Assessment of national health systems performance in the WHO African region

There is growing peer and donor pressure on African countries to utilize available resources more efficiently in a bid to support the ongoing efforts to expand coverage of health interventions with a view to achieving the health-related Millennium Development Goals. The purpose of this study was to estimate the technical and scale efficiency of national health systems in African continent. Methods The study applied the Data Envelopment Analysis approach to estimate the technical efficiency and scale efficiency among the 53 countries of the African Continent. Results Out of the 38 low-income African countries, 12 countries national health systems manifested a constant returns to scale technical efficiency (CRSTE) score of 100%; 15 countries had a VRSTE score of 100%; and 12 countries had a SE score of one. The average variable returns to scale technical efficiency (VRSTE) score was 95% and the mean scale efficiency (SE) score was 59%; meaning that while on average the degree of inefficiency was only 5%, the magnitude of scale inefficiency was 41%. Of the 15 middle-income countries, 5 countries, 9 countries and 5 countries had CRSTE, VRSTE and SE scores of 100%. Ten countries, six countries and 10 countries had CRSTE, VRSTE and SE scores of less than 100%; and thus, they were deemed inefficient. The average VRSTE (i.e. pure efficiency) score was 97.6%. The average SE score was 49.9%. Conclusion There are large unmet need for health and health-related services among countries of the African Continent. Thus, it would not be advisable for health policy-makers address NHS inefficiencies through reduction in excess human resources for health. Instead, it would be more prudent for them to leverage health promotion approaches and universal access prepaid (tax-based, insurance-based or mixtures) health financing systems to create demand for under utilised health services/interventions with a view to increasing ultimate health outputs to efficient target levels.

Therapeutic potential of statins and the induction of heme oxygenase-1 in preeclampsia

Heme oxygenase (Hmox) is an endogenous system that offers protection against placental cytotoxic damage associated with preeclampsia. The Hmox1/carbon monoxide (CO) pathway inhibits soluble Flt-1 (sFlt-1) and soluble Endoglin (sEng). More importantly, statins induce Hmox1 and suppress the release of sFlt-1 and sEng; thus, statins and Hmox1 activators are potential novel therapeutic agents for treating preeclampsia. The contribution of the Hmox system to the pathogenesis of preeclampsia has been further indicated by the incidence of preeclampsia being reduced by a third in smokers, who had reduced levels of circulating sFlt-1. Interestingly, preeclamptic women exhale less CO compared with women with healthy pregnancies. Hmox1 is reduced prior to the increase in sFlt-1 as Hmox1 mRNA expression in the trophoblast is decreased in the first trimester in women who go on to develop preeclampsia. Induction of Hmox1 or exposure to CO or bilirubin has been shown to inhibit the release of sFlt-1 and sEng in animal models of preeclampsia. The functional benefit of statins and Hmox1 induction in women with preeclampsia is valid not only because they inhibit sFlt-1 release, but also because statins and Hmox1 are associated with anti-apoptotic, anti-inflammatory, and anti-oxidant properties. The StAmP trial is the first randomized control trial (RCT) evaluating the use of pravastatin to ameliorate severe preeclampsia. This proof-of-concept study will pave the way for future global RCT, the success of which will greatly contribute to achieving the United Nations Millennium Development Goals (MDG4 and MDG5) and offering an affordable and easily accessible therapy for preeclampsia. © 2014 The Authors.

Hungarian international development cooperation:context, stakeholders and performance

This paper explores the domestic and international context of Hungary's emerging international development policy. Specifically, it looks at three factors that may influence how this policy operates: membership in the European Union (EU) and potential ‘Europeanization’, Hungary's wider foreign policy strategy, and the influence of domestic stakeholders. In order to uncover how these factors affect the country's international development policy, semi-structured interviews were carried out with the main stakeholders. The main conclusions are: (1) While accession to the EU did play a crucial role in restarting Hungary's international development policy, the integration has had little effect since then; (2) international development policy seems to serve mainly Hungary's regional strategic foreign policy and economic interests, and not its global development goals; and (3) although all the domestic development stakeholders are rather weak, the Ministry of Foreign Affairs (MFA) still seems to play a dominating role. Convergence with European requirements and best practices is, therefore, clearly hindered by foreign policy interests and also by the weakness of non- governmental stakeholders.

Vision2020 and the English language : a study of the role of language in national development.

The research reported here is an investigation into the problems of social and economic development of a multiethic and multicultural country which has the added challenge of adopting a non-indigenous code to facilitate the development process. Malaysia's power to negotiate outcomes favourable to the interest of the country is critical for the successful attainment of the goals and objectives of VISION2020. Therefore the mechanisms of the human resource development programme have to be efficacious. The three hypotheses of this study are as follows: 1. there is a fear that the problems and challenges posed by the development plans, have been conceptually trivialised; 2. based on (1) above there is a concern that solutions proposed are inadequate and inappropriate and 3. the outcome of both (1) and (2) can lead to the potential underachievement of national goals and objectives. The study proposes a complex model for conceptualising the problem which looks at the relationship between society and language, which any solutions proposed must take into proper consideration. The study looks at the mechanisms available for the smooth absorption of new Malaysian members to new and international communities. A large scale investigation was undertaken with the researcher functioning as a participant observer. An in-depth study of one particular educational ecology yielded approximately 38 hours of interviews and 100 questionnaires. These data were analysed both for explicit information and implicit implications. By some criteria national policies appear to be having the desired effect, and can be given a clean bill of health. By others it is clear that major adjustments would be necessary if the nation is to achieve its objectives in full. Based on the evidence gathered, thr study proposes an apprenticeship approach to training programmes for effective participation of new members in the new ecologies.

New Europe’s new development aid

This book examines the international development policies of five East Central European new EU member states, the Czech Republic, Hungary, Poland, Slovakia and Slovenia. These countries turned from being aid recipients to donors after the turn of the millennium in the run-up to EU accession in 2004. The book explains the evolution subsequent to EU accession and current state of foreign aid policies in the region and the reasons why these deviate from many of the internationally agreed best practices in development cooperation. It argues that after the turn of the millennium, a 'Global Consensus' has emerged on how to make foreign aid more effective for development. A comparison between the elements of the Global Consensus and the performance of the five countries reveals that while they have generally implemented little of these recommendations, there are also emerging differences between the countries, with the Czech Republic and Slovenia clearly aspiring to become globally responsible donors. Building on the literatures on foreign policy analysis, international socialization and interest group influence, the book develops a model of foreign aid policy making in order to explain the general reluctance of the five countries in implementing international best practices, and also the differences in their relative performance.

Business information systems:technology, development and management for the e-business

In order to run a successful business, today’s manager needs to combine business skills with an understanding of information systems and the opportunities and benefits that they bring to an organisation. Starting from basic concepts, this book provides a comprehensive and accessible guide to: •understanding the technology of business information systems; •choosing the right information system for an organisation; •developing and managing an efficient business information system; •employing information systems strategically to achieve organisational goals. Taking a problem-solving approach, Business Information Systems looks at information systems theory within the context of the most recent business and technological advances. This thoroughly revised new edition has updated and expanded coverage of contemporary key topics such as: •Web 2.0 •enterprise systems •implementation and design of IS strategy •outsourcing