particularly in Lagos State, the economic hub and most populous state, faces the challenge of ensuring quality healthcare access. The overview of the effect of quality improvement initiatives in this paper focuses on private healthcare providers in Lagos State, Nigeria. The study assesses the impact of donor-funded quality improvement projects on these private healthcare facilities. It explores the level of participation, perceived support, and tangible effects of the initiatives on healthcare delivery within private healthcare facilities. It also examines how these initiatives influence patient inflow and facility ratings, and bring about additional benefits and improvements, provides insights into the challenges faced by private healthcare providers in implementing quality improvement projects and elicits recommendations for improving the effectiveness of such initiatives. Methods: Qualitative research design was employed for in-depth exploration, utilizing semi-structured interviews. Private healthcare providers in Lagos involved in the SP4FP Quality Improvement Project were purposively sampled for diversity. Face-to-face interviews elicited insights into participation, perceived support, and project effects. Questions covered participation levels, support perception, changes observed, challenges faced, and recommendations. Thematic analysis identified recurring themes from interview transcripts. Adherence to ethical guidelines ensured participant confidentiality and informed consent. Results: Respondents affirmed active involvement in the SP4FP Quality Improvement Project, echoing literature emphasizing private-sector collaboration with the public sector. While acknowledging positive influences on facility ratings, respondents highlighted challenges within the broader Nigerian healthcare landscape affecting patient numbers. Respondents cited tangible improvements, particularly in staf

关键词： Private Healthcare Quality Improvement Projects Donor-Funded Initiatives Healthcare Delivery Lagos State Nigeria

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Advancing the National Immunization Program in an era of achieving universal vaccine coverage in China and beyond

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贫困所致传染病(英文) 2024年第2期13卷 1-5页

作者： Chen Shu Rodewald Lance E. Heng Du Anna Tang Shenglan ARC Centre of Excellence in Population Ageing Research (CEPAR) University of New South Wales Sydney Australia School of Risk and Actuarial Studies University of New South Wales Sydney Australia Department of the National Immunization Program Chinese Center for Disease Control and Prevention National Immunization Program China CDC Beijing China China Country Office Bill &amp melinda gates foundation Beijing China Duke Global Health Institute Duke University Durham NC USA Global Health Research Center Duke Kunshan University No. Duke Avenue Kunshan Jiangsu China SingHealth Duke-NUS Global Health Institute Duke-NUS Singapore Singapore

Background Immunization is a cornerstone of public health. Despite great success, China’s National Immunization Program (NIP) faces challenges, such as the integration of several World Health Organization-recommended vaccines and other systemic issues. The Innovation Laboratory for Vaccine Delivery Research (VaxLab), supported by the bill & melinda gates foundation and established in 2021 at Duke Kunshan University, focuses on enhancing China’s NIP through research and policy advocacy. This editorial aims to summarize the key findings of the manuscripts published in the collection contributed by VaxLab team and set the future research agenda.Key findings The collection contains eleven manuscripts discussing China’s immunization landscape and strategies to improve coverage, particularly for non-NIP vaccines like human papillomavirus vaccine (HPV), pneumococcal conjugate vaccine (PCV),Haemophilus influenzae type b vaccine (Hib), and rotavirus vaccines. Key findings include: (i) The COVID-19 vaccination campaign demonstrated China’s capacity for rapid, large-scale immunization efforts, suggesting potential for broader vaccine coverage improvements; (ii) Efforts in combating cervical cancer through the HPV vaccine indicate progress but also highlight challenges like vaccine supply and equitable access; (iii) The lag in adopting higher-valent paediatric combination vaccines in China needs attention to address regulatory and health system hurdles; (iv) Disparities in access to non-NIP vaccines underscore the need for government initiatives to improve vaccine coverage, especially for remote areas and marginalized populations; (v) Original studies emphasize the influence of caregivers’ knowledge, health workers’ financial incentives, and concerns about vaccine efficacy on immunization rates; (vi) Case studies from the Weifang City of China and Indonesia to introduce PCV offer insights on successful vaccine introduction strategies and the impact of innovative financing and government support.Conclusion The articles emphas

