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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
Complete mitochondrial genome of nipa palm hispid beetle Octodonta nipae Maulik (Coleoptera: Chrysomelidae: Cassidinae)
2021
Octodonta nipae (Maulik 1921) is a dangerous forestry quarantine pest, which mainly harms palms. In the present study, we determined complete mitogenome of O. nipae. This mitogenome was 15,397 bp in length (GenBank Accession no. MW802252), which contained 2 ribosomal RNA genes, 22 transfer RNAs, 13 protein-coding genes (PCGs) and one non-coding AT-rich region with the length of 883 bp. All of the 22 tRNA genes displayed a typical clover-leaf structure, with the exception of tRNA
Phe
, tRNA
Leu
, tRNA
Asn
, tRNA
Pro
and tRNA
Thr
. Twelve PCGs were initiated by ATN codons, and NAD1 started with TTG. Ten PCGs used the typical stop codon 'TAA' and 'TGA', while three PCGs (COX2, COX3, NAD4) used the incomplete stop codons 'TA' or 'T'. Phylogenetic tree demonstrated that O. nipae belongs to the family Chrysomelidae and closer to the superfamily Cassidinae.
Journal Article
SPi CRM expands Madison contact center, to employ 350 by Q2
2017
\"SPi CRM in Madison is our first call center in the United States,\" said Maulik Parekh, President & CEO, SPi CRM. \"Our investments in the site have created 200 new jobs in eighteen months. In the three years since launching in Madison, we've transformed the site into a top-performing inbound contact center for a leading global brand.\" The Madison team performs inbound sales, utilizing voice and chat, for a US-based satellite TV provider. SPi CRM Madison is the highest-producing inbound sales site in the client's network, beating even its in-house operations.
Trade Publication Article
Japan-Based Relia, Inc. to Acquire SPi Global's Customer Relationship Management Business
2016
[Maulik Parekh] commented, \"This transaction not only combines Relia's leadership in the Japanese market with SPi CRM's complementary footprint in the United States, Latin America, the Philippines, and the rest of the Asia Pacific region, but also creates a distinct platform leveraging Relia's advanced CRM technology together with SPi CRM's unique operational DNA. With this enhanced footprint and capabilities, we are confident that together with the Relia Group, we will achieve greater heights.\"
Trade Publication Article
Repairing renovation of the 2nd floor staff qtr. Of Prof Ujjwal Maulik, at 40A Southern Avenue, JU Staff Qtr. Tender documents : T28939902
2015
Tenders are invited for Repairing & renovation of the 2nd floor staff qtr. Of Prof Ujjwal Maulik, at 40A Southern Avenue, JU Staff Qtr.
Newsletter
U.S.: UNDOCUMENTED WORKERS FIND COURAGE IN SOLIDARITY
2013
\"Our members... and many others in immigrant communities are really disappointed with this legislation. It's turning out to be more and more repressive, harsher measures,\" she said. \"So we are following it very closely.\" Employers tend to say, \"I hire you even if you're illegal, so you should say 'thank you', no matter how much I pay you,\" [Vincent] told IPS. \"Employers often don't pay workers for a week or months at a time. There has been a case of a year at a time. They'll do things like hold people's passports, threaten to call immigration if they ask for the wages that they earned,\" [Monami Maulik] told IPS.
Newsletter
Man Charged In Dunmore Crack Deal
2016
Maulik Reeves, 42, 212 E. Elm St., is charged with several drug counts after authorities said he sold crack on Wheeler Avenue at 6:20 p.m. Wednesday, Dunmore police said.
Newspaper Article
Does religion undermine reason?
in
Maulik, Dev
2014
Despite a strong heritage of ritualistic worship and various acts of faith, Hinduism cultivates a deep reverence for knowledge and rational thinking and does not enforce blind faith. Debate and reasoning have been a central part of Indian heritage, and formalized discipline of logic has been one of the main schools of Hindu philosophy. The famous British philosopher Bertrand Russell acknowledged this: \"Credit must be given to the Quran which first kindled the spark of inquiry and revolutionized the mentality of the believers in less than two centuries. From simple, boorish, uncouth, and unlettered Bedouins, the Arabs became leaders of the world in arts and sciences. That was a great revolution and a great achievement.\" Recognizing the shortcomings of human nature and the fact that scientific achievements alone cannot ensure peace and establish a just world order, the Qur'an gave humanity the golden principle of \"perpetuating the good and forbidding the evil.\"
Newspaper Article
Scripps College's event with \30 Rock\ actor Maulik Pancholy postponed
by
Woods, Wes
in
Pancholy, Maulik
2012
Actor Maulik Pancholy's Friday March 2 lecture on \"Diversity on Screen\" at Scripps College...
Newspaper Article
Cade Museum announces four finalists in Prize for Innovation
by
Clark, Anthony
in
Shah, Maulik
2011
The final four hopefuls for the $50,000 Cade Prize for Innovation include a seizure detection device, a biodegradable plastic, indoor air purifiers and an exoskeleton for hip and knee rehab. \"One of the things the judges are looking at is a good management team -- a balance of good science and good business -- as well as that key indefinable something which is truly an innovative idea, something that will make a difference in whatever field they are in,\" said Dorrie Hipschman, Cade executive director. \"I recognized he was much further along in his technology development in terms of being able to create a viable product,\" [Maulik Shah] said. \"He had the technical skills. I had the business skills. We came together in November and said, 'Why don't we work on this together?' \"
Newspaper Article