Search results for: Universal Health Coverage.

Authors: Karim Hajjar, Luis Lillo, Diego Martinez, Manuel Hermosilla, Nicholas Risko

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Objectives: This study examines the relationship between universal health coverage (UCH) and the burden of emergency diseases at a global level. Methods: Data on Disability-Adjusted Life Years (DALYs) from emergency conditions were extracted from the Institute for Health Metrics and Evaluation (IHME) database for the years 2015 and 2019. Data on UHC, measured using two variables, 1) coverage of essential health services and 2) proportion of population spending more than 10% of household income on out-of-pocket health care expenditure, was extracted from the World Bank Database for years preceding our outcome of interest. Linear regression was performed, analyzing the effect of the UHC variables on the DALYs of emergency diseases, controlling for other variables. Results: A total of 133 countries were included. 44.4% of the analyzed countries had coverage of essential health services index of at least 70/100, and 35.3% had at least 10% of their population spend greater than 10% of their household income on healthcare. For every point increase in the coverage of essential health services index, there was a 13-point reduction in DALYs of emergency medical diseases (95% CI -16, -11). Conversely, for every percent decrease in the population with large household expenditure on healthcare, there was a 0.48 increase in DALYs of emergency medical diseases (95% CI -5.6, 4.7). Conclusions: After adjusting for multiple variables, an increase in coverage of essential health services was significantly associated with improvement in DALYs for emergency conditions. There was, however, no association between catastrophic health expenditure and DALYs.

Keywords: emergency medicine, universal healthcare, global health, health economics

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Authors: Richard Ssempala, Francis Kintu, Christine K. Tashobya

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Funding for health remains a key constraint facing many developing countries, Uganda inclusive. Uganda’s health sector budget to the national budgetary allocation has stagnated between 8.2% to 10% over the years. Using data collected from different government documents, we sought to establish the implications of the budget allocation over the period (FY2010/11-2018/19) on health services delivery in Uganda to inform policymakers specifically Members of Parliament who are critical in making sectorial allocation on the steps they can adapt to change the terrain of health financing in Uganda. Findings revealed that the contribution of public funding to the health sector is low (15.7%) with private sources (42.6%) and donors contributing much more, with the bulk of private funds, are out of pocket. The study further revealed that low budget allocation had been manifested in inadequate and poorly motivated health workers, essential drug stock-outs that ultimately contribute to poor access to services, catastrophic health expenditures, and high morbidity rates. We recommend for a substantial and sustained increase in the government health budget, optimizing the available resources by addressing wastages, prioritizing health promotion, prevention and finally, institutionalizing the National Health Insurance Scheme.

Keywords: budget allocations, universal health coverage, health service delivery, Uganda

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Authors: Yosika Dian Komala, Uke Kurniawan Usman, Yuyun Siti Rohmah

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The enable technology fills up needs of high-speed data service is Universal Mobile Telecommunications Service (UMTS). UMTS has a data rate up to 2Mbps.UMTS terrestrial system has a coverage area about 1-2km. High Altitude Platform Station (HAPS) can be built by a macro cell that is able to serve the wider area. Design method of UMTS using HAPS is planning base on coverage and capacity. The planning method is simulated with 2.8.1 Atoll’s software. Determination of radius of the cell based on the coverage uses free space loss propagation model. While the capacity planning to determine the average cell through put is available with the Offered Bit Quantity (OBQ).

Keywords: UMTS, HAPS, coverage planning, capacity planning, signal level, Ec/Io, overlapping zone, throughput

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Authors: Ming-Juei Chang, Hui-Ing Ma, Tsung-Hsueh Lu

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Introduction: Because of the advance of medical care (e.g., ventilation techniques and gastrostomy feeding), more and more children with CP can live to adulthood. However, little is known about the use of health care services from children to adults who have CP. The patterns of utilization of ambulatory care are heavily influenced by insurance coverage and primary care gatekeeper regulation. The purpose of this study was to examine patterns of ambulatory care utilization among individuals with CP in Taiwan, a country with universal coverage and no gatekeeper regulation. Methods: A representative sample of one million patients (about 1/23 of total population) covered by Taiwan’s National Health Insurance was used to analyze the ambulatory care utilization in individuals with CP. Data were analyzed by 3 different age groups (children, youth and adults) during 2000 to 2003. Participants were identified by the presence of CP diagnosis made by pediatricians or physicians of physical and rehabilitation medicine and stated at least three times in claims data. Results: Annual rates of outpatient physician visits were 31680 for children, 16492 for youth, and 28617 for adults with CP (per 1000 persons). Individuals with CP received over 50% of their outpatient care from hospital outpatient department. Higher use of specialist physician services was found in children (54.7%) than in the other two age groups (28.4% in youth and 18.8% in adults). Diseases of respiratory system were the most frequent diagnoses for visits in both children and youth with CP. Diseases of the circulatory system were the main reasons (24.3%) that adults with CP visited hospital outpatient care department or clinics. Conclusion: This study showed different patterns of ambulatory care utilization among different age groups. It appears that youth and adults with CP continue to have complex health issues and rely heavily on the health care system. Additional studies are needed to determine the factors which influence ambulatory care utilization among individuals with CP.

