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Health systems and services in low and middle income settings

Section edited by Dina Balabanova, Hengjin Dong, David Hotchkiss and Kaspar Wyss 

This section aims to publish research on health systems and services with a focus on research relevant to low and middle income settings as defined by The World Bank.

Page 1 of 24

  1. There is growing interest in the use of reliable evidence for health decision-making among low-and middle-income countries. Ghana has deployed DHIMS2 to replace the previously existing manual data harmonizatio...

    Authors: Eliezer Ofori Odei-Lartey, Rebecca Kyerewaa Dwommoh Prah, Edward Apraku Anane, Harry Danwonno, Stephaney Gyaase, Felix Boakye Oppong, Godwin Afenyadu and Kwaku Poku Asante

    Citation: BMC Health Services Research 2020 20:514

    Content type: Research article

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  2. Little is known about how to build leadership capacity to support implementation of evidence-based practices within health systems. We observed substantial variability across sites in uptake and sustainability...

    Authors: L. M. Puchalski Ritchie, H. Mundeva, Monique van Lettow, S. E. Straus, E. Kip and A. Makwakwa

    Citation: BMC Health Services Research 2020 20:513

    Content type: Research article

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  3. Although tuberculosis (TB) patients often incur high costs to access TB-related services, it was unclear beforehand whether the implementation of universal health coverage (UHC) in Indonesia in 2014 would redu...

    Authors: Ahmad Fuady, Tanja A. J. Houweling, Muchtaruddin Mansyur, Erlina Burhan and Jan Hendrik Richardus

    Citation: BMC Health Services Research 2020 20:502

    Content type: Research article

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  4. In order to analyze use of health services and identify sources of delays in accessing the right care for patients with Alzheimer’s disease and related dementias (AD/ADRD), understanding of care seeking pathwa...

    Authors: Nathan Kakongi, Godfrey Zari Rukundo, Bizu Gelaye, Edith K. Wakida, Celestino Obua and Elialilia S. Okello

    Citation: BMC Health Services Research 2020 20:498

    Content type: Research article

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  5. Sepsis is the leading cause of death and disability in children. Every hour of delay in treatment is associated with an escalating risk of morbidity and mortality. The burden of sepsis is greatest in low- and ...

    Authors: Alishah Mawji, Edmond Li, Clare Komugisha, Samuel Akech, Dustin Dunsmuir, Matthew O. Wiens, Niranjan Kissoon, Nathan Kenya-Mugisha, Abner Tagoola, David Kimutai, Jeffrey N. Bone, Guy Dumont and J. Mark Ansermino

    Citation: BMC Health Services Research 2020 20:493

    Content type: Study protocol

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  6. Hemorrhage is the leading cause of maternal mortality worldwide and accounts for 56% of maternal deaths in Afghanistan. Postpartum hemorrhage (PPH) is commonly caused by uterine atony, genital tract trauma, re...

    Authors: Nasratullah Ansari, Farzana Maruf, Partamin Manalai, Sheena Currie, Mohammad Samim Soroush, Sher Shah Amin, Ariel Higgins-Steele, Young Mi Kim, Jelle Stekelenburg, Jos van Roosmalen and Hannah Tappis

    Citation: BMC Health Services Research 2020 20:484

    Content type: Research article

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  7. In the light of the increasing burden of non-communicable diseases (NCDs) on health systems in low- and middle-income countries, particularly in Sub-Saharan Africa, context-adapted, cost-effective service deli...

    Authors: Marthe Frieden, Blessing Zamba, Nisbert Mukumbi, Patron T. Mafaune, Brian Makumbe, Elizabeth Irungu, Virginia Moneti, Petros Isaakidis, Daniela Garone and Madhu Prasai

    Citation: BMC Health Services Research 2020 20:486

    Content type: Research article

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  8. Despite significant reductions in mortality, preventable and treatable conditions remain leading causes of death and illness in children in South Africa. The PACK Child intervention, comprising clinical decisi...

    Authors: Jamie Murdoch, Robyn Curran, Ruth Cornick, Sandy Picken, Max Bachmann, Eric Bateman, Makhosazana Lungile Simelane and Lara Fairall

    Citation: BMC Health Services Research 2020 20:479

    Content type: Research article

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  9. Non-communicable Diseases (NCDs) are the leading cause of global mortality and disability with a rising burden in low- and middle-income countries. Their multifactorial aetiology, and their requirement of long...

