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Health systems and services in low and middle income settings

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.

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  1. An estimated nine out of ten persons in sub-Saharan Africa (SSA) are unable to access timely, safe and affordable surgery. District hospitals (DHs) which are strategically located to provide basic (non-special...

    Authors: Martilord Ifeanyichi, Henk Broekhuizen, Mweene Cheelo, Adinan Juma, Gerald Mwapasa, Eric Borgstein, John Kachimba, Jakub Gajewski, Ruairi Brugha, Chiara Pittalis and Leon Bijlmakers

    Citation: BMC Health Services Research 2021 21:728

    Content type: Research article

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  2. Oxygen is vital in the treatment of illnesses in children and adults, yet is lacking in many low and middle-income countries health care settings. Oxygen concentrators (OCs) can increase access to oxygen, comp...

    Authors: Susan McAllister, Louise Thorn, Sainimere Boladuadua, Mireia Gil, Rick Audas, Tim Edmonds, Eric Rafai, Philip C. Hill and Stephen R. C. Howie

    Citation: BMC Health Services Research 2021 21:636

    Content type: Research article

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  3. Decentralization of healthcare services has been widely utilized, especially in developing countries, to improve the performance of healthcare systems by increasing the access and efficiency of service deliver...

    Authors: Bandar Noory, Sara Hassanain, Jeffrey Edwards and Benedikte V. Lindskog

    Citation: BMC Health Services Research 2021 21:581

    Content type: Research article

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  4. There is a disparity in outcomes between rural and urban emergency medical services (EMS) around the world. However, there is a scarcity of research that directly asks EMS staff in both rural and urban areas h...

    Authors: Ahmed Ramdan M Alanazy, John Fraser and Stuart Wark

    Citation: BMC Health Services Research 2021 21:562

    Content type: Research article

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  5. Patient engagement is effective in promoting adherence to HIV care. In an effort to promote patient-centered care, we implemented an enhanced patient care (EPC) intervention that addresses a combination of sys...

    Authors: Juddy Wachira, Becky Genberg, Diana Chemutai, Ann Mwangi, Omar Galarraga, Siika Abraham and Ira Wilson

    Citation: BMC Health Services Research 2021 21:515

    Content type: Research article

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  6. There is a need for information and healthcare support for the fertility desires and contraceptive needs of people living with HIV (PLHIV) in order to provide safer conception support for sero-discordant coupl...

    Authors: Cecilia Milford, Mags Beksinska, Ross Greener, Jacqueline Pienaar, Letitia Rambally Greener, Zonke Mabude and Jennifer Smit

    Citation: BMC Health Services Research 2021 21:509

    Content type: Research article

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  7. Asylum evaluations are highly specialized medico-legal encounters to collect physical or mental health evidence for use in immigration proceedings. Although the field of asylum medicine is growing, access to t...

    Authors: Ranit Mishori, Kathryn Hampton, Hajar Habbach, Elsa Raker, Anjali Niyogi and Dona Murphey

    Citation: BMC Health Services Research 2021 21:508

    Content type: Research article

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  8. Improving the quality of primary healthcare provision is a key goal in low-and middle-income countries (LMICs). However, to develop effective quality improvement interventions, we first need to be able to accu...

    Authors: Navneet Aujla, Temitope Ilori, Achiaka Irabor, Abimbola Obimakinde, Eme Owoaje, Olufunke Fayehun, Motunrayo M. Ajisola, Sinmisola O. Bolaji, Samuel I. Watson, Timothy P. Hofer, Akinyinka Omigbodun and Richard J. Lilford

    Citation: BMC Health Services Research 2021 21:488

    Content type: Research article

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  9. Yemen that has been devastated by war is facing various challenges to respond to the recent potential outbreaks and other public health emergencies due to lack of proper strategies and regulations, which are e...

    Authors: Hanan Noman, Fekri Dureab, Iman Ahmed, Abdulwahed Al Serouri, Taha Hussein and Albrecht Jahn

    Citation: BMC Health Services Research 2021 21:477

    Content type: Research article

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    The Correction to this article has been published in BMC Health Services Research 2021 21:677

  10. The aim of this study was to determine the feasibility of implementing and evaluating essential interventions for the management of hypertension and prevention of cardiovascular disease in primary healthcare i...