Keywords: cerebral palsy, health services, lifespan, universal coverage

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Authors: Paul Moses Ndegwa, Teresia Kabucho, Lucy Wanjiru, Esther Wanjiru, Brian Githaiga, Jecinta Wambui

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Health outcome has improved in the country since 2013 following the adoption of the new constitution in Kenya with devolved governance with administration and health planning functions transferred to county governments. 2018-2022 development agenda prioritized universal healthcare coverage, food security, and nutrition, however, the emergence of Covid-19 and the increase of non-communicable diseases pose a challenge and constrain in an already overwhelmed health system. A study was conducted July-November 2021 to establish key challenges in achieving universal healthcare coverage within the county and best practices for improved non-communicable disease control. 14 health workers ranging from nurses, doctors, public health officers, clinical officers, and pharmaceutical technologists were purposely engaged to provide critical information through questionnaires by a trained duo observing ethical procedures on confidentiality. Data analysis. Communicable diseases are major causes of morbidity and mortality. Non-communicable diseases contribute to approximately 39% of deaths. More than 45% of the population does not have access to safe drinking water. Study noted geographic inequality with respect to distribution and use of health resources including competing non-health priorities. 56% of health workers are nurses, 13% clinical officers, 7% doctors, 9%public health workers, 2% are pharmaceutical technologists. Poor-quality data limits the validity of disease-burdened estimates and research activities. Risk factors include unsafe water, sanitation, hand washing, unsafe sex, and malnutrition. Key challenge in achieving universal healthcare coverage is the rise in the relative contribution of non-communicable diseases. Improve targeted disease control with effective and equitable resource allocation. Develop high infectious disease control mechanisms. Improvement of quality data for decision making. Strengthen electronic data-capture systems. Increase investments in the health workforce to improve health service provision and achievement of universal health coverage. Create a favorable environment to retain health workers. Fill in staffing gaps resulting in shortages of doctors (7%). Develop a multi-sectional approach to health workforce planning and management. Need to invest in mechanisms that generate contextual evidence on current and future health workforce needs. Ensure retention of qualified, skilled, and motivated health workforce. Deliver integrated people-centered health services.

Keywords: multi-sectional approach, equity, people-centered, health workforce retention

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Authors: Jill Hanass-Hancock, Bradley Carpenter, Samantha Willan, Kristin Dunkle

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Access to quality health care for persons with disabilities is the litmus test in our strive toward universal health coverage. Persons with disabilities experience a variety of health disparities related to increased health risks, greater socioeconomic challenges, and persistent ableism in the provision of health care. In low- and middle-income countries, the support needed to address the diverse needs of persons with disabilities and close the gaps in inclusive and accessible health care can appear overwhelming to staff with little knowledge and tools available. An action-orientated disability inclusion toolkit for health facilities was developed through consensus-building consultations and field testing in South Africa. The co-creation of the toolkit followed a bottom-up approach with healthcare staff and persons with disabilities in two developmental cycles. In cycle one, a disability facility assessment tool was developed to increase awareness of disability accessibility and service delivery gaps in primary healthcare services in a simple and action-orientated way. In cycle two, an intervention menu was created, enabling staff to respond to identified gaps and improve accessibility and inclusion. Each cycle followed five distinct steps of development: a review of needs and existing tools, design of the draft tool, consensus discussion to adapt the tool, pilot-testing and adaptation of the tool, and identification of the next steps. The continued consultations, adaptations, and field-testing allowed the team to discuss and test several adaptations while co-creating a meaningful and feasible toolkit with healthcare staff and persons with disabilities. This approach led to a simplified tool design with ‘key elements’ needed to achieve universal health coverage: universal design of health facilities, reasonable accommodation, health care worker training, and care pathway linkages. The toolkit was adapted for paper or digital data entry, produces automated, instant facility reports, and has easy-to-use training guides and online modules. The cyclic approach enabled the team to respond to emerging needs. The pilot testing of the facility assessment tool revealed that healthcare workers took significant actions to change their facilities after an assessment. However, staff needed information on how to improve disability accessibility and inclusion, where to acquire accredited training, and how to improve disability data collection, referrals, and follow-up. Hence, intervention options were needed for each ‘key element’. In consultation with representatives from the health and disability sectors, tangible and feasible solutions/interventions were identified. This process included the development of immediate/low-cost and long-term solutions. The approach gained buy-in from both sectors, who called for including the toolkit in the standard quality assessments for South Africa’s health care services. Furthermore, the process identified tangible solutions for each ‘key element’ and highlighted where research and development are urgently needed. The cyclic and consultative approach enabled the development of a feasible facility assessment tool and a complementary intervention menu, moving facilities toward universal health coverage for and persons with disabilities in low- or better-resourced contexts while identifying gaps in the availability of interventions.

