Few studies have systematically examined the efficiency of routine infant immunization services. Using a representative sample of infant immunization sites in Benin, Ghana, Honduras, Moldova, Uganda and Zambia (316 total), we estimated average efficiency levels and variation in efficiency within each country, and investigated the properties of published efficiency estimation techniques.
Efforts from the developed world to improve surgical, anesthesia and obstetric care in low- and middle-income countries have evolved from a primarily volunteer mission trip model to a sustainable health system strengthening approach as private and public stakeholders recognize the enormous health toll and financial burden of surgical disease. The National Surgical, Obstetric and Anesthesia Plan (NSOAP) has been developed as a policy strategy for countries to address, in part, the health burden of diseases amenable to surgical care, but these plans have not developed in isolation. The NSOAP has become a phenomenon of globalization as a broad range of partners – individuals and institutions – help in both NSOAP formulation, implementation and financing. As the nexus between policy and action in the field of global surgery, the NSOAP reflects a special commitment by state actors to make progress on global goals such as Universal Health Coverage and the United Nations Sustainable Development Goals. This requires a continued global commitment involving genuine partnerships that embrace the collective strengths of both national and global actors to deliver sustained, safe and affordable high-quality surgical care for all poor, rural and marginalized people.
Autologous platelet-rich plasma contains concentrated platelets after graded centrifugation, which has various applications. Skin grafting is an age-old procedure, which has been used for wound coverage. But the healing process is longer and may be difficult, depending on the wound site, skin defect size, and patient comorbidities, and is difficult to be carried out in patients who have limited donor sites, such as in burns or those who are not fit for long procedures. Hence, pixel grafting can be used in these areas. Platelet-rich plasma can be used to aid the graft take, and thereby decreasing patient morbidity and improve the surgeon’s efforts.
Of the complications of diabetes mellitus, foot ulcers are the most dreaded complications, as they can progress at an alarming rate and can be very difficult to treat. Various modalities have been described in the treatment of diabetic foot ulcers. One such modality of phenytoin therapy uses the disadvantage of the drug, that is, gingival hyperplasia to the advantage of wound healing. We hereby report a case of diabetic foot ulcer managed with injection phenytoin sprayed topically over the wound.
Various studies have reported different conclusions over the safety and benefits of early tracheostomy in burns. Our study aimed to assess the role of prophylactic tracheostomy in treatment and improvement of outcomes in inhalational burns in India.
The nationwide opioid epidemic has substantially impacted economically-depressed regions in the USA. Eastern Appalachia has some of the lowest socioeconomic indicators in the USA and has suffered the highest rate of opioid-related fatality in 2016. Despite devoting considerable federal and state resources towards public health initiatives, the region continued to experience one of the highest death rates and sought alternative approaches to address the opioid crisis. Here, we describe a community-based co-creation initiative that convened diverse sectors and utilised design thinking principles to generate sustainable public health ventures towards addressing the opioid crisis. Participants of diverse backgrounds came together to attack key challenges and developed and implemented solutions, including a mobile application for naloxone delivery and exercise programs for high schools to promote healthy habits. Grassroots innovation efforts catalysed by the event strengthened community engagement and facilitated a sense of agency among participants. Through specific examples of initiatives that were launched, we provide evidence to encourage and highlight the value of healthcare innovation efforts in low-resource settings.
Although the national obesity epidemic has been well documented, less is known about obesity at the U.S. state level. Current estimates are based on body measures reported by persons themselves that underestimate the prevalence of obesity, especially severe obesity.