    Authors: Dylan Collins, Laura Inglin, Tiina Laatikainen, Mekhri Shoismatuloeva, Dilorom Sultonova, Bunafsha Jonova, Katoyon Faromuzova, Marifat Abdullaeva, Maisara Otambekova and Jill L. Farrington

    Citation: BMC Health Services Research 2021 21:472

    Content type: Research article

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  11. In 2015 the US President’s Emergency Plan for AIDS Relief (PEPFAR) initiated its Geographic Prioritization (GP) process whereby it prioritized high burden areas within countries, with the goal of more rapidly ...

    Authors: Daniela C. Rodríguez, Diwakar Mohan, Caroline Mackenzie, Jess Wilhelm, Ezinne Eze-Ajoku, Elizabeth Omondi, Mary Qiu and Sara Bennett

    Citation: BMC Health Services Research 2021 21:457

    Content type: Research article

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  12. The significant contribution of community-based distribution (CBD) of family planning services and contraceptives to the uptake of contraceptives in hard-to-reach communities has resulted in the scaling-up of ...

    Authors: Lucy Nyundo, Maxine Whittaker, Lynne Eagle and David R. Low

    Citation: BMC Health Services Research 2021 21:437

    Content type: Research article

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  13. Implementation research has emerged as part of evidence-based decision-making efforts to plug current gaps in the translation of research evidence into health policy and practice. While there has been a growin...

    Authors: Chukwudi A. Nnaji, Charles S. Wiysonge, Joseph C. Okeibunor, Thobile Malinga, Abdu A. Adamu, Prosper Tumusiime and Humphrey Karamagi

    Citation: BMC Health Services Research 2021 21:414

    Content type: Research article

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  14. Adequate financing is a crucial function, securing that physical rehabilitation services (i.e., physiotherapy, occupational therapy, prosthetics and orthotics) are available with no financial hardship. Like ma...

    Authors: Saeed Shahabi, Parviz Mojgani, Hosein Shabaninejad, Ahmad Ahmadi Teymourlouy, Masoud Behzadifar and Kamran Bagheri Lankarani

    Citation: BMC Health Services Research 2021 21:413

    Content type: Research article

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  15. Access to contraceptive services is a cornerstone of human well-being. While Community Health Volunteers (CHVs) promote family planning in Kenya, the unmet need for contraceptives among youth remains high. CHV...

    Authors: Hermen Ormel, George Oele, Maryse Kok, Happiness Oruko, Beatrice Oluoch, Eefje Smet and Dorcus Indalo

    Citation: BMC Health Services Research 2021 21:405

    Content type: Research article

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  16. Multi-professional obstetric emergencies training is one promising strategy to improve maternity care. Sustaining training programmes following successful implementation remains a challenge. Understanding, and...

    Authors: Kiren Ghag, Rachna Bahl, Cathy Winter, Mary Lynch, Nayda Bautista, Rogelio Ilagan, Matthew Ellis, Isabel de Salis and Timothy J. Draycott

    Citation: BMC Health Services Research 2021 21:384

    Content type: Research article

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  17. In response to the rising global NCD burden, humanitarian actors have rapidly scaled-up NCD services in crisis-affected low-and-middle income countries. Using the RE-AIM implementation framework, we evaluated ...

    Authors: Éimhín Ansbro, Tobias Homan, Jamil Qasem, Karla Bil, Mohammed Rasoul Tarawneh, Bayard Roberts, Pablo Perel and Kiran Jobanputra

    Citation: BMC Health Services Research 2021 21:381

    Content type: Research article

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  18. In Kenya, street-connected children and youth (SCY) have poor health outcomes and die prematurely due to preventable causes. This suggests they are not accessing or receiving adequately responsive healthcare t...

    Authors: Embleton Lonnie, Shah Pooja, Gayapersad Allison, Kiptui Reuben, Ayuku David, Wachira Juddy, Apondi Edith and Braitstein Paula

    Citation: BMC Health Services Research 2021 21:363

    Content type: Research article

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  19. The Integrated eDiagnosis Approach (IeDA), centred on an electronic Clinical Decision Support System (eCDSS) developed in line with national Integrated Management of Childhood Illness (IMCI) guidelines, was im...