Keywords: public health, disability, accessibility, inclusive health care, universal health coverage

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Authors: Nelson Kimeli Kemboi Yego, Juma Kasozi, Joseph Nkruzinza, Francis Kipkogei

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The study investigated the low uptake of health insurance in Kenya despite efforts to achieve universal health coverage through various health insurance schemes. Unsupervised machine learning techniques were employed to identify patterns in health insurance uptake based on sociodemographic factors among Kenyan households. The aim was to identify key demographic groups that are underinsured and to provide insights for the development of effective policies and outreach programs. Using the 2021 FinAccess Survey, the study clustered Kenyan households based on their health insurance uptake and sociodemographic features to reveal patterns in health insurance uptake across the country. The effectiveness of k-prototypes clustering, hierarchical clustering, and agglomerative hierarchical clustering in clustering based on sociodemographic factors was compared. The k-prototypes approach was found to be the most effective at uncovering distinct and well-separated clusters in the Kenyan sociodemographic data related to health insurance uptake based on silhouette, Calinski-Harabasz, Davies-Bouldin, and Rand indices. Hence, it was utilized in uncovering the patterns in uptake. The results of the analysis indicate that inclusivity in health insurance is greatly related to affordability. The findings suggest that targeted policy interventions and outreach programs are necessary to increase health insurance uptake in Kenya, with the ultimate goal of achieving universal health coverage. The study provides important insights for policymakers and stakeholders in the health insurance sector to address the low uptake of health insurance and to ensure that healthcare services are accessible and affordable to all Kenyans, regardless of their socio-demographic status. The study highlights the potential of unsupervised machine learning techniques to provide insights into complex health policy issues and improve decision-making in the health sector.

Keywords: health insurance, unsupervised learning, clustering algorithms, machine learning

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Authors: Shaimaa M. Mohamed, Haitham S. Hamza, Imane A. Saroit

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Many wireless sensor network applications require K-coverage of the monitored area. In this paper, we propose a scalable harmony search based algorithm in terms of execution time, K-Coverage Enhancement Algorithm (KCEA), it attempts to enhance initial coverage, and achieve the required K-coverage degree for a specific application efficiently. Simulation results show that the proposed algorithm achieves coverage improvement of 5.34% compared to K-Coverage Rate Deployment (K-CRD), which achieves 1.31% when deploying one additional sensor. Moreover, the proposed algorithm is more time efficient.

Keywords: Wireless Sensor Networks (WSN), harmony search algorithms, K-Coverage, Mobile WSN

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Authors: Alexander Suuk Laar, Emmanuel Bekyieriya, Sylvester Isang, Benjamin Baguune

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Introduction: In Ghana, despite the implementation of strategies and initiatives to ensure universal access to reproductive health and family planning (FP) services for the past two decades, interventions have not adequately addressed the access and utilization needs of women of reproductive age, especially in rural Ghana. To improve access and use of reproductive and maternal health services in Ghana, a free maternal care exemption policy under the universal health coverage of the National Health Insurance Scheme was implemented in 2005. Despite the importance of FP, this service was left out of the benefit package of the policy. Low or no use of FP services is often associated with poor health among women. However, to date, there has been limited research on perspectives of women for not making FP services as part of the benefit package of the free maternal health services. This qualitative study explored perceptions of women on the comprehensiveness of the free maternal health benefit package and the effects on utilisation of services in the rural Upper West region of Ghana to improve services. Methods: This exploratory qualitative study used focus group discussions with pregnant and lactating women in three rural districts in the Upper West region of Ghana. Six focus groups were held with both pregnant women and lactating mothers at the time of the interview. Three focus group discussions were organised with the same category of women in each district. We used a purposive sampling procedure to select the participants from the districts. The interviews with the written consent of the participants lasted between 60 minutes and 120 minutes. Interviews were audio-recorded and transcribed verbatim. Data were analysed using Braun and Clarke thematic framework guidelines. Results: This research presents an in-depth account of women's perceptions on the effects associated with the uptake of FP services and its exclusion from the benefit package of the free maternal health policy. Our study found that participants did not support the exclusion of FP services in the benefit package. Participants mentioned factors hampering their access to and use of FP and contraceptive services to include the cost of services, distance and cost of transport to health facilities, lack of knowledge about FP services, socio-cultural norms and negative attitude of healthcare professionals. Participants are of the view that making FP services part of the benefit package could have addressed the cost aspect of services which act as the main barrier to improve the use of services by poor rural women. Conclusion: Women of reproductive age face cost barriers that limit their access to and use of FP and contraception services in the rural Upper West region of Ghana and need health policymakers to revise the free maternal health package to include FP services. It is essential for policymakers to begin considering revising the free maternal health policy benefit package to include FP services to help address the cost barrier for rural poor women to use services.

Keywords: benefit package, free maternal policy, women, Ghana, rural Upper West Region, Universal Health Coverage.

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Authors: Mohammad Ranjbar, Mohammad Bazyar, Blake Angell, Thomas Lung, Yibeltal Assefa

