Articles: health.
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There is increasing interest in the prospects for managed market reforms in developing countries, stimulated by current reforms and policy debates in developed countries, and by perceptions of widespread public sector inefficiency in many countries. This review examines the prospects for such reforms in a developing country context, primarily by drawing on the arguments and evidence emerging from developed countries, with a specific focus on the provision of hospital services. The paper begins with a discussion of the current policy context of these reforms, and their main features. ⋯ Extensive managed market reforms are therefore unlikely to succeed, although limited introduction of particular elements of these reforms may be more successful. Developed country experience is useful in defining the conditions under which such limited reforms may succeed. There is an urgent need to evaluate the existing experience of different forms of contracting in developing countries, as well as to interpret emerging evidence from developed country reforms in the light of conditions in developing countries.
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The present study comprised 100 mothers of newborn babies with regard to their belief and practices about lactation. A vast majority (98.2%) of the mothers were breast feeding, 87.9% mothers used prelacteal feeds of one sort or the other. Only 0.5% breast fed their babies within 6 hours and nearly 50% started after 48 hours. ⋯ The age of weaning preferred was after 1 year by 91%. Only 24.7% mothers had undergone antenatal check ups. Hence, much needs to be done with regards to proper antenatal care and advice to discourage wrong and harmful feeding practices.
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To assess the effect of introducing consensus guidelines on avoidable blood transfusions in Mwanza region, Tanzania. ⋯ The development and introduction of consensus guidelines was not sufficient to change prescribing practice. The proportion of avoidable blood transfusions decreased only in hospitals where compliance was maintained through regular clinic meetings and strict supervision by senior medical staff.