    Authors: Sophie Sarrassat, James J. Lewis, Arsene S. Some, Serge Somda, Simon Cousens and Karl Blanchet

    Citation: BMC Health Services Research 2021 21:354

    Content type: Research article

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  20. SMS for Life was one of the earliest large-scale implementations of mHealth innovations worldwide. Its goal was to increase visibility to antimalarial stock-outs through the use of SMS technology. The objectiv...

    Authors: Carmen Sant Fruchtman, Selemani Mbuyita, Mary Mwanyika-Sando, Marcel Braun, Don de Savigny and Daniel Cobos Muñoz

    Citation: BMC Health Services Research 2021 21:343

    Content type: Research article

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  21. Patient experience is a key measure widely used to evaluate quality of healthcare, yet there is little discussion about it in China using national survey data. This study aimed to explore rural and urban diffe...

    Authors: Dantong Zhao, Zhongliang Zhou, Chi Shen, Rashed Nawaz, Dan Li, Yangling Ren, Yaxin Zhao, Dan Cao and Xiaohui Zhai

    Citation: BMC Health Services Research 2021 21:330

    Content type: Research article

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  22. Nigeria faces an increase in the burden of non-communicable diseases (NCDs), including cardiovascular diseases (CVDs), leading to an estimated 29% of all deaths in the country. Nigeria has an estimated hyperte...

    Authors: Ikechukwu A. Orji, Abigail S. Baldridge, Kasarachi Omitiran, Mainzhao Guo, Whenayon Simeon Ajisegiri, Tunde M. Ojo, Gabriel Shedul, Namratha R. Kandula, Lisa R. Hirschhorn, Mark D. Huffman and Dike B. Ojji

    Citation: BMC Health Services Research 2021 21:322

    Content type: Research article

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  23. Correctional facilities are an underutilized venue for reaching young adults who have not vaccinated for human papillomavirus (HPV). The objective of this study was to identify factors that are associated with...

    Authors: Amanda Emerson, Molly Allison, Lisa Saldana, Patricia J. Kelly and Megha Ramaswamy

    Citation: BMC Health Services Research 2021 21:309

    Content type: Research article

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  24. Rapid spread of COVID-19 forced the public to turn to community pharmacies as the most accessible points of primary healthcare, overloading pharmacy services. The objectives of this research were to detect and...

    Authors: Jelena Jovičić-Bata, Nebojša Pavlović, Nataša Milošević, Neda Gavarić, Svetlana Goločorbin-Kon, Nemanja Todorović and Mladena Lalić-Popović

    Citation: BMC Health Services Research 2021 21:304

    Content type: Research article

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  25. Although donor transitions from HIV programs are more frequent, little research exists seeking to understand the perceptions of patients and providers on this process. Between 2015 and 2017, PEPFAR implemented...

    Authors: Henry Zakumumpa, Ligia Paina, Jess Wilhelm, Freddie Ssengooba, Eric Ssegujja, Moses Mukuru and Sara Bennett

    Citation: BMC Health Services Research 2021 21:302

    Content type: Research article

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  26. Blackpool is one of the most deprived Local Authority (LA) areas in England; in April 2015 the Blackpool Better Start (BBS) Partnership was allocated £45 million over 10 years from the Big Lottery Fund (BLF) a...

    Authors: C. F. Mills, E. Lowrie, K. Kinloch and E. Hall

    Citation: BMC Health Services Research 2021 21:283

    Content type: Research article

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  27. The aim of this study was to identify the range of ways that safety net hospitals (SNHs) have been empirically operationalized in the literature and determine the extent to which patterns could be identified i...

    Authors: Jennifer L. Hefner, Tory Harper Hogan, William Opoku-Agyeman and Nir Menachemi

    Citation: BMC Health Services Research 2021 21:278

    Content type: Research article

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  28. Tanzania’s primary healthcare system suffers from a scarcity of financial and human resources that impedes its effectiveness to deliver dependable and uniform quality healthcare. Adherence to standard treatmen...

    Authors: Karin Wiedenmayer, Eva Ombaka, Baraka Kabudi, Robert Canavan, Sarah Rajkumar, Fiona Chilunda, Selemani Sungi and Manfred Stoermer

    Citation: BMC Health Services Research 2021 21:272

    Content type: Research article

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  29. Studies focusing on the Integrated Management of Childhood Illness (IMCI) program in the Philippines are limited, and perspectives of frontline health care workers (HCWs) are largely absent in relation to the ...

