MyMedR

Ethical and legal issues in organ transplantation: Indian scenario

Mathiharan K

Med Sci Law, 2011 Jul;51(3):134-40.

PMID: 21905567 DOI: 10.1258/msl.2011.010134

In 1994, the Government of India enacted the Transplantation of Human Organs Act (THOA) to prevent commercial dealings in human organs. However, a greater number of scandals involving medical practitioners and others in the kidney trade has surfaced periodically in every state in India. The present regulatory system has failed mainly due to the misuse of Section 9(3) of the THOA, which approves the consent given by a live unrelated donor for the removal of organs for the reason of affection or attachment towards the recipient or for any other special reason. Currently in India, approximately 3500-4000 kidney transplants and 150-200 liver transplants are performed annually. However, the availability of organs from brain-dead persons is very low. As a result, live related or unrelated donors form the main source of organ transplantation. Therefore, physicians and policy-makers should re-examine the value of introducing regulated incentive-based organ donation to increase the supply of organs for transplantation and to end unlawful financial transaction.

Matched MeSH terms: Tissue Donors/supply & distribution

Are essential medicines in Malaysia accessible, affordable and available?

Saleh K, Ibrahim MI

Pharm World Sci, 2005 Dec;27(6):442-6.

PMID: 16341951 DOI: 10.1007/s11096-005-1318-8

OBJECTIVE: To assess the pharmaceutical sector to know whether people have access to essential medicines.

SETTING: The study was conducted in 20 public health clinics, five public district drug stores and 20 private retail pharmacies selected randomly in five different areas randomly selected (four states and a federal territory).

METHOD: The methodology used was adopted from the World Health Organization study protocol. The degree of attainment of the strategic pharmaceutical objectives of improved access is measured by a list of tested indicators. Access is measured in terms of the availability and affordability of essential medicines, especially to the poor and in the public sector. The first survey in the public health clinics and public district drug stores gathered information about current availability of essential medicines, prevalence of stock-outs and affordability of treatment (except drug stores). The second survey assessed affordability of treatment in public health clinics and private retail pharmacies.

MAIN OUTCOME MEASURE: Availability, stock-out duration, percent of medicines dispensed, accessibility and affordability of key medicines.

RESULTS: The average availability of key medicines in the public health clinics for the country was 95.4%. The average stock-out duration of key medicines was 6.5 days. However, average availability of key medicines in the public district drug stores was 89.2%; with an average stock-out duration of 32.4 days. Medicines prescribed were 100% dispensed to the patients. Average affordability for public health clinics was 1.5 weeks salary and for the private pharmacies, 3.7 weeks salary.

CONCLUSIONS: The present pharmaceutical situation in the context of essential medicines list implementation reflected that the majority of the population in Malaysia had access to affordable essential medicines. If medicines need to be obtained from the private sector, they are hardly affordable. Although the average availability of essential medicines in Malaysia was high being more than 95.0%, in certain areas in Sabah availability was less than 80.0% and still a problem.

Matched MeSH terms: Drugs, Essential/supply & distribution*

Improving access to essential drugs for people living with HIV/AIDS

Balasubramaniam K

Issues Med Ethics, 2000 Jan-Mar;8(1):26-7.

PMID: 16323335

Matched MeSH terms: Anti-HIV Agents/supply & distribution

Evaluate the impact of hospital types on the availability of antidotes for the management of acute toxic exposures and poisonings in Malaysia

Al-Sohaim SI, Awang R, Zyoud SH, Rashid SM, Hashim S

Hum Exp Toxicol, 2012 Mar;31(3):274-81.

PMID: 21478291 DOI: 10.1177/0960327111405861

The availability of antidotes may be considered essential and lifesaving in the management of certain poisonings. Surveys carried out in a number of countries have demonstrated inadequate availability of a variety of poisoning antidotes.

Matched MeSH terms: Antidotes/supply & distribution*

An analysis of blood utilization for elective surgery in a tertiary medical centre in Malaysia

Jayaranee S, Prathiba R, Vasanthi N, Lopez CG

Malays J Pathol, 2002 Jun;24(1):59-66.

PMID: 16329557

The purpose of this study is to determine the efficiency of blood utilization for elective surgery at the University of Malaya Medical Centre (UMMC). A similar study conducted six years earlier in the same unit resulted in the introduction and implementation in December 1997 of the local Maximum Surgical Blood Order Schedule (MSBOS) and the Group Screen and Hold (GSH) procedure instead of a full crossmatch. This paper compares the findings of the current study with that conducted earlier.

Matched MeSH terms: Blood Banks/supply & distribution

Medicines prices and Malaysia--untangling the medicines web

Hill S

PLoS Med, 2007 Mar 27;4(3):e149.