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Background: Current health insurance programs in Iran suffer from low enrolment and are not sufficient to attain the country to universal health coverage (UHC). We hypothesize that improving the enrollment rate and moving towards a more sustainable UHC can be achieved by improving the benefits package and providing new incentives. The objective of this study is to assess public preferences and willingness to pay (WTP) for social health insurance (SHI) in Iran. Methods: A discrete choice experiment (DCE) was conducted in 2021, using a self-administered questionnaire on 500 participants to estimate WTP and determine individual preferences for the SHI in Yazd, Iran. Respondents were presented with an eight-choice set and asked to select their preferred one. In each choice set, scenarios were described by eight attributes with varying levels. The conditional logit regression model was used to analyze the participants' preferences. Willingness to pay for each attribute was also calculated. Results: Most included attributes were significant predictors of the choice of a health insurance package. The maximum coverage of hospitalization costs in the private sector, ancillary services such as glasses, canes, etc., as well as coverage for hospitalization costs in the public sector and drug costs, were the most important determining factors for this choice. Coverage of preventive dental care did not significantly influence respondent choices. Estimating WTP showed that individuals are willing to pay more for higher financial protection, particularly against private sector costs; the WTP to increase the coverage of hospitalization costs in the private sector from 50% to 90% is estimated at 362,068 IR, Rials per month. Conclusion: This study identifies the key factors that the population value with regard to health insurance and the tradeoffs they are willing to make between them. Hospitalization, drugs, and ancillary services were the most important determining factors for their choice. The data suggest that additional resources coming into the Iranian health system might best be prioritized to cover hospitalization and drug costs and those associated with ancillary services.

Keywords: social health insurance, preferences, discrete choice experiment, willingness to pay

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Authors: Shailender Kumar

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Current health policy pronouncements in India advocate for insurance-based financing mechanism to achieve universal health coverage (UHC), while undermine the role of comprehensive healthcare provision system. UHC is achieved when all people receive the health services they need without suffering financial hardship. This study, using 68th & 71st NSS rounds data, examines their relative and combined strength in achieving the above objective. Health-insurance has been unsuccessful in reducing prevalence and catastrophic effects of out-of-pocket payment and even dismantle the effectiveness of traditional way of health financing system. Healthcare provision is the best way forward to enhance health and well-being of households in condition if India removes existing inadequacies and inequalities in service provision across districts/states and ensure free/low cost medicines/diagnostics to the citizens.

Keywords: health policy, demand-side financing, supply-side financing, incidence of health payment

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Authors: Mohd Zuhair, Ram Babu Roy

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This paper presents an overview of the accessibility, design, and functioning of health insurance plans launched by state governments in India. In recent years, the governments of several states in India have come forward to provide health insurance coverage for the low-income group and rural population to reduce the out of pocket expenditure (OPE) on healthcare. Different health insurance schemes have different structures and offerings which differ in the different demographic factors. This study will portray a comparative analysis of the various health insurance schemes by analyzing different offerings and finance generation of the schemes. The comparative analysis will explain the lesson to be learned from these schemes and extend the existing knowledge of the health insurance in India. This would help in recognizing tension between various drivers and identifying issues pertaining to the sustainability of health insurance schemes in India.

Keywords: health insurance, out of pocket expenditure, universal healthcare, sustainability

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Authors: Fathonah Siti, Ardiana Irma

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Indonesia is currently on its track to achieve Universal Health Coverage (UHC) by 2019. The program aims to address issues on disintegration in the implementation and coverage of various health insurance schemes and fragmented fund pooling. Family planning service is covered as one of benefit packages under preventive care. However, little has been done to examine how family planning program are appropriately managed across levels of governments and how family planning services are delivered to the end user. The study is performed through focus group discussion to related policy makers and selected programmers at central and district levels. The study is also benefited from relevant studies on family planning in the UHC scheme and other supporting data. The study carefully investigates some programmatic implications when family planning is integrated in the UHC program encompassing the need to recalculate contraceptive logistics for beneficiaries (eligible couple); policy reformulation for contraceptive service provision including supply chain management; establishment of family planning standard of procedure; and a call to update Management Information System. The study confirms that there is a significant increase in the numbers of contraceptive commodities needs to be procured by the government. Holding an assumption that contraceptive prevalence rate and commodities cost will be as expected increasing at 0.5% annually, the government need to allocate almost IDR 5 billion by 2019, excluded fee for service. The government shifts its focus to maintain eligible health facilities under National Population and Family Planning Board networks. By 2019, the government has set strategies to anticipate the provision of family planning services to 45.340 health facilities distributed in 514 districts and 7 thousand sub districts. Clear division of authorities has been established among levels of governments. Three models of contraceptive supply planning have been developed and currently in the process of being institutionalized. Pre service training for family planning services has been piloted in 10 prominent universities. The position of private midwives has been appreciated as part of the system. To ensure the implementation of quality and health expenditure control, family planning standard has been established as a reference to determine set of services required to deliver to the clients properly and types of health facilities to conduct particular family planning services. Recognition to individual status of program participation has been acknowledged in the Family Enumeration since 2015. The data is precisely recorded by name by address for each family and its members. It supplies valuable information to 15.131 Family Planning Field Workers (FPFWs) to provide information and education related to family planning in an attempt to generate demand and maintain the participation of family planning acceptors who are program beneficiaries. Despite overwhelming efforts described above, some obstacles remain. The program experiences poor socialization and yet removes geographical barriers for those living in remote areas. Family planning services provided for this sub population conducted outside the scheme as a complement strategy. However, UHC program has brought remarkable improvement in access and quality of family planning services.