    Authors: Mark Donald C. Reñosa, Kate Bärnighausen, Sarah L. Dalglish, Veronica L. Tallo, Jhoys Landicho-Guevarra, Maria Paz Demonteverde, Carol Malacad, Thea Andrea Bravo, Mary Lorraine Mationg, Socorro Lupisan and Shannon A. McMahon

    Citation: BMC Health Services Research 2021 21:270

    Content type: Research article

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  30. Improving access to radiotherapy services in low and middle-income countries (LMICs) is challenging. Many LMICs’ radiotherapy initiatives fail because of multi-faceted barriers leading to significant wastage o...

    Authors: Andrew Donkor, Tim Luckett, Sanchia Aranda, Verna Vanderpuye and Jane L. Phillips

    Citation: BMC Health Services Research 2021 21:268

    Content type: Research article

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  31. In this study, we sought to assess healthcare professionals’ acceptance of and satisfaction with a shared decision making (SDM) educational workshop, its impact on their intention to use SDM, and their perceiv...

    Authors: Samira Abbasgholizadeh Rahimi, Charo Rodriguez, Jordie Croteau, Alireza Sadeghpour, Amir-Mohammad Navali and France Légaré

    Citation: BMC Health Services Research 2021 21:225

    Content type: Research article

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  32. To improve care for patients with chronic diseases, a recent policy initiative in Thailand focused on strengthening primary care based on the concept of Chronic Care Model (CCM). This study aimed to assess the...

    Authors: Wichai Aekplakorn, Paibul Suriyawongpaisal, Samrit Srithamrongsawadi and Phanuwich Kaewkamjonchai

    Citation: BMC Health Services Research 2021 21:223

    Content type: Research article

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  33. The shortage of healthcare professionals (HCP) negatively affects health services in rural areas in many parts of the world, as is the case in South Africa. Innovative programs designed to improve the recruitm...

    Authors: Dumsani M. Gumede, Myra Taylor and Jane D. Kvalsvig

    Citation: BMC Health Services Research 2021 21:220

    Content type: Research article

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  34. Delays in care-seeking for childhood illness may lead to more severe outcomes. We evaluated whether community distance from a primary healthcare facility was associated with decreased healthcare utilization in...

    Authors: Catherine E. Oldenburg, Ali Sié, Mamadou Ouattara, Mamadou Bountogo, Valentin Boudo, Idrissa Kouanda, Elodie Lebas, Jessica M. Brogdon, Ying Lin, Fanice Nyatigo, Benjamin F. Arnold and Thomas M. Lietman

    Citation: BMC Health Services Research 2021 21:212

    Content type: Research article

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  35. Social enterprises are organizations created to address social problems that use business models to sustain themselves financially. Social enterprises can help increase access to primary health care in low res...

    Authors: Lutfi Lokman and Teresa Chahine

    Citation: BMC Health Services Research 2021 21:211

    Content type: Research article

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  36. Research capacity strengthening could be an indirect outcome of implementing a research project. The objective of this study was to explore the ability of the global maternal sepsis study (GLOSS), implemented ...

    Authors: Rachidatou Compaoré, Vanessa Brizuela, Anne M. Khisa, Alejandra López Gómez, Adama Baguiya, Mercedes Bonet, Anna Thorson, Evelyn Gitau and Seni Kouanda

    Citation: BMC Health Services Research 2021 21:208

    Content type: Research article

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  37. Poor reproductive, maternal, newborn, child, and adolescent health outcomes in Nigeria can be attributed to several factors, not limited to low health service coverage, a lack of quality care, and gender inequ...

    Authors: Chioma Oduenyi, Joya Banerjee, Oniyire Adetiloye, Barbara Rawlins, Ugo Okoli, Bright Orji, Emmanuel Ugwa, Gbenga Ishola and Myra Betron

    Citation: BMC Health Services Research 2021 21:198

    Content type: Research article

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  38. People living with diabetes have an increased risk of developing mental health issues. Mexico has observed a high prevalence of people living with diabetes suffering from mental health issues, such as anxiety ...

    Authors: Benjamín Aceves, Manuel Ruiz, Maia Ingram, Catalina Denman, David O. Garcia, Purnima Madhivanan and Cecilia Rosales

    Citation: BMC Health Services Research 2021 21:177

    Content type: Research article

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  39. The COVID-19 pandemic has posed unprecedented challenges and threats to the health care system, particularly affecting the effective delivery of essential health services in resource-poor countries such as Nep...