    Authors: Nicole Vidal, Montserrat León-García, Marta Jiménez, Keven Bermúdez and Pol De Vos

    Citation: BMC Health Services Research 2020 20:474

    Content type: Research article

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  10. Health worker strikes are a significant threat to universal access to care globally and especially in sub Saharan Africa. Kenya’s health sector has seen an increase in such industrial action. Globally there is...

    Authors: Grace Kiringa Kaguthi, Videlis Nduba and Mary Beth Adam

    Citation: BMC Health Services Research 2020 20:469

    Content type: Research article

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  11. Accurate diagnosis of anemia by community workers using a point-of-care device is a challenge. The objective of the study was to establish the diagnostic accuracy of point-of-care devices for detecting anemia ...

    Authors: Sutapa Bandyopadhyay Neogi, Jyoti Sharma, Shivam Pandey, Nausheen Zaidi, Maitreyee Bhattacharya, Rakhee Kar, Sitanshu Sekhar Kar, Abhishek Purohit, Sanjib Bandyopadhyay and Renu Saxena

    Citation: BMC Health Services Research 2020 20:468

    Content type: Research article

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  12. A major part of midwifery care involves the empowerment of women and their families for the control of factors affecting their health. To this end, midwives should experience their own empowerment first. The p...

    Authors: Maryam Hajiesmaello, Nourossadat Kariman, Hamid Sharif Nia, Gity Ozgoli, Sepideh Hajian, Shahin Bazzazian and Tahereh Mokhtarian-Gilani

    Citation: BMC Health Services Research 2020 20:466

    Content type: Research article

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  13. Accurate and high-quality data are important for improving program effectiveness and informing policy.

    Authors: Tahmina Begum, Shaan Muberra Khan, Bridgit Adamou, Jannatul Ferdous, Muhammad Masud Parvez, Mohammad Saiful Islam, Feroza Akhter Kumkum, Aminur Rahman and Iqbal Anwar

    Citation: BMC Health Services Research 2020 20:465

    Content type: Research article

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  14. The World Health Organization estimated that 1.12 million children developed tuberculosis (TB) in 2018, and at least 200,000 children died from TB. Implementation of effective child contact management is an im...

    Authors: Yael Hirsch-Moverman, Joanne E. Mantell, Limakatso Lebelo, Andrea A. Howard, Anneke C. Hesseling, Sharon Nachman, Koen Frederix, Llang Bridget Maama and Wafaa M. El-Sadr

    Citation: BMC Health Services Research 2020 20:461

    Content type: Research article

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  15. Navajo community members face high rates of diabetes mellitus and other chronic diseases. The Navajo Community Health Representative Outreach Program collaborated with healthcare providers and academic partner...

    Authors: Calvin Franz, Sidney Atwood, E. John Orav, Cameron Curley, Christian Brown, Letizia Trevisi, Adrianne Katrina Nelson, Mae-Gilene Begay and Sonya Shin

    Citation: BMC Health Services Research 2020 20:460

    Content type: Research article

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  16. Health seeking behavior is one of the challenges affecting tuberculosis (TB) control program because of its high risk to prolonged diseases transmission and poor treatment outcome. Although there are few prima...

    Authors: Dinka Fikadu Gamtesa, Habteyes Hailu Tola, Zemedu Mehamed, Ephrem Tesfaye and Ayinalem Alemu

    Citation: BMC Health Services Research 2020 20:445

    Content type: Research article

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  17. Anaemia and malaria are both major contributors to maternal and child mortality, and morbidity, with some of the worst outcomes occurring in sub-Saharan Africa. Point of care tests (POCT), if used appropriatel...

    Authors: Tanith Palmer, Abiola O. Aiyenigba, Imelda Bates, Doris Dokua Okyere, Harry Tagbor and Gifty Dufie Ampofo

    Citation: BMC Health Services Research 2020 20:444

    Content type: Research article

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  18. In Nigeria, anecdotes abound that female clients, particularly within northern Nigeria, have gender-based preferences for frontline health workers (FLHWs) who provide healthcare services. This may adversely af...

    Authors: Ekechi Okereke, Godwin Unumeri, Akinwumi Akinola, George Eluwa and Sylvia Adebajo

    Citation: BMC Health Services Research 2020 20:441

    Content type: Research article

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  19. About 20–40% of patients with diabetes mellitus (DM) suffer from depressive disorders (DD) during the course of their illness. Despite the high burden of DD among patients with DM, it is rarely identified and ...