关键词： National Immunization Program New vaccine introduction Universal vaccine coverage Health system strengthening

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Equal Partnership in Agriculture

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Beijing Review 2023年第43期66卷 26-27页

作者： Obai Khalifa the bill&melinda gates foundation

It was wonderful to be back in China in June for the Third China-Africa Economic and Trade Expo(CAETE)in the city of Changsha,Hunan Province.Since its inauguration in 2019,the CAETE has become an important platform for expanding the China-Africa relationship,of which agricultural cooperation is an increasingly significant element.The scale of the activities in Changsha was testament to the scope and ambition of all those involved in China-Africa exchanges.

关键词： Province. Trade Hunan

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The COVID-19 Pandemic and Elimination of Tuberculosis in China

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China CDC weekly 2021年第12期3卷 260-264页

作者： Daniel P.Chin Global Health Programbill&melinda gates foundation

One of the best kept secrets in global public health ishow China achieved the tuberculosis(TB)targets inthe United Nation’s Millennium Development Goals(MDG).The MDG’s TB targets were to reduce theprevalence and mortality of TB by 50%between 1990and 2015.By 2010,China had reduced its TBprevalence and mortality by 65%and 80%,(1−2)which meant China exceeded the MDG targets 5 yearsbefore the MDG deadline.

关键词： mortality prevalence tuberculosis

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The Impact of COVID-19 on Tuberculosis Patients’Behavior of Seeking Medical Care——China,2020

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China CDC weekly 2021年第26期3卷 553-556页

作者： Yinyin Xia Fei Huang Hui Chen Ni Wang Xin Du Wei Chen Tao Li Shitong Huan Miaomiao Sun Jianjun Liu Yanlin Zhao Chinese Center for Disease Control and Prevention BeijingChina China office The Bill&Melinda Gates FoundationBeijingChina China office PATHBeijingChina

Summary What is already known on this topic?The coronavirus disease 2019(COVID-19)pandemic has disrupted the tuberculosis(TB)service system.However,the impact on TB patients in China remains unknown.What is added by this report?This report firstly addressed the impact of COVID-19 on TB patients in China.About half of TB patients did not revisit the hospital due to personal reasons.The reasons for irregular medication and postponing or cancelling examination after full treatment course were different.

关键词： Patients Medical tuberculosis

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Agent-based modeling of COVID-19 outbreaks for New York state and UK:Parameter identification algorithm

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Infectious Disease Modelling 2022年第1期7卷 30-44页

作者： Olga Krivorotko Mariia Sosnovskaia Ivan Vashchenko Cliff Kerr Daniel Lesnic Institute of Computational Mathematics and Mathematical Geophysics Siberian Branch of the Russian Academy of Sciences 6 Prospect Akademika Lavrentieva StreetNovosibirsk630090Russia Novosibirsk State University 2 Pirogova StreetNovosibirsk630090Russia Institute for Disease Modeling Bill&Melinda Gates FoundationSeattleUSA University of Leeds LS29JTUK

This paper uses Covasim,an agent-based model(ABM)of COVID-19,to evaluate and scenarios of epidemic spread in New York State(USA)and the UK.Epidemiological parameters such as contagiousness(virus transmission rate),initial number of infected people,and probability of being tested depend on the region's demographic and geographical features,the containment measures introduced;they are calibrated to data about COVID-19 spread in the region of interest.At the first stage of our study,epidemiological data(numbers of people tested,diagnoses,critical cases,hospitalizations,and deaths)for each of the mentioned regions were analyzed.The data were characterized in terms of seasonality,stationarity,and dependency spaces,and were extrapolated using machine learning techniques to specify unknown epidemiological parameters of the model.At the second stage,the Optuna optimizer based on the tree Parzen estimation method for objective function minimization was applied to determine the model's unknown parameters.The model was validated with the historical data of 2020.The modeled results of COVID-19 spread in New York State and the UK have demonstrated that if the level of testing and containment measures is preserved,the number of positive cases in New York State remain the same during March of 2021,while in the UK it will reduce.