Keywords: beneficiary, family planning services, national population and family planning board, universal health coverage

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Authors: Jemima C. A. Sumboh

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Given the urgency and consensus for countries to move towards Universal Health Coverage (UHC), health financing systems need to be accurately and consistently monitored to provide valuable data to inform policy and practice. Most of the indicators for monitoring UHC, particularly catastrophe and impoverishment, are established based on the impact of out-of-pocket health payments (OOPHP) on households’ living standards, collected through varied household surveys. These surveys, however, vary substantially in survey methods such as the length of the recall period or the number of items included in the survey questionnaire or the farming of questions, potentially influencing the level of OOPHP. Using different survey instruments can provide inaccurate, inconsistent, erroneous and misleading estimates of UHC, subsequently influencing wrong policy decisions. Using data from a household budget survey conducted by the Navrongo Health Research Center in Ghana from May 2017 to December 2018, this study intends to explore the potential implications of using surveys with varied levels of disaggregation of OOPHP data on estimates of financial risk protection. The household budget survey, structured around food and non-food expenditure, compared three OOPHP measuring instruments: Version I (existing questions used to measure OOPHP in household budget surveys), Version II (new questions developed through benchmarking the existing Classification of the Individual Consumption by Purpose (COICOP) OOPHP questions in household surveys) and Version III (existing questions used to measure OOPHP in health surveys integrated into household budget surveys- for this, the demographic and health surveillance (DHS) health survey was used). Version I, II and III contained 11, 44, and 56 health items, respectively. However, the choice of recall periods was held constant across versions. The sample size for Version I, II and III were 930, 1032 and 1068 households, respectively. Financial risk protection will be measured based on the catastrophic and impoverishment methodologies using STATA 15 and Adept Software for each version. It is expected that findings from this study will present valuable contributions to the repository of knowledge on standardizing survey instruments to obtain estimates of financial risk protection that are valid and consistent.

Keywords: Ghana, household budget surveys, measuring financial risk protection, out-of-pocket health payments, survey instruments, universal health coverage

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Authors: Nihayatul Munaa, Nyoman A. Damayanti

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This study seeks to understand what factors might influence a patient’s perception of health care under national health insurance in early implementation. In Indonesia, National Health Insurance was first implemented in 2014 and planned to achieve universal health coverage by 2019. However, the little understanding of this new policy lead to increase of complaint in hospital as a health care provider. This is a observational descriptive study with cross sectional design method. Data was collected through in-depth interview with 96 patient from Jemursari Islamic Hospital of Surabaya (Rumah Sakit Islam Jemursari Surabaya) who participate in National Health Insurance. Subject was selected by simple random sampling. The findings demonstrated that from five categories, 82,3% patient was satisfied in reliability aspect and 85,4% in assurance aspect, while in tangible, responsiveness and empathy aspect > 90% patient was satisfied. Meanwhile, in Indonesia, the minimum service standard of healthcare of patient satisfaction is 90%.

Keywords: patient’s satisfaction, national health insurance, hospital, complaint

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Authors: Ehsan Abdolzadeh, Sanaz Nouri, Siamak Khalaj

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Today WSNs have many applications in different fields like the environment, military operations, discoveries, monitoring operations, and so on. Coverage size and energy consumption are the important challenges that these networks need to face. This paper tries to solve the problem of coverage with a requirement of k-coverage and minimum energy consumption. In order to minimize energy consumption, visual sensor networks have been used that observe and process just those targets that are located in their view direction. As a result, sensor rotations have decreased, and subsequently, energy consumption has been minimized. To solve the problem of coverage particle swarm optimization, coverage optimization has been able to ensure coverage requirement together with minimizing sensor rotations while meeting the problem requirement of k≤14. So energy consumption has decreased, and this could extend the sensors’ lifetime subsequently.

Keywords: K coverage, particle union optimization algorithm, wireless sensor networks, visual sensor networks

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Authors: Marzieh Bakhtiary Noodeh, Mahla Zabet

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Attempts have been carried out to enhance the anticorrosion properties as well as edge coverage of an automotive electrocoating using the nano silica particles. To this end, the automotive electrocoating was reinforced with the nano silica particles at various weight fractions. The electrocoats were applied on the surface of punched edge followed by curing at 160⁰C for 20 min. The effects of nano silica particles on the rheological properties, influencing edge coverage were studied by a RMS (Rheometric Mechanical Spectrometer) technique. The anticorrosion properties were studied by a salt-spray test. The results obtained revealed that nano silica particles can significantly enhance the edge coverage by increasing minimum melt viscosity of electrocoats. It was shown that using 4 wt% nano silica particles, both anticorrosion properties and edge coverage of the electrocoats were significantly improved.

Keywords: nano silica, electrocoat, edge coverage, anticorrosion

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Authors: Sekou Kangoye, Alexis Todoskoff, Mihaela Barreau

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Modified Condition/Decision Coverage (MC/DC) is a structural coverage criterion that is highly recommended or required for safety-critical software coverage. Therefore, many testing standards include this criterion and require it to be satisfied at a particular level of testing (e.g. validation and unit levels). However, an important amount of time is needed to meet those requirements. In this paper we propose to automate MC/DC test data generation. Thus, we present an approach to automatically generate MC/DC test data, from software module description written over a dedicated language. We introduce a new merging approach that provides high MC/DC coverage for the description, with only a little number of test cases.