    Authors: Dickens Akena, Elialilia S. Okello, Jane Simoni and Glenn Wagner

    Citation: BMC Health Services Research 2020 20:436

    Content type: Research article

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  20. Globally, injuries cause more than 5 million deaths annually, a similar number to those from HIV, Tuberculosis and Malaria combined. In people aged between 5 and 44 years of age trauma is the leading cause of ...

    Authors: Dan Magnus, Santosh Bhatta, Julie Mytton, Elisha Joshi, Emma L. Bird, Sumiksha Bhatta, Sunil Raja Manandhar and Sunil Kumar Joshi

    Citation: BMC Health Services Research 2020 20:433

    Content type: Study protocol

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  21. To tackle the issue with the low usage of primary healthcare service in China, it is essential to align resource distribution with the preferences of the community residents. There are few academic researches ...

    Authors: Ming-zhu Jiang, Qiang Fu, Ju-yang Xiong, Xiang-lin Li, Er-ping Jia, Ying-ying Peng and Xiao Shen

    Citation: BMC Health Services Research 2020 20:430

    Content type: Research article

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  22. More alternatives have become available for the diagnosis and treatment of cancer in low- and middle-income countries. Because of increasing demands, governments are now facing a problem of limited affordabili...

    Authors: Daniela Moye-Holz, Margaret Ewen, Anahi Dreser, Sergio Bautista-Arredondo, Rene Soria-Saucedo, Jitse P. van Dijk, Sijmen A. Reijneveld and Hans V. Hogerzeil

    Citation: BMC Health Services Research 2020 20:424

    Content type: Research article

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  23. Interventions aimed at improving accessing of health care services, including HIV testing, remain a priority in global HIV eradication efforts. Grassroot Soccer Zimbabwe (GRSZ) is an adolescent health organisa...

    Authors: Mayibongwe Louis Mzingwane, Greanious Alfred Mavondo, Fennie Mantula, Claudinos Mapfumo, Calleta Gwatiringa, Bhekimpilo Moyo, Primrose Dube and Cynthia Nombulelo Chaibva

    Citation: BMC Health Services Research 2020 20:420

    Content type: Research article

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  24. Citizen-led accountability initiatives are a critical strategy for redressing the causes of health inequalities and promoting better health system governance. A growing body of evidence points to the need for ...

    Authors: Alison Hernández, Anna-Karin Hurtig, Isabel Goicolea, Miguel San Sebastián, Fernando Jerez, Francisco Hernández-Rodríguez and Walter Flores

    Citation: BMC Health Services Research 2020 20:416

    Content type: Research article

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  25. Non-communicable disease (NCD) care in Sub-Saharan Africa is challenging due to barriers including poverty and insufficient health system resources. Local culture and context can impact the success of interven...

    Authors: Claudia L. Leung, Mackenzie Naert, Benjamin Andama, Rae Dong, David Edelman, Carol Horowitz, Peninah Kiptoo, Simon Manyara, Winnie Matelong, Esther Matini, Violet Naanyu, Sarah Nyariki, Sonak Pastakia, Thomas Valente, Valentin Fuster, Gerald S. Bloomfield…

    Citation: BMC Health Services Research 2020 20:415

    Content type: Research article

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  26. In many low- and middle-income countries, insufficient human resources limit access to oral health services. Shifting clinical tasks to less specialized health professionals, such as community health workers, ...

    Authors: Daniel J. Erchick, Nitin K. Agrawal, Subarna K. Khatry, Joanne Katz, Steven C. LeClerq, Bhola Rai, Mark A. Reynolds and Luke C. Mullany

    Citation: BMC Health Services Research 2020 20:412

    Content type: Research article

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  27. Community-based diabetes management is known to be an important strategy for global diabetes control. In China, community-based diabetes management care, including regular blood glucose tests and guidance on m...

    Authors: Jingjing Yao, Haipeng Wang, Jia Yin, Di Shao, Xiaolei Guo, Qiang Sun and Xiao Yin

    Citation: BMC Health Services Research 2020 20:407

    Content type: Research article

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  28. Improving access to optimal quality of care is a core priority and ambitious health policy goal in spite of impediments, threats and challenges in Palestine. Understanding the factors that may impede quality o...