关键词： Epidemiology Agent-based modeling COVID-19 Interventions analysis Coronavirus data analysis Forecasting scenarios Reproduction number Optimization Parameter identification

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Effectiveness of the Integrated TB Surveillance System--China,2018-2019

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China CDC weekly 2020年第12期2卷 190-193页

作者： Ni Wang Tao Li Xin Du You Li Miaomiao Sun Shitong Huan Hui Zhang Lixia Wang Mingting Chen Fei Huang Yanlin Zhao National Center for Tuberculosis Control and Prevention Chinese Center for Disease Control and PreventionBeijingChina PATH Beijing officeBeijingChina bill&melinda gates foundation Beijing officeBeijingChina

What is already known about this topic?China’s national health information system provides important support and means for deepening the country’s medical and health reform,for improving relevant delivery services,for enhancing the level of scientific management of health,and for promoting the goal of basic medical and health services for everyone in China.What is added by this report?To further the construction of the national health information system,the National Center for Tuberculosis Control and Prevention of China CDC,started a pilot project for a new tuberculosis(TB)integrated health(iHealth)surveillance system,which was integrated with regional health information platforms.The goal was to explore automatic data exchange between hospitals and disease control facilities to reduce the workload of data-entry.What are the implications for public health practice?This pilot proved that data sharing and automatic exchanges between different information systems can be achieved through a unified surveillance dataset,which could provide a reference point for the construction of surveillance systems for other infectious diseases or for the entire public health information system.

关键词： services deepening everyone

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Access to and affordability of healthcare for TB patients in China: issues and challenges

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Infectious Diseases of Poverty 2016年第1期5卷 82-86页

作者： Shenglan Tang Lixia Wang Hong Wang Daniel P.Chin Duke Global Health Institute Duke UniversityDurhamUSA Global Health Research Center Duke Kunshan UniversityKunshanChina National Center for TB control and prevention China CDCNo 155 Changbai RoadChangping DistrictBeijing 102206People’s Republic of China bill&melinda gates foundation SeattleWashingtonUSA bill&melinda gates foundation Beijing officeBeijingChina

This paper introduces the background,aim and objectives of the project entitled“China—the gates foundation Collaboration on TB Control in China”that has been underway for many years.It also summarizes the key findings of the nine papers included in this special issue,which used data from the baseline survey of Phase II of the project.Data were collected from the survey of TB and MDR-TB patients,from designated hospitals,health insurance agencies and the routine health information systems,as well as key informant interviews and focus group discussions with relevant key stakeholders.Key issues discussed in this series of papers include the uses of TB services and anti-TB medicines and their determining factors related to socio-economic and health systems development;expenditures on TB care and the financial burden incurred on TB patients;and the impact of health insurance schemes implemented in China on financial protection.

关键词： China-gates TB project TB control Healthcare financing China

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The Place of Human Resource Management in Lagos State Healthcare Delivery: A Statistical Overview

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Health 2023年第3期15卷 251-265页

作者： Maxwell Obubu Nkata Chuku Alozie Ananaba Rodio Diallo Firdausi Umar Sadiq Emmanuel Sambo Oluwatosin Kolade Tolu Oyenkanmi Kehinde Olaosebikan Oluwafemi Serrano Health Systems Consult Limited (HSCL) Abuja Nigeria bill and melinda gates foundation Abuja Nigeria Lagos State Health Management Agency (LASHMA) Lagos State Nigeria

