World Health & Population
From the Editor-in-Chief
The first paper in this issue is an update on the progress of Kuwait in meeting the objectives at the country level of the 2000 World Health Organization-decreed Bone and Joint Decade (BJD). Although the Millennium Development Goals (MDGs) have consumed much of the world's attention over the last 10 years, it is important to remember that there are many other health issues facing us, in particular those concerned with chronic diseases such as the musculoskeletal issues addressed by the BJD. Elham Hamdan, Fawzi Bouzubar and Michel Landry report on the achievements of one country, Kuwait, on meeting BJD objectives for that country. Performing a straightforward and useful gap analysis, the authors conclude that much remains to be done in this area, although the goals are reachable. This kind of "final report" on a program at the national level is very helpful for holding ourselves accountable and preparing the groundwork for the next initiatives.
"Preventing Malnutrition in Children under Two (PM2A): A Case Study in the Food Insecure Context of South Sudan," by Shannon Doocy, Hannah Tappis et al., brings us back to thinking in terms of the MDGs. Doocy and colleagues describe a relatively new, integrative and holistic approach, called PM2A, that has been adopted by the United States Agency for International Development (USAID) to improve the effectiveness of non-emergency food aid programs. The comprehensive PM2A approach includes health education and food rations for families as well avoiding diversion of the specific rations for mothers and infants. The authors conducted a mixed-methods study of PM2A implementation in South Sudan in 2011–2012 and concluded that the approach, although undeniably helpful, was insufficient to fully address household food insecurity. The extraordinarily difficult issues faced by the newly emerging nation of South Sudan may overwhelm the designs of all assistance programs; however, efforts, aid and adaptations need to continue. Doocy et al.'s analysis and evaluation is very helpful in moving us in this direction.
In our third paper, Ayodele Jegede, Prisca Adejumo et al. examine factors influencing motivation and retention of primary healthcare workers (PHCWs) in rural Nigeria, using a survey approach based on qualitative interviews. They found that PCHW motivation and retention are based on multiple critical factors, and no one magic bullet exists. Both financial and non-financial incentives are important. Issues around human resources for health (HRH) are critical for all countries in the world, but are particularly challenging in resource-constrained settings and in light of the transition from a focus on acute, infectious diseased–based primary care to more chronic and prevention-oriented services. World Health & Population published a theme issue on HRH in 2011 (WHP 13:2, December 2011). Jegede et al.'s paper in this issue continues the HRH theme and focus.
"Does Health Insurance Ensure Equitable Health Outcomes? An Analysis of Hospital Services Usage in Urban India" is the subject of the fourth paper in this issue. Economists Mousumi Dutta and Zakir Husain analyze survey data on socio-economic status (SES) and health insurance status in terms of utilization of in-patient care. The analysis is restricted to the urban sample of the extremely large India-wide Morbidity and Health Care Survey of 2005–2006. In the urban sample alone, only 2.86% were covered by insurance; for the rural sample, insurance coverage was essentially zero. Econometric models examined both moral hazard and adverse selection, concluding that SES factors, more that health insurance status, determine hospital utilization. Health insurance coverage by residents of India, already a rare attribute, has yet to make an impact in significantly increasing use of hospital-based care.
We hope that you find the papers in this issue interesting and worthwhile, and that you will also consult others recently released online at www.worldhealthandpopulation.com. We would also like to take this opportunity to thank our reviewers for the last year. Their names, so far unknown to our contributors, appear at the back of this issue. Their anonymous observations, comments and suggestions immeasurably improved the quality of the papers submitted to our journal and made the editor's job possible. Thank you very much.
In summary, WHP remains committed to its mission to provide a forum for researchers and policy makers worldwide to publish and disseminate health- and population-related research, and to encourage applied research and policy analysis from diverse global and resource-constrained settings. WHP is indexed on MEDLINE and is accessible through PubMed. We look forward to continued enthusiastic submission of manuscripts for consideration, peer review and publication. Finally, please note that the editors and publishers of WHP are always interested in any comments or suggestions you might have on the papers or about the journal and our mission. Please feel free to call, write or e-mail us.
John E. Paul, PhD MSPH
Editor-in-Chief, World Health & Population
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