    Authors: Marwan Mosleh, Yousef Al Jeesh, Koustuv Dalal, Charli Eriksson, Heidi Carlerby and Eija Viitasara

    Citation: BMC Health Services Research 2020 20:406

    Content type: Research article

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  29. While HIV Testing Services (HTS) have increased, many South Africans have not been tested. Non-communicable diseases (NCDs) are the top cause of death worldwide. Integrated NCD-HTS could be a strategy to contr...

    Authors: Kathryn L. Hopkins, Khuthadzo E. Hlongwane, Kennedy Otwombe, Janan Dietrich, Mireille Cheyip, Nompumelelo Khanyile, Tanya Doherty and Glenda E. Gray

    Citation: BMC Health Services Research 2020 20:404

    Content type: Research article

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  30. Respiratory diseases are among the leading causes of morbidity and mortality in Uganda, but there is little attention and capacity for management of chronic respiratory diseases in the health programmes. This ...

    Authors: Rebecca Nantanda, Gerald Kayingo, Rupert Jones, Frederik van Gemert and Bruce J. Kirenga

    Citation: BMC Health Services Research 2020 20:402

    Content type: Research article

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  31. Aboriginal women experience disproportionately higher rates of cervical cancer mortality yet are less likely to participate in screening for early detection. This study sought to determine whether a community-...

    Authors: Tegan Dutton, Jo Marjoram, Shellie Burgess, Laurinne Montgomery, Anne Vail, Nichole Callan, Sunil Jacob, David Hawkes, Marion Saville and Jannine Bailey

    Citation: BMC Health Services Research 2020 20:398

    Content type: Research article

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  32. Community advisory groups (CAGs) have been shown to be catalysts who bridge the gap between communities and primary health care facilities by sustaining good working relationships through community engagement ...

    Authors: Thoko Ndaba, Myra Taylor and Musawenkosi Mabaso

    Citation: BMC Health Services Research 2020 20:392

    Content type: Research article

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  33. Ideally situated within the community, pharmacists can be involved in a broad range of health promotion campaigns including prevention of obesity. Limited evidence is available regarding their involvement in w...

    Authors: Mohamad Ali Hijazi, Hibeh Shatila, Abdalla El-Lakany, Hiba Al Rifai, Maha Aboul-Ela and Farah Naja

    Citation: BMC Health Services Research 2020 20:386

    Content type: Research article

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  34. In sub-Saharan Africa (SSA), the delivery of eye care services continues to be undermined by health systems performance bottlenecks. There is a growing focus by partners in the sector on the analysis of the di...

    Authors: Stevens Bechange, Emma Jolley, Bhavisha Virendrakumar, Vladimir Pente, Juliet Milgate and Elena Schmidt

    Citation: BMC Health Services Research 2020 20:381

    Content type: Research article

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  35. Good dispensing practice is vital for rational use of medicines. There are many paediatric specific challenges when maintaining good dispensing practices to children. Lack of age appropriate dosage forms, lack...

    Authors: Abarna Nadeshkumar, Gitanjali Sathiadas and Shalini Sri Ranganathan

    Citation: BMC Health Services Research 2020 20:377

    Content type: Research article

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  36. Despite improvement in health outcomes over the past few decades, China still experiences striking rural-urban health inequalities. There is limited research on the rural-urban differences in health system per...

    Authors: Vicky Mengqi Qin, Barbara McPake, Magdalena Z. Raban, Thomas E. Cowling, Riyadh Alshamsan, Kee Seng Chia, Peter C. Smith, Rifat Atun and John Tayu Lee

    Citation: BMC Health Services Research 2020 20:372

    Content type: Research article

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  37. Electronic data capturing has the potential to improve data quality and user-friendliness compared to manually processed, paper-based documentation systems. The MyChild system uses an innovative approach to pr...

    Authors: Annika Äijö, Ina Schäffner, Peter Waiswa, Rornald Muhumuza Kananura, Mesfin Kassaye Tessma and Claudia Hanson

    Citation: BMC Health Services Research 2020 20:367

    Content type: Research article

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  38. Substantial efforts have been made to ensure people living with HIV (PLHIV) are linked to and retained in care but many challenges deter care utilization. We report perceived benefits of seeking HIV care and b...

    Authors: V. Naanyu, J. Ruff, S. Goodrich, T. Spira, M. Bateganya, C. Toroitich-Ruto, B. Otieno-Nyunya, A. M. Siika and K. Wools-Kaloustian

    Citation: BMC Health Services Research 2020 20:355

    Content type: Research article

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  39. Methods on developing new (de novo) clinical practice guidelines (CPGs) have received substantial attention. However, research into alternative methods of CPG development using existing CPG documents (CPG adap...