Background: Behind every great system is an organized team;this is especially true in the healthcare industry, where a dedicated human resources team can effectively recruit employees, train staff, and implement safety measures in the workplace. The importance of human resources in the healthcare industry cannot be overstated, with benefits ranging from providing an orderly and effectively run facility to equipping staff with the most accurate and up-to-date training. Proper human resources management is critical in providing high-quality health care. A refocus on human resources management in healthcare requires more research to develop new policies. Effective human resources management strategies are greatly needed to achieve better outcomes and access to health care worldwide. Methods: This study leveraged NOI Polls census data on Health Facility Assessment for Lagos State. One thousand two hundred fifty-six health care facilities were assessed in Lagos State;numbers of Health workers were documented alongside their area of specialization. Also, demographic characterizations of the facilities, such as LGA, Ownership type, Facility Level Care, and Category of the facility, were also documented. Descriptive statistics alongside cross tabulation was done to present the various area of specialization of the health workers. Multiple response analysis was done to understand the distribution of human resources across the health facilities. At the same time, Chi-square and correlation tests were conducted to test the independence of various categories recorded while understanding the relationships among selected specialties. Results: The study revealed that Nurses were the most common health specialist in the Lagos State health facilities. At the same time, Gynecologists and General surgeons are the two medical specialists mostly common in health facilities. Midwives are the second most common health specialist working full time, while Generalist medical doctors make up the top three health specialists working full ti

关键词： Healthcare Facilities Human Resources for Health Healthcare Delivery Lagos State SDGs on Health Multiple Response Analysis

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Lagos State Hospital Waste Management Practices: A Descriptive Overview with Stakeholders’ Role and Key Recommendations

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Journal of Environmental Protection 2023年第2期14卷 108-125页

作者： Maxwell Obubu Nkata Chuku Alozie Ananaba Firdausi Umar Sadiq Sadiq Emmanuel Sambo Oluwatosin Kolade Tolulope Oyekanmi Kehinde Olaosebikan Oluwafemi Serrano Health Systems Consult Limited (HSCL) Abuja Nigeria bill and melinda gates foundation Abuja Nigeria Head of Operations Lagos State Health Management Agency (LASHMA) Lagos State Nigeria

Background: Waste generation and its disposal is an essential issue in the sustainability of the environment and the planet’s future. Waste management is essential across sectors, likewise the health sector. Therefore, there is a need to employ extra care and attention to handling waste generated from healthcare facilities to avoid the dangers of poor biomedical waste management. We carried out this study to examine the waste management practice in healthcare facilities in Lagos State. Methods: The study was a descriptive survey carried out in one-thousand two hundred and fifty-six (1256) healthcare facilities in Lagos State. Nine hundred sixty-nine (969) of these facilities are located in urban areas, while two hundred and eighty-seven (287) are rural. The facilities studied are government/public health facilities (15.45%), private-for-profit facilities (82.88%), NGOs, Mission/Faith-Based medical facilities (1.67%). The data collected were analyzed using descriptive statistics. Specifically, we utilized bar charts, frequency, and percentage. Result: The result shows that 98.4% (1236) of the studied facilities are registered with the Lagos State Waste Management Authority (LAWMA), while 1.6% (20) are not registered. 98.5% (191) of the 194 government-owned facilities, 98.5% (1025) of the 1041 private-for-profit facilities, and 98.2% (20) of the 21 NGOs/faith-based health facilities are registered with Lagos State Waste Management Authority. The result also shows that 94% of the healthcare facilities studied in Lagos State use color-coded waste bags to segregate waste at the point of origin. 58.7% of the facilities use red-colored bags, 33.3% use yellow-colored bags, 10.7% use black-colored bags, and 1.3% use brown biohazard bags for segregating Infectious waste. Also, 34.2% of the health facilities in Lagos state use red-colored bags, 36.9% use yellow-colored bags, 11% use black-colored bags, and 4.1% use brown-colored bags to segregate their hazardous waste. Conclusion: Some healthcare facilities in Lagos State d

关键词： Waste Generation Hospital Waste Management Stakeholder Roles Healthcare Facilities Lagos State Lagos Waste Management Authority

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