Between August-December 2014, Ebola Virus Disease (EVD) patients from Tonkolili District were referred for care to two Médecins Sans Frontières (MSF) Ebola Management Centres (EMCs) outside the district (distant EMCs). In December 2014, MSF opened an EMC in Tonkolili District (district EMC). We examined the effect of opening a district-based EMC on time to admission and number of suspect cases ...

AIM To explore district nurses' workload management, job satisfaction and the challenges they face. BACKGROUND This paper reports qualitative findings from a qualitative and quantitative study to identify a district nursing perspective on use of time, challenges and work satisfaction. District nursing is under increasing pressure because of the increasing shift to care in the community, early...

To the Editor: The evaluation of the surgical outreach programme to district hospitals in Sisonke Health District (SHD), KwaZulu-Natal, South Africa (SA), recently published in the SAMJ demonstrates an admirable commitment to improving district health services. While the authors documented a large number of flying hours and kilometres travelled and 2 160 operations performed over a 6-month peri...

BACKGROUND There is increasing evidence that good district management practices can improve health system performance and conversely, that poor and inefficient management practices have detrimental effects. The aim of the present study was to identify factors contributing to inefficient management practices of district health managers and ways to improve their overall efficiency. METHODS Nine...

Decentralisation has become an essential tool of democracy and development. Decentralisation has been widely promoted all over the world as a means of promoting governance, participation and local development. Undoubtedly, decentralisation is a positive action. However, decentralised local governments are yet to effectively deliver the much-expected results. In Ghana, concerns have been raised ...

BACKGROUND To eliminate blinding trachoma, the World Health Organization emphasizes implementing the SAFE strategy, which includes annual mass drug administration (MDA) with azithromycin to the whole population of endemic districts. Prevalence surveys to assess impact at the district level are recommended after at least 3 years of intervention. The decision to stop MDA is based on a prevalence ...

An urban district heating network represents an energy efficient way to supply the cities heat demand. The extension of district heating and the increase of it’s share in heat supply allows replacing ecological inefficient heating technologies. The economic feasibility of the extension and expansion and the operation of a local district heating network is a major issue. Hence the investment dec...

Since the early 1970s, the states of the Tenth Federal Reserve District have experienced wide swings in economic activity and interstate migration. The swings in migration not only reflect the region’s economic performance but also have important consequences for future economic activity. This article discusses recent trends and prospects for migration into and out of the district. The first se...

OBJECTIVE To examine the influence of state laws and district policies on district-wide elementary school and middle school practices related to physical education (PE) time and the percentage of moderate-to-vigorous physical activity (MVPA) time during PE. DESIGN Multivariate, cross-sectional analysis of state laws, district wellness and PE policies, and district PE practices for school year...

BACKGROUND Multiple micronutrient deficiencies during pregnancy in Vietnam may contribute to poor fetal growth and stunting, which are major determinants of the health and development offuture generations. OBJECTIVE We assessed the effects of prenatal multiple micronutrient supplementation on maternal weight gain during pregnancy, infant birthweight, and height of the child at around 2 years ...