    Authors: Michael McCaul, Taryn Young, Stevan R. Bruijns and Mike Clarke

    Citation: BMC Health Services Research 2020 20:349

    Content type: Research article

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  40. By expanding primary health care services, Ethiopia has reduced under-five mor4tality. Utilisation of these services is still low, and concerted efforts are needed for continued improvements in newborn and chi...

    Authors: Della Berhanu, Yemisrach B. Okwaraji, Abebe Bekele Belayneh, Ephrem Tekle Lemango, Nesibu Agonafer, Bizuhan Gelaw Birhanu, Kurabachew Abera, Wuleta Betemariam, Araya Abrha Medhanyie, Muluemebet Abera, Mezgebu Yitayal, Fitsum Woldegebriel Belay, Lars Åke Persson and Joanna Schellenberg

    Citation: BMC Health Services Research 2020 20:339

    Content type: Study protocol

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  41. School going children across the world continue to experience high levels of untreated dental diseases. The South African Oral Health policy documents present measures to address the oral health needs of child...

    Authors: Mpho Molete, Aimee Stewart, Edna Bosire and Jude Igumbor

    Citation: BMC Health Services Research 2020 20:338

    Content type: Research article

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  42. The National Immunization Program Information System (SIPNI - Sistema de Informação do Programa Nacional de Imunização) in Brazil is a technological innovation management tool that enhances the performance of man...

    Authors: Brener Santos Silva, Eliete Albano de Azevedo Guimarães, Valéria Conceição de Oliveira, Ricardo Bezerra Cavalcante, Marta Macedo Kerr Pinheiro, Tarcísio Laerte Gontijo, Samuel Barroso Rodrigues, Ana Paula Ferreira, Humberto Ferreira de Oliveira Quites and Ione Carvalho Pinto

    Citation: BMC Health Services Research 2020 20:333

    Content type: Research article

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  43. The rising co-epidemic of tuberculosis (TB) and diabetes mellitus (DM) is a challenge for constrained health systems in low and middle-income countries. Diabetes is a known risk factor for tuberculosis and ass...

    Authors: Shifa Salman Habib, Sana Rafiq, Wafa Zehra Jamal, Shaikh Muhammad Ayub, Rashida Abbas Ferrand, Aamir Khan and Syed Mohammad Asad Zaidi

    Citation: BMC Health Services Research 2020 20:328

    Content type: Research article

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  44. The assessment of unmet need is one way to gauge inequities in access to healthcare services. While there are multiple reasons for unmet need, financial barriers are a major reason particularly in low- and mid...

    Authors: Purity Njagi, Jelena Arsenijevic and Wim Groot

    Citation: BMC Health Services Research 2020 20:322

    Content type: Research article

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  45. Dengue fever (DF) is a rapidly spreading mosquito-borne disease along the China-Myanmar border. Understanding treatment-seeking behaviors (TSBs) and associated factors of suspected DF patients in local communi...

    Authors: Hui Liu, Jian-Wei Xu, Zadan Ai, Yan Yu and Bian Yu

    Citation: BMC Health Services Research 2020 20:318

    Content type: Research article

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  46. Since 2009, the Chinese government has been reforming the healthcare system and has committed to reinforcing increased use of primary care. To date, however, the Chinese healthcare system is still heavily reli...

    Authors: Zhuojun Luo, Yuanzhu Ma, Naiqi Ke, Shuyi Xu, Ruwei Hu, Nan Hu and Li Kuang

    Citation: BMC Health Services Research 2020 20:313

    Content type: Research article

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  47. The Philippines decentralized government health services through devolution to local governments in 1992. Over the years, opinions varied on the impact of devolved governance to decision-making for local healt...

    Authors: Harvy Joy Liwanag and Kaspar Wyss

    Citation: BMC Health Services Research 2020 20:305

    Content type: Research article

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  48. Specialized Institution-Based Rehabilitation (SIBR) is the cornerstone of care and treatment for individuals with spinal cord injury, but most people with chronic spinal cord injury (CSCI) living in China have...

    Authors: Fengshui Chang, Qi Zhang, Haixia Xie, Yuhui Yang, Mei Sun, Airong Wu, Jinghua Wu, Gang Chen, Feng Shen, Chengyue Li and Jun Lu

    Citation: BMC Health Services Research 2020 20:298

    Content type: Research article

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