PMID: 17388686

Matched MeSH terms: Drugs, Essential/supply & distribution*

Evaluating drug prices, availability, affordability, and price components: implications for access to drugs in Malaysia

Babar ZU, Ibrahim MI, Singh H, Bukahri NI, Creese A

PLoS Med, 2007 Mar 27;4(3):e82.

PMID: 17388660

Malaysia's stable health care system is facing challenges with increasing medicine costs. To investigate these issues a survey was carried out to evaluate medicine prices, availability, affordability, and the structure of price components.

Matched MeSH terms: Drugs, Essential/supply & distribution*

Periodontal treatment needs and workforce requirements: comparisons between the normative and sociodental approaches using different skill mix models

Ab-Murat N, Sheiham A, Tsakos G, Watt R

Community Dent Oral Epidemiol, 2015 Apr;43(2):106-15.

PMID: 25178437 DOI: 10.1111/cdoe.12125

Assessment of dental treatment needs has predominantly been based on the normative approach, despite its numerous limitations. The sociodental approach is a more rational method of needs assessment as it incorporates broader concepts of health and needs and behavioural propensity. This study compares estimates of periodontal dental treatment needs and workforce requirements for different skill mixes using normative and sociodental approaches among a sample of adults in Malaysia.

Matched MeSH terms: Dentists/supply & distribution*

Optimizing national immunization program supply chain management in Thailand: an economic analysis

Riewpaiboon A, Sooksriwong C, Chaiyakunapruk N, Tharmaphornpilas P, Techathawat S, Rookkapan K, et al.

Public Health, 2015 Jul;129(7):899-906.

PMID: 26027451 DOI: 10.1016/j.puhe.2015.04.016

This study aimed to conduct an economic analysis of the transition of the conventional vaccine supply and logistics systems to the vendor managed inventory (VMI) system in Thailand.

Matched MeSH terms: Vaccines/supply & distribution*

Neurology in Asia

Tan CT

Neurology, 2015 Feb 10;84(6):623-5.

PMID: 25666629 DOI: 10.1212/WNL.0000000000001224

Asia is important as it accounts for more than half of the world population. The majority of Asian countries fall into the middle income category. As for cultural traditions, Asia is highly varied, with many languages spoken. The pattern of neurologic diseases in Asia is largely similar to the West, with some disease features being specific to Asia. Whereas Asia constitutes 60% of the world's population, it contains only 20% of the world's neurologists. This disparity is particularly evident in South and South East Asia. As for neurologic care, it is highly variable depending on whether it is an urban or rural setting, the level of economic development, and the system of health care financing. To help remedy the shortage of neurologists, most counties with larger populations have established training programs in neurology. These programs are diverse, with many areas of concern. There are regional organizations serving as a vehicle for networking in neurology and various subspecialties, as well as an official journal (Neurology Asia). The Asian Epilepsy Academy, with its emphasis on workshops in various locations, EEG certification examination, and fellowships, may provide a template of effective regional networking for improving neurology care in the region.

Matched MeSH terms: Physicians/supply & distribution*

Fulltext Turkish health system reform from the people's perspective: a cross sectional study

Ali Jadoo SA, Aljunid SM, Sulku SN, Nur AM

BMC Health Serv Res, 2014;14:30.

PMID: 24447374 DOI: 10.1186/1472-6963-14-30

Since 2003, Turkey has implemented major health care reforms to develop easily accessible, high-quality, efficient, and effective healthcare services for the population. The purpose of this study was to bring out opinions of the Turkish people on health system reform process, focusing on several aspects of health system and assessing whether the public prefer the current health system or that provided a decade ago.

Matched MeSH terms: Health Resources/supply & distribution

Relative importance of demographic, socioeconomic and health factors on life expectancy in low- and lower-middle-income countries

Mondal MN, Shitan M

J Epidemiol, 2014;24(2):117-24.

PMID: 24390415

BACKGROUND: We attempted to identify the pathways by which demographic changes, socioeconomic inequalities, and availability of health factors influence life expectancy in low- and lower-middle-income countries.

METHODS: Data for 91 countries were obtained from United Nations agencies. The response variable was life expectancy, and the determinant factors were demographic events (total fertility rate and adolescent fertility rate), socioeconomic status (mean years of schooling and gross national income per capita), and health factors (physician density and human immunodeficiency virus [HIV] prevalence rate). Path analysis was used to determine the direct, indirect, and total effects of these factors on life expectancy.

RESULTS: All determinant factors were significantly correlated with life expectancy. Mean years of schooling, total fertility rate, and HIV prevalence rate had significant direct and indirect effects on life expectancy. The total effect of higher physician density was to increase life expectancy.