    Authors: Devendra Raj Singh, Dev Ram Sunuwar, Sunil Kumar Shah, Kshitij Karki, Lalita Kumari Sah, Bipin Adhikari and Rajeeb Kumar Sah

    Citation: BMC Health Services Research 2021 21:174

    Content type: Research article

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  40. While the nexus of migration and health outcomes is well acknowledged, the effect of rural–urban migration on the use of sexual and reproductive health (SRH) services has received less attention. We assessed t...

    Authors: Mulekya F. Bwambale, Paul Bukuluki, Cheryl A. Moyer and Bart H. W. Van den Borne

    Citation: BMC Health Services Research 2021 21:169

    Content type: Research article

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  41. Several countries including Tanzania, have established voluntary non-profit insurance schemes, commonly known as community-based health insurance schemes (CBHIs), that typically target rural populations and th...

    Authors: Alphoncina Kagaigai, Amani Anaeli, Amani Thomas Mori and Sverre Grepperud

    Citation: BMC Health Services Research 2021 21:162

    Content type: Research article

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  42. Despite health centres being the first point of contact of care, there are challenges faced in providing care to patients at this level. In Malawi, service provision barriers reported at this level included lo...

    Authors: Mtisunge Joshua Gondwe, Marc Y. R. Henrion, Thomasena O’Byrne, Clemens Masesa, Norman Lufesi, Queen Dube, Maureen D. Majamanda, Martha Makwero, David G. Lalloo and Nicola Desmond

    Citation: BMC Health Services Research 2021 21:150

    Content type: Research article

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  43. This paper aims to describe the profile of oral cancer (OC) patients, their risk classification and identify the time between screening and treatment initiation in Rio de Janeiro Municipality.

    Authors: Manoela Garcia Dias da Conceição, Isabel Cristina Martins Emmerick, Ana Claudia Figueiró and Vera Lucia Luiza

    Citation: BMC Health Services Research 2021 21:145

    Content type: Research article

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  44. Solving inequality of health human resource (HHR) is one of the motives of Pakistan health policies, however, there is still exists a massive quantity of HHR inequality in almost every district of Pakistan. Th...

    Authors: Rashed Nawaz, Zhongliang Zhou, Neelum Khalid, Dan Cao, Guanping Liu, Yangling Ren, Dantong Zhao, Yaxin Zhao and Yaru Chen

    Citation: BMC Health Services Research 2021 21:142

    Content type: Research article

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  45. Cardiovascular disease (CVD) is the largest contributor to the non-communicable diseases (NCD) burden in Cameroon, but data on its economic burden is lacking.

    Authors: Leopold Ndemnge Aminde, Anastase Dzudie, Yacouba N. Mapoure, Jacques Cabral Tantchou and J. Lennert Veerman

    Citation: BMC Health Services Research 2021 21:140

    Content type: Research article

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  46. Patients’ non-adherence with medical orders of physicians in outpatient clinics can lead to reduced clinical effectiveness, inadequate treatment, and increased medical care expenses. This study was conducted t...

    Authors: Vahid Yazdi-Feyzabadi, Nouzar Nakhaee, Mohammad Hossein Mehrolhassani, Soheila Naghavi and Enayatollah Homaie Rad

    Citation: BMC Health Services Research 2021 21:136

    Content type: Research article

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  47. Patient satisfaction is one proxy indicator of the health care quality; however, enhancing patient satisfaction in low-income settings is very challenging due to the inadequacy of resources as well as low heal...

    Authors: Mukesh Adhikari, Narendra Raj Paudel, Shiva Raj Mishra, Archana Shrestha and Dipak Prasad Upadhyaya

    Citation: BMC Health Services Research 2021 21:135

    Content type: Research article

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  48. This study aimed to estimate both direct medical and indirect costs of treating the Coronavirus disease 2019 (COVID-19) from a societal perspective in the patients at a referral hospital in Fars province as we...

    Authors: Mohsen Ghaffari Darab, Khosro Keshavarz, Elnaz Sadeghi, Javad Shahmohamadi and Zahra Kavosi

    Citation: BMC Health Services Research 2021 21:132

    Content type: Research article

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