Keywords: domain-specific language, MC/DC, test data generation, safety-critical software coverage

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Authors: Diane Ezeh-Aruah

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This study examined newspaper coverage of President Muhammadu Buhar’s anti-corruption crusade, a case study of Guardian, Nation, Sun and Vanguard newspapers. It assessed the frequency of coverage given to President Buhari’s war against corruption, the prominence of coverage, the angles/framing of topics and the direction of the news stories. The determinants of the prominence of coverage were page placement, length of the story, illustrations and story types. The author made use of agenda setting and framing theories. The research was carried through the method of survey, by distribution of copies of the questionnaire. The result of this study showed that the media gave adequate coverage of President Buhari’s anti-corruption war, even though the reports were not many in the early stages of the law enactment, but the coverages lacked prominence as most of the major stories were not given front page coverage; they lacked pictorial illustrations and not exhaustive enough to be impactful. Newspaper organizations are therefore encouraged to include humanistic angles in their corruption stories rather than focus highly on political angles. They should adopt the elements of investigative and interpretative journalism in their coverage of corruption news.

Keywords: newspaper, coverage, president Muhammadu Buhari, anti-corruption campaign

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Authors: Suparat Niwitpong, Sa-aat Niwitpong

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Statistical inference of normal mean with known coefficient of variation has been investigated recently. This phenomenon occurs normally in environment and agriculture experiments when the scientist knows the coefficient of variation of their experiments. In this paper, we constructed new confidence intervals for the normal population mean with known coefficient of variation. We also derived analytic expressions for the coverage probability of each confidence interval. To confirm our theoretical results, Monte Carlo simulation will be used to assess the performance of these intervals based on their coverage probabilities.

Keywords: confidence interval, coverage probability, expected length, known coefficient of variation

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Authors: Lian Liu

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By analyzing the content of the New York Times' China-related energy reports, this study aims to explore the construction of China's national image by the mainstream media in the United States. The study analyzes three aspects of the coverage: topics, reporting tendencies, and countries involved. The results of the study show that economic issues are the main focus of the New York Times’ China-related energy coverage, followed by political issues and environmental issues. Overall, the coverage tendency was mainly negative, but positive coverage was dominated by science and technology issues. In addition, the study found that U.S.-China relations and Sino-Russian relations were important contexts for the construction of China's national image in the NYT's China-related energy coverage. These stories highlight China's interstate interactions with the United States, Japan, and Russia, which serve as important links in the coverage. The findings of this study reveal some characteristics and trends of the U.S. mainstream media's country image of China, which are important for a deeper understanding of the U.S.-China relationship and the media's influence on the construction of the country's image.

Keywords: media coverage, China, content analysis, visualization technology

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Authors: Mastewal Endeshaw Getnet

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Imunization is one of the most cost-effective and extensively adopted public health strategies for preventing child disability and mortality. Expanded Program on Immunization (EPI) was launched in 1974 with the goal of providing life-saving vaccines to all children in all and building on the success of the global smallpox eradication program. According to World Health Organization report, by 2020, all countries should have achieved 90% vaccination coverage. Many developing countries still have not achieved the goal. Ethiopia is one of Africa's developing countries. The Ethiopian Ministry of health (MoH) launched the EPI program in 1980, with the goal of achieving 90% coverage among children under the age of 1 year by 1990. Among children aged 12-23 months, complete immunization coverage was 47% based on the Ethiopian Demographic and Health Survey (EDAS) 2019 report. The coverage varies depending on the administrative region, ranging from 21% in Afar region to 89% in Amhara region, Ethiopia. Therefore, identifying risk factors for incomplete immunization among children is a key challenge, particularly in Ethiopia, which has a large geographical diversity and a predicted with 119.96 million projected population size in the year 2022. Despite its critical and challenging issue, this issue is still open and has not yet been fully investigated. Recently, a few previous studies have been conducted on the assessment of incomplete children immunization determinants. However, the majority of the studies were cross-sectional surveys that assessed only EPI coverage. Motivated by the above investigation, this study focuses on investigating determinants associated with incomplete immunization among Ethiopian children to facilitate the rate of full immunization coverage. Moreover, we consider both individual immunization and service performance-related factors to investigate incomplete children's determinants. Consequently, we adopted an ecological model in this study. Individual and environmental factors are combined in the Ecological model, which provides multilevel framework for exploring different determinants related with health behaviors. The Ethiopian Demographic and Health Survey will be used as a source of data from 2021 to achieve the objective of this study. The findings of this study will be useful to the Ethiopian government and other public health institutes to improve the coverage score of childhood immunization based on the identified risk determinants.

Keywords: incomplete immunization, children, ethiopia, ecological model

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Authors: (Ted) Edward Holmberg, Mahdi Abdelguerfi, Elias Ioup

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This research details a coverage measure for evaluating the effectiveness of observer node placements in a spatial bipartite network. This coverage measure can be used to optimize the configuration of stationary or mobile spatially oriented observer nodes, or a hybrid of the two, over time in order to fully utilize their capabilities. To demonstrate the practical application of this approach, we construct a SpatioTemporal Bipartite Network (STBN) using real-time crime center (RTCC) camera nodes and NOPD calls for service (CFS) event nodes from New Orleans, La (NOLA). We use the coverage measure to identify optimal placements for moving mobile RTCC camera vans to improve coverage of vulnerable areas based on temporal patterns.