CONCLUSIONS: We identified several direct and indirect pathways that predict life expectancy. The findings suggest that policies should concentrate on improving reproductive decisions, increasing education, and reducing HIV transmission. In addition, special attention should be paid to the emerging need to increase life expectancy by increasing physician density.

Matched MeSH terms: Physicians/supply & distribution

Fulltext Factors affecting the HIV/AIDS epidemic: an ecological analysis of global data

Mondal MN, Shitan M

Afr Health Sci, 2013 Jun;13(2):301-10.

PMID: 24235928 DOI: 10.4314/ahs.v13i2.15

All over the world the prevalence of Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) has became a stumbling stone in progress of human civilization and is a huge concern for people worldwide.

Matched MeSH terms: Physicians/supply & distribution

Availability and affordability of cardiovascular disease medicines and their effect on use in high-income, middle-income, and low-income countries: an analysis of the PURE study data

Khatib R, McKee M, Shannon H, Chow C, Rangarajan S, Teo K, et al.

Lancet, 2016 Jan 2;387(10013):61-9.

PMID: 26498706 DOI: 10.1016/S0140-6736(15)00469-9

BACKGROUND: WHO has targeted that medicines to prevent recurrent cardiovascular disease be available in 80% of communities and used by 50% of eligible individuals by 2025. We have previously reported that use of these medicines is very low, but now aim to assess how such low use relates to their lack of availability or poor affordability.
METHODS: We analysed information about availability and costs of cardiovascular disease medicines (aspirin, β blockers, angiotensin-converting enzyme inhibitors, and statins) in pharmacies gathered from 596 communities in 18 countries participating in the Prospective Urban Rural Epidemiology (PURE) study. Medicines were considered available if present at the pharmacy when surveyed, and affordable if their combined cost was less than 20% of household capacity-to-pay. We compared results from high-income, upper middle-income, lower middle-income, and low-income countries. Data from India were presented separately given its large, generic pharmaceutical industry.
FINDINGS: Communities were recruited between Jan 1, 2003, and Dec 31, 2013. All four cardiovascular disease medicines were available in 61 (95%) of 64 urban and 27 (90%) of 30 rural communities in high-income countries, 53 (80%) of 66 urban and 43 (73%) of 59 rural communities in upper middle-income countries, 69 (62%) of 111 urban and 42 (37%) of 114 rural communities in lower middle-income countries, eight (25%) of 32 urban and one (3%) of 30 rural communities in low-income countries (excluding India), and 34 (89%) of 38 urban and 42 (81%) of 52 rural communities in India. The four cardiovascular disease medicines were potentially unaffordable for 0·14% of households in high-income countries (14 of 9934 households), 25% of upper middle-income countries (6299 of 24,776), 33% of lower middle-income countries (13,253 of 40,023), 60% of low-income countries (excluding India; 1976 of 3312), and 59% households in India (9939 of 16,874). In low-income and middle-income countries, patients with previous cardiovascular disease were less likely to use all four medicines if fewer than four were available (odds ratio [OR] 0·16, 95% CI 0·04-0·57). In communities in which all four medicines were available, patients were less likely to use medicines if the household potentially could not afford them (0·16, 0·04-0·55).
INTERPRETATION: Secondary prevention medicines are unavailable and unaffordable for a large proportion of communities and households in upper middle-income, lower middle-income, and low-income countries, which have very low use of these medicines. Improvements to the availability and affordability of key medicines is likely to enhance their use and help towards achieving WHO's targets of 50% use of key medicines by 2025.
FUNDING: Population Health Research Institute, the Canadian Institutes of Health Research, Heart and Stroke Foundation of Ontario, AstraZeneca (Canada), Sanofi-Aventis (France and Canada), Boehringer Ingelheim (Germany and Canada), Servier, GlaxoSmithKline, Novartis, King Pharma, and national or local organisations in participating countries.

Matched MeSH terms: Adrenergic beta-Antagonists/supply & distribution; Angiotensin-Converting Enzyme Inhibitors/supply & distribution; Aspirin/supply & distribution; Cardiovascular Agents/supply & distribution*; Platelet Aggregation Inhibitors/supply & distribution; Hydroxymethylglutaryl-CoA Reductase Inhibitors/supply & distribution

Fulltext Trans-Pacific Partnership Provisions in Intellectual Property, Transparency, and Investment Chapters Threaten Access to Medicines in the US and Elsewhere

Baker BK

PLoS Med, 2016 Mar;13(3):e1001970.

PMID: 26954325 DOI: 10.1371/journal.pmed.1001970

Brook Baker describes the potential harms to global health from the Trans Pacific Partnership Agreement and its failure to balance the interests of patients and the public with those of industry.

Matched MeSH terms: Pharmaceutical Preparations/supply & distribution; Drugs, Generic/supply & distribution*

Management of rheumatoid arthritis in clinical practice using treat-to-target strategy: Where do we stand in the multi-ethnic Malaysia population?

