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Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990–2015: a novel analysis from the Global Burden of Disease Study 2015
2017
National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015.
We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure–the Healthcare Quality and Access (HAQ) Index–on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r=0·88), an index of 11 universal health coverage interventions (r=0·83), and human resources for health per 1000 (r=0·77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years of education, and total fertility rates. This frontier allowed us to better quantify the maximum levels of personal health-care access and quality achieved across the development spectrum, and pinpoint geographies where gaps between observed and potential levels have narrowed or widened over time.
Between 1990 and 2015, nearly all countries and territories saw their HAQ Index values improve; nonetheless, the difference between the highest and lowest observed HAQ Index was larger in 2015 than in 1990, ranging from 28·6 to 94·6. Of 195 geographies, 167 had statistically significant increases in HAQ Index levels since 1990, with South Korea, Turkey, Peru, China, and the Maldives recording among the largest gains by 2015. Performance on the HAQ Index and individual causes showed distinct patterns by region and level of development, yet substantial heterogeneities emerged for several causes, including cancers in highest-SDI countries; chronic kidney disease, diabetes, diarrhoeal diseases, and lower respiratory infections among middle-SDI countries; and measles and tetanus among lowest-SDI countries. While the global HAQ Index average rose from 40·7 (95% uncertainty interval, 39·0–42·8) in 1990 to 53·7 (52·2–55·4) in 2015, far less progress occurred in narrowing the gap between observed HAQ Index values and maximum levels achieved; at the global level, the difference between the observed and frontier HAQ Index only decreased from 21·2 in 1990 to 20·1 in 2015. If every country and territory had achieved the highest observed HAQ Index by their corresponding level of SDI, the global average would have been 73·8 in 2015. Several countries, particularly in eastern and western sub-Saharan Africa, reached HAQ Index values similar to or beyond their development levels, whereas others, namely in southern sub-Saharan Africa, the Middle East, and south Asia, lagged behind what geographies of similar development attained between 1990 and 2015.
This novel extension of the GBD Study shows the untapped potential for personal health-care access and quality improvement across the development spectrum. Amid substantive advances in personal health care at the national level, heterogeneous patterns for individual causes in given countries or territories suggest that few places have consistently achieved optimal health-care access and quality across health-system functions and therapeutic areas. This is especially evident in middle-SDI countries, many of which have recently undergone or are currently experiencing epidemiological transitions. The HAQ Index, if paired with other measures of health-system characteristics such as intervention coverage, could provide a robust avenue for tracking progress on universal health coverage and identifying local priorities for strengthening personal health-care quality and access throughout the world.
Bill & Melinda Gates Foundation.
Journal Article
Drilling At Doubleview's Hat Project Steps Out Beyond Lisle Zone
2016
Information set forth in this news release contains forward-looking statements that are based on assumptions as of the date of this news release. These statements reflect management's current estimates, beliefs, intentions and expectations. They are not guarantees of future performance. Doubleview cautions that all forward looking statements are inherently uncertain and that actual performance may be affected by a number of material factors, many of which are beyond Doubleview's control. Such factors include, among other things: risks and uncertainties relating to Doubleview's limited operating history and the need to comply with environmental and governmental regulations. Accordingly, actual and future events, conditions and results may differ materially from the estimates, beliefs, intentions and expectations expressed or implied in the forward looking information. Except as required under applicable securities legislation, Doubleview undertakes no obligation to publicly update or revise forward-looking information.
Trade Publication Article
An Iranian and an Israeli Make Filmmaking History
2023
When co-directors Guy Nattiv and Zar Amir Ebrahimi embarked on Tatami, about a female Iranian judo player who challenges her country's strict authoritarian rule, they found renewed focus - and emotion - after widespread anti-government protests erupted in Iran: 'We just felt this sudden urgency of telling the story' The death of Mahsa Amini on Sept. 16 would shake Iran to its core. The film, receiving its world premiere in Venice's Orizzonti (Horizons) competition on Sept. 1, almost a year to the day from Amini's death, was already heavy with poignancy and historic weight as the first feature to be co-directed by an Israeli, Guy Nattiv, and an Iranian, Zar Amir Ebrahimi - nationalities that aren't supposed to interact with each other, as it's literally criminalized in Iran, let alone make art together. For Ebrahimi, who had begun her creative career making short films in Iran and had been slowly working toward her feature debut behind the camera, it was a \"beautiful offer.\"
Trade Publication Article
Doubleview Capital Corp. Announces Proposed Qualifying Transaction
2011
(Marketwire - Feb. 22, 2011) - DOUBLEVIEW CAPITAL CORP. (\"Doubleview\") (TSX VENTURE:DBV.P), a capital pool company, is pleased to announce that it has entered into an agreement dated February 22, 2011 (the \"Agreement\") with 0895277 B.C. Ltd. (the \"Optionor\"), a company controlled by Farshad Shirvani, a director of Doubleview, whereby the Optionor has granted Doubleview an option to acquire a 100% interest in the Mount Milligan North Property (the \"Transaction\"). Doubleview is a capital pool company (\"CPC\") and intends the Transaction to constitute a Qualifying Transaction under the TSX Venture Exchange (the \"Exchange\") Policy 2.4 - Capital Pool Companies. Information set forth in this news release contains forward-looking statements. These statements reflect management's current estimates, beliefs, intentions and expectations; they are not guarantees of future performance. Doubleview cautions that all forward looking statements are inherently uncertain and that actual performance may be affected by a number of material factors, many of which are beyond Doubleview's control. Such factors include, among other things: risks and uncertainties relating to Doubleview's ability to complete the proposed Qualifying Transaction; its ability to acquire a 100% interest in the Property and other risks and uncertainties, including those described in Doubleview's Amended and Restated Prospectus dated September 8, 2010 filed with the Canadian Securities Administrators and available on www.sedar.com. Accordingly, actual and future events, conditions and results may differ materially form the estimates, beliefs, intentions and expectations expressed or implied in the forward looking information. Except as required under applicable securities legislation, Doubleview undertakes no obligation to publicly update or revise forward-looking information.