Keywords: coverage measure, mobile node dynamics, Monte Carlo simulation, observer nodes, observable nodes, spatiotemporal bipartite knowledge graph, temporal spatial analysis

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Authors: Surinder Sood, Debajyoti Mukherjee

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Formal verification techniques have become widely popular in pre-silicon verification as an alternate to constrain random simulation based techniques. This paper proposed a novel formal verification-based coverage augmentation technique in verifying complex RTL functional verification faster. The proposed approach relies on augmenting coverage analysis coming from simulation and formal verification. Besides this, the functional qualification framework not only helps in improving the coverage at a faster pace but also aids in maturing and qualifying the formal verification infrastructure. The proposed technique has helped to achieve faster verification sign-off, resulting in faster time-to-market. The design picked had a complex control and data path and had many configurable options to meet multiple specification needs. The flow is generic, and tool independent, thereby leveraging across the projects and design will be much easier

Keywords: COI (cone of influence), coverage, formal verification, fault injection

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Authors: Dr.Prabhat Dixit Dr.Sanjay Pandey

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Russian invasion of Ukraine has hogged the limelight in both national and international media. It is expected that the news about the war, which had affected the entire world, especially its economy, will continue to dominate the coverage on TV and newspapers in the next few days, at least until the hostilities come to an end. Although the war still continues, and it is hard to predict its ending, its coverage by the Indian media has raised eyebrows, and it has been observed that the coverage lacks depth, authenticity and a majority of information was sought to be presented in a sensational manner only to attract more number of viewers. It is said that Truth is the first casualty of war. The media should, especially while airing or publishing news about the wars, exercise caution so as not to inflame the already volatile situation in the warring countries. It was also observed that there were differences in the facts and figures presented by different media outlets in the country about the war.

Keywords: economy, media, russia, ukraine, war

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Authors: Liya Abraham

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Eritrea is located along the Red Sea, north of the Horn of Africa, between Djibouti and Sudan and has a population of about 3.2 million as of 2010. It has six administrative regions; Anseba, Debub, Debubawi K’eyih Bahri, Gash-Barka, Ma'akel, and Semenawi K’eyih Bahri. Eritrea has got its independence in 1991 after 30 years war of liberation. The country is blessed with various medicinal flora and fauna, and marine and terrestrial biodiversity. Traditional Medicine (TM) has been an integral part of the Eritrean culture for centuries. So far, more than 19 TM modalities have been recognized, and are broadly categorized as; herbal, procedure-based and spiritual. Despite the availability of modern medicine to the majority of the population, TM is still widely practiced. The rationale behind widespread use is accessibility, affordability and cultural acceptability. Hence, TM is of great contribution to the Eritrean health care system. As a matter of fact, harnessing the potential contribution of effective and safe TM in order to attain Universal Health Coverage (UHC) has been emphasized in the WHO TM strategy 2014-2023. The Eritrean TM, however, was operating without regulation and reliable scientific justification behind its safety and efficacy. Thus, the Ministry of Health (MoH), in recognition of the role of TM in primary healthcare and safeguard public health, established a regulatory body for TM so-called as Traditional Medicine Unit (TMU) in 2012. The mission of the unit is to ensure rational TM use through an integrated health service delivery system and contribute to the country’s economic and social development. The unit has established its national TM policy in 2017. The activities of the unit are guided by the National TM Advisory Committee (TMAC), responsible for the provision of technical assistance and advisory role. Moreover, the Legal Framework and Code of Ethics and Practice which provide a legal basis for the regulation of TM have also been drafted. In recognition of the importance of TM research and development, the unit launched a nationwide TM survey in 2017 and had surveyed two zones (Gash-Barka and Debub). The findings of the survey were subjected to a research dissemination workshop and publication in international journals. Furthermore, TM-related adverse events reporting tool (Green Form) aiming to guide regulatory interventions and researches have been established by the unit, and ever since reports are flowing. The unit has also been offering training to THPs, pharmacy students and health care professionals regarding TM and its regulatory activities. In addition, as part of the establishment of the national medicinal plants' database and herbal monograph, more than 329 and 30 medicinal plants, have been compiled respectively. In conclusion, TM is still widely accepted and practiced in Eritrea. The TMU ever since its establishment is endeavoring to ensure the safety and efficacy of the TM, and its integration in the mainstream health service delivery system.

Keywords: efficacy, regulation, safety, traditional medicine, traditional medicine unit, universal health coverage

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Authors: Shahzad Ali

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This article expounds the coverage of Pak-US relations in the context of Osama Bin Laden killing in four selected leading newspapers of UK and the US viz The Telegraph, The Guardian, The New York Times and The Washington Post during the specific time period of three months, i.e., April-June, 2011. The study is scrutinized on the basis of Operation Neptune Spear. The research study is theoretically linked with the propaganda model of Herman and Chomsky and the Shoemaker and Reeve‘s theory of content effect, specifically the impact of foreign policy as a driving instrument influencing the nature and treatment of the coverage of Pak-US relations. The relations between Pakistan and USA are of great importance in the context of Bin Laden. The Pak-US relations were less aggravated and hostile in pre OBL period but post OBL period worsened these relations. It is also interesting to mention that the policies of these newspapers were dependent on the foreign policy of their countries. It was explored that the news coverage was found favorable as and when the relations Pakistan and the US or UK were cordial and smooth. And it turned into negative and unfavorable when the relations were in strain and deteriorating and endorsed various studies that the Western mainstream media tried to be more nationalistic in projecting official stance while covering foreign coverage instead of adhering to universal cannon of journalism, i.e., objectivity, fairness, and neutrality, etc. Overall 219 news items of these four selected newspapers regarding Pak-US relations in the context of pre and post OBL’s killing operation were undertaken for analysis. The ratio of negative slants was found higher as compared to the positive and neutral slants. Besides, the ratio of news items with unfavorable frames was found higher in post OBL operation in comparison of pre-era of the coverage related to Pak-US relations in the leading British and American newspapers.