Tan BE, Lim AL, Kan SL, Lim CH, Ng YF, Tng SLC, et al.

Rheumatol Int, 2017 Jun;37(6):905-913.

PMID: 28389855 DOI: 10.1007/s00296-017-3705-6

To evaluate the achievement of treat-to-target (T2T) strategy in rheumatoid arthritis (RA) and identify factors associated with failed treatment target in a public rheumatology center. A cross-sectional study was conducted from June 2015 to February 2016. RA patients with disease duration greater than 2 years and under T2T for over a year were invited to the study. Demographic, clinical data, disease activity score of 28 joints (DAS28), and clinical disease activity index (CDAI) were collected in a single routine clinic visit. Treatment target was defined as DAS28 <3.2 or CDAI ≤10. Retrospective chart review was performed to determine reasons of failed treatment target. A total of 371 patients were recruited and 87.1% were female. Mean age and duration of RA were 53.5 years (SD 10.3) and 9.1 years (SD 6.6), respectively. Ethnic distribution was 49% Chinese, 27% Malay, and 24% Indian. T2T was achieved in 81.7% of the cohort. Non-Chinese ethnicity, positive rheumatoid factor, and treatment with three disease modifying anti-rheumatic drugs (DMARDs) were associated with failed treatment target. After controlling for covariates, Malay ethnicity (OR 2.96; 95% CI 1.47-5.96) and treatment with three DMARDs (OR 2.14; 95% CI 1.06-4.35) were associated with failed treatment target. There was no association between age, gender, duration of RA, BMI, smoking status, anti-citrulinated cyclic peptide, and achievement of T2T. The most common reasons of failed treatment target were inability to escalate DMARDs due to side effects (18.8%), lack of biologics fund (15.6%), and persistent disease despite optimum treatment (14.1%). T2T was successfully implemented. Malay patients need aggressive treatment adaptation to achieve optimal outcome.

Matched MeSH terms: Biological Products/supply & distribution; Antirheumatic Agents/supply & distribution

Fulltext Cancer in Sabah (Borneo) a prelimanry survey

Muir CS, Evans MD, Roche PJ

Br. J. Cancer, 1968 Dec;22(4):637-45.

PMID: 5705133 DOI: 10.1038/bjc.1968.75

Matched MeSH terms: Health Facilities/supply & distribution; Physicians/supply & distribution

Effect of privatization of the drug distribution system on drug prices in Malaysia

Babar ZD, Izham MI

Public Health, 2009 Aug;123(8):523-33.

PMID: 19665741 DOI: 10.1016/j.puhe.2009.06.011

Previous studies on anti-infective and cardiovascular drugs have shown extraordinary price increases following privatization of the Malaysian drug distribution system. Therefore, it was felt that there was a need to undertake a full-scale study to evaluate the effect of privatization of the Malaysian drug distribution system on drug prices.

Matched MeSH terms: Drugs, Generic/supply & distribution; Drugs, Essential/supply & distribution*

The rise of methamphetamine in Southeast and East Asia

McKetin R, Kozel N, Douglas J, Ali R, Vicknasingam B, Lund J, et al.

Drug Alcohol Rev, 2008 May;27(3):220-8.

PMID: 18368602 DOI: 10.1080/09595230801923710

Southeast and East Asia has become a global hub for methamphetamine production and trafficking over the past decade. This paper describes the rise of methamphetamine supply and to what extent use of the drug is occurring in the region.

Matched MeSH terms: Central Nervous System Stimulants/supply & distribution*; Methamphetamine/supply & distribution*

Maternity services and the role of the traditional birth attendant, bidan kampung, in rural Malaysia

Ali A, Howden-Chapman P

J Public Health Manag Pract, 2007 May-Jun;13(3):278-86.

PMID: 17435495 DOI: 10.1097/01.PHH.0000267686.08282.3c

This study was undertaken to explore the roles played by bidan kampungs and understand their contribution to rural Malay women during pregnancy and childbirth hundred sixteen pregnant women, 13 Western midwives, and 12 bidan kampungs were recruited using convenience and snowball sampling. Data were collected from focus groups, in-depth interviews, field notes, and observations. The findings indicated that although the women were happy to have Western maternity care, they valued the social and spiritual support received from bidan kampungs during pregnancy and postnatal care. Western care was considered useful for "modern" illnesses. The traditional maternity care that women received included pantang or ritual prohibitions that helped them through pregnancy and helped them achieve better postnatal recovery. The study indicates that there is a need to combine Western and traditional care for the benefit of the pregnant women and their infants' health.

Matched MeSH terms: Community Health Workers/supply & distribution*; Nurse Midwives/supply & distribution*

Displaying publications 61 - 80 of 119 in total