BACKGROUND Mid-level medical workers play an important role in health systems and hold great potential for addressing the human resource shortage, especially in low- and middle-income countries. South Africa began the production of its first mid-level medical workers - known as clinical associates - in small numbers in 2008. OBJECTIVE We describe the way in which scopes of practice and course...

BACKGROUND Achieving high rates of adherence to antiretroviral therapy (ART) in resource-poor settings comprises serious, but different, challenges in both the first months of treatment and during the life-long maintenance phase. We measured the impact of a health system-oriented, facility-based intervention to improve clinic attendance and patient adherence. METHODS This was a quasi-experime...

Two hundred consecutive male cases of myocardial infarction have been treated along lines designed to provide a minimal time spent in bed, and in hospital, with early return to work. The method of treatment and the results are described. Rapid rehabilitation enabled 40 per cent to be discharged within a fortnight and 87 per cent within a month. Twenty-three per cent returned to work within 4 we...

Introduction It is often said that the majority of surgery in Africa occurs in cities because the surgeons prefer to live in the cities. This is certainly true in Malawi where all the country’s practising surgeons live in the four main towns. We have recently reported (1) on the low level of surgical activity in district hospitals despite several new district hospitals being built with multiple...

AIMS To evaluate the characteristics of manual haemoglobin methods in use in Malawi and provide evidence for the Ministry of Health in Malawi to enable them to choose a suitable method for district hospitals. METHODS Criteria on accuracy, clinical usefulness, user friendliness, speed, training time, and economic costs were determined by local health professionals and used to compare six diffe...

BACKGROUND The Ethiopian epidemic is currently on the wane. However, the situation for infected children is in some ways lagging behind due to low treatment coverage and deficient prevention of mother-to-child transmission. Too few studies have examined HIV infected children presenting to care in low-income countries in general. Considering the presence of local variations in the nature of the ...

BACKGROUND: For a health district to function referral from health centres to district hospitals is critical. In many developing countries referral systems perform well below expectations. Niger is not an exception in this matter. Beyond obvious problems of cost and access this study shows to what extent the behaviour of the health worker in its interaction with the patient can be a barrier of ...

Dear Editor, I have read with great interest the article titled "The Relationship between Caesarean and Neonatal Hypothyroidism in Chadegan City" by Naderi et al[1]. Best regards and thanks to the authors, it is an interesting topic however these few points that I would entitled to highlight. First in the method section, that author mentioned the record 86 cases. This is not likely ...