Trade Publication Article
Kurds fighters celebrate ousting Islamic State militants from Kobani
by
Karam, Zeina
in
Shami, Farshad
2015
BEIRUT - Jubilant Kurdish fighters ousted Islamic State militants from the key Syrian border town of Kobani on Monday after a four-month battle - a significant victory for both the Kurds and the U.S.-led coalition. The Kurds raised their flag on a hill that once flew the Islamic State group's black banner. On Kobani's war-ravaged streets, gunmen fired in the air in celebration, male and female fighters embraced, and troops danced in their baggy uniforms. At one point in October, the U.S. air dropped bundles of weapons and medical supplies for Kurdish fighters a first in the Syrian conflict. Dozens of Iraqi Kurdish peshmerga forces joined their brethren in Kobani, bringing in heavy weapons that neutralized the Islamic State group's artillery advantage. Rami Abdurrahman, director of the Observatory, also confirmed Kobani was entirely in Kurdish hands. He said the Kurdish force was led by Mohammed Barkhadan, the Kobani commander of the main Kurdish militia known as the People's Protection Units, or YPG.
Newspaper Article
Eye surgeons did not just save my sight... they have saved my LIFE
by
Lockley, Mike
in
Sanaee, Farshad
2014
Former Iran war veteran Farshad Sanaee, better known to world-wide lovers of his work as \"The Apple\", told the Sunday Mercury: \"They are the artists, not me.\" thanks to the medical expertise of professors Philip Murray and Robert Scott at Birmingham and Midlanf Eye Centre, sight in Farshad's left eye has been restored to such an extent he can again work on his intricate, abstract acrylic designs. One of the pictures presented to the medical experts is Farshad's interpretation of this year's operation. He was awake as the damaged optic was removed. Sandwell & West Birmingham Hospitals NHS Trust - in charge of the eye centre - has publicly thanked Farshad for his donation. A spokeswoman said: \"All at the trust and the Eye Centre are delighted with the paintings. \"We will proudly display them within the centre so our many patients and visitors can enjoy them for years to come.\"
Newspaper Article
Iranian officials say media reports on quake toll inaccurate
2003
Kerman, 27 December: Two Iranian officials on Saturday [27 December] refuted certain media figures on the toll from Friday's quake disaster in southeastern city of Bam. Deputy Governor-General of Kerman for Political and Security Affairs Mohammad Farshad said in an interview with IRNA on Saturday that certain media reports on tolls from Friday's deadly quake in Bam were not correct, insisting that the figure is much less than what they announce. He said the injured have been admitted by hospitals in provinces of Khorasan, Fars, Esfahan, Yazd and Kerman. He added however that some of the injured had received outpatient medicare services and the rest had been hospitalized.
Newsletter
Kurds celebrate ousting Islamic State fighters from Kobani
2015
\"Daesh gambled on [Kobani] and lost,\" said senior Kurdish official Idriss Nassan, using the Arabic acronym for the Islamic State group. At one point in October, the U.S. air dropped bundles of weapons and medical supplies for Kurdish fighters -- a first in the Syrian conflict. Dozens of Iraqi Kurdish peshmerga forces joined their brethren in Kobani, bringing in heavy weapons that neutralized the Islamic State group's artillery advantage. Rami Abdurrahman, director of the Observatory, also confirmed Kobani was entirely in Kurdish hands. He said the Kurdish force was led by Mohammed Barkhadan, the Kobani commander of the main Kurdish militia known as the People's Protection Units, or YPG.
Newspaper Article
Kurds celebrate ousting Islamic State fighters from Kobani
2015
\"Daesh gambled on [Kobani] and lost,\" said senior Kurdish official Idriss Nassan, using the Arabic acronym for the Islamic State group. At one point in October, the U.S. air dropped bundles of weapons and medical supplies for Kurdish fighters -- a first in the Syrian conflict. Dozens of Iraqi Kurdish peshmerga forces joined their brethren in Kobani, bringing in heavy weapons that neutralized the Islamic State group's artillery advantage. Rami Abdurrahman, director of the Observatory, also confirmed Kobani was entirely in Kurdish hands. He said the Kurdish force was led by Mohammed Barkhadan, the Kobani commander of the main Kurdish militia known as the People's Protection Units, or YPG.
Newspaper Article