Keywords: Osama Bin Laden, Pakistan, USA, UK, relations, Guardian, Washington Post, Telegraph, New York Times, Operation Neptune Spear

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Authors: A. Sottomayor, M. Perez Duque, M. C. Henriques

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Introduction: Migration is not a new phenomenon; nomads often traveled, seeking better living conditions, including food and water. The increase of migrations affects all countries, rising health-related challenges. In Portugal, we have had migrant movements in the last decades, pairing with economic behavior. Irregular immigrants are detained in Santo António detention center from Portuguese Immigration and Borders Service (USHA-SEF) in Porto until court decision for a maximum of 60 days. It is the only long stay officially designated detention center for immigrants in Portugal. Immigrant health is important for public health (PH). It affects and is affected by the community. The XXVII Portuguese Government considered immigrant integration, including access to health, health promotion, protection and reduction of inequities a political priority. Many curative, psychological and legal services are provided for detainees, but until 2015, no structured health promotion or prevention actions were being held at USHA-SEF. That year, Porto Occidental PH Local Unit started to provide vaccination and health literacy on this theme for detainees and SEF workers. Our activities include a vaccine lecture, a medical consultation with vaccine prescription and administration, along with documented proof of vaccination. All vaccines are volunteer and free of charge. This action reduces the risk of importation and transmission of diseases, contributing to world eradication and elimination programs. We aimed to characterize the demography of irregular immigrant detained at UHSA-SEF and describe our activity. Methods: All data was provided by Porto Occidental Public Health Unit. All paper registers of vaccination were uploaded to MicrosoftExcel®. We included all registers and collected demographic variables, nationality, vaccination date, category, and administered vaccines. Descriptive analysis was performed using MicrosoftExcel®. Results: From 2015 to 2018, we delivered care to 256 individuals (179 immigrants; 77 workers). Considering immigrants, 72% were male, and 8 (16%) women were pregnant. 85% were between 20-54 years (ᵡ=30,8y; 2-71y), and 11 didn’t report any age. Migrants came from 48 countries, and India had the highest number (9%). MMR and Tetanus vaccines had > 90% vaccination rate and Poliomyelitis, hepatitis B and flu vaccines had around 85% vaccination rates. We had a consistent number of refusals. Conclusion: Our irregular migrant population comes from many different countries, which increases the risk of disease importation. Pregnant women are present as a particular subset of irregular migrants, and vaccination protects them and the baby. Vaccination of migrant is valuable for them and for the countries in which they pass. It contributes to universal health coverage, for eradication programmes and accomplishment of the Sustainable Development Goals. Peer influence may present as a determinant of refusals so we must consistently educate migrants before vaccination. More studies would be valuable, particularly on the migrant trajectory, duration of stay, destiny after court decision and health impact.

Keywords: migrants, public health, universal health coverage, vaccination

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Authors: Yong Wook Kim

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The purpose of this study is to develop an instruction analysis checklist applicable to inclusive setting based on the Universal Design for Learning Guideline 2.0. To do this, two self-validation reviews, two expert validity reviews, and two usability evaluations were conducted based on the Universal Design for Learning Guideline 2.0. After validation and usability evaluation, a total of 36 items consisting of 4 items for each instruction was developed. In all questions, examples are presented for the purpose of reinforcing concrete. All the items were judged by the 3-point scale. The observation results were provided through a radial chart allowing SWOT analysis of the universal design for learning of teachers. The developed checklist provides a description of the principles and guidelines in the checklist itself as it requires a thorough understanding by the observer of the universal design for learning through prior education. Based on the results of the study, the instruction criteria, the specificity of the criteria, the number of questions, and the method of arrangement were discussed. As a future research, this study proposed the characteristics of application of universal design for learning for each subject, the comparison with the observation results through the self-report teaching tool, and the continual revision and supplementation of the lecture checklist.

Keywords: inclusion, universal design for learning, instruction analysis, instruction checklist

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Authors: Baratali Monfarediraz

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Humans’ identity is not only under the influence of a certain society or social structure but also it is influenced by an international identity. This article is a research on role of education in the manifestation of universally accepted values such as, advancement of science, improvement in the quality of education, preservation of the natural environment, preservation, and spread of peace, exchange of knowledge and technology, equal educational opportunities, benefiting from a universal morality and etc. Therefore, the relation between universal beliefs and values and educational approaches and programs is the first thing to pay attention to. Studies indicate that the first step in achieving the above mentioned goals is offering learning strategies. Therefore the importance of educational approaches and programs as a tool for the transference of ideas, experiences and thoughts becomes quite clear. Proper education gives everyone the opportunity of acquiring knowledge while creating tendency toward social activities paves the way for achieving the universal values.

Keywords: globalization, universal values, education, universal goal, values, society

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