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 ...

BACKGROUND An innovative, three-year training programme, the Bachelor of Clinical Medical Practice (BCMP), for mid-level medical healthcare workers was started in 2009 by the Department of Family Medicine, University of Pretoria. AIM To measure the students' perceptions of the instructional quality of district hospitalbased training. SETTING Training of students took place at clinical learn...

BACKGROUND Eighty per cent of Malawi's 8 million children live in rural areas, and there is an extensive tiered health system infrastructure from village health clinics to district hospitals which refers patients to one of the four central hospitals. The clinics and district hospitals are staffed by nurses, non-physician clinicians and recently qualified doctors. There are 16 paediatric special...

BACKGROUND The 'resource readiness' of health facilities to provide effective services is captured in the structure component of the classical Donabedian paradigm often used for assessment of the quality of care in the health sector. Periodic inventories are commonly used to confirm the presence (or absence) of equipment or drugs by physical observation or by asking those in charge to indicate ...

An efficient Telehealth system for Tonga is currently but a dream. The kingdom of Tonga consists of 36 inhabited islands occupying 669 kms2 and a population of 97,784 (1996). There is a referral hospital in the Capital and three other district hospitals, 14 peripheral health centres, 32 maternal child health clinics and eight general practitioners. Within the kingdom the use of the telephone, t...

a University of Michigan Medical School, Ann Arbor, MI, USA b Ghana Health Service, Sekyere Kumawu District Health Directorate, Kumawu, Ghana c Department of Obstetrics and Gynecology, University of Science and Technology School of Medical Sciences, Kumasi, Ghana d Ghana Health Service, Bosomtwe District Health Directorate, Bosomtwe, Ghana e Department of Epidemiology, University of Michigan Sc...