HIV/AIDS and Mental Health are two chronic diseases with huge economic burden in developing countries. For HIV/AIDS, this year marked three decades since HIV/AIDs first identified with more than 34 million people in the world are living with this chronic condition with 2.6 million new cases. More than 90% of cases are adult in their economically productive life and nearly half are women. Even though HIV/AIDs incidence fell by more than 25% in 33 countries for the last ten years, the existing burden is still huge. Africa, the least resource continent in the world bears most of the brunt of this chronic condition housing nearly two thirds of global HIV positive cases. It is estimated that the available resources for HIV/AIDs in 2009 is USD 15.9 billion, there is a shortage of nearly USD10 billion. Only one third of these countries make HIV/AIDs a high budgetary priority. Mental illness is a chronic non-communicable disease responsible for 37% of global healthy life years lost. It was also estimated that in 25% of the patients visiting any health facilities, at least one suffer from undiagnosed mental health, neurological or behavioural disorder. The current global cost of mental health is estimated at USD 2.5 trillion. This will increase to USD 6.1 trillion in 2030. More than two thirds of this cost is indirect cost mostly due to loss in productivity. Managing these two conditions posed great challenges to low and middle income countries. Huge economic burden means that additional source of funding should be sought with full participation of all stakeholders. Mobilizing resources at the community level should be seriously considered. Support for community to provide long term care for HIV/Aids and mental health patients should be adequately supported by governments through properly targeted and well organized programme. Incentives and disincentives to influence efficient and effective performance should be put in place with innovative financing approach. Vertical programme should be avoided while more integrated approach with significant task shifting should be given a priority to ensure success and sustainability. In conclusion, policy makers in low and middle income countries should take positive measures to ensure that HIV/Aids and mental health is properly addressed by mobilising efforts from all stakeholders.

Health care has emerged as one of the fastest growing industry worldwide. This induced health care costto rise tramendously. However, it is important to preserve high quality health care services that are equitable and affordable. In many countries, people are expected to contribute to the cost of the health care. Are populations ready to accept the concept and willing to pay for health financing scheme? What possible factors that may associate with their decision? This is the objective of the study, to examine the relevance evidence for this through a systematic review of literatures.We systematically searched Ovid MEDLINE and Google Schoolar databases until April 2016. We assessed the study population willingness to pay for health financing scheme and determine the significant variables that associate with WTP. 19 full-text articles were included in the review. Factors that were found significantly associated with WTP for health financing scheme by many studies were age, education, income and residential locality. Other factors that also found associated with WTP were health care services utilization and expenditure. The review findings showed that WTP for health financing scheme is beyond the households’ financial capacity and has multifactorial influences.
Willingness to pay, health financial scheme, health insurance, social health insurance

Whole-cell Pertussis (wcPertussis) vaccines combined with diphtheria and tetanus toxoids are effective in preventing clinical pertussis. The study aimed at determining the cost of managing fever and convulsions and cost of adverse events associated with wcPertussis. Parents who brought their children to health clinics and parents of children who were admitted for febrile convulsions were interviewed using structured questionnaire and the information were used to determine the cost of managing adverse events. Mean cost of managing mild fever per case was RM249, mean cost of managing high fever per case was RM1,036 and mean cost of managing convulsions was RM1,225. Total cost of managing adverse events was RM261 million for mild fever, RM66.7 million for high fever and RM1.3 million for convulsions. Costs of managing mild and high fever were less than the cost of managing convulsions. Total cost of managing mild fever was highest at RM261 million compared with RM66.7 million for high fever and RM1.3 million for convulsions. Thus, lower risk of adverse events actually contributed to higher costs of managing the adverse event.

Increasing prevalence of chronic diseases is a major contributor for rapid rise in healthcare cost in developing countries since the last decade. It was estimated that around 54% of deaths in developing countries are due to chronic non-communicable diseases which is predicted to rise by 65% by 2030. Diabetes mellitus is among the most prevalent chronic diseases suffered by more than 180 million people worldwide. By 2030 it is estimated that around 400 million people in the world will be afflicted with diabetes. Annual deaths attributable to diabetes are probably as high as 3 million with more than 80% occur in developing countries. India, China and Indonesia are three countries in the Asian region with most number of people with diabetes. The total number of cases in these three countries is expected to increase more than double from 61 million in 2000 to 163 million in 2030. China and India will suffer cumulative GDP loss of 13.8% and 16.7% respectively, over the next ten year period. Assessing economic burden of diabetes is a challenging task for researchers because identification of direct and indirect cost of the disease is often complex since patients with diabetes also suffers from other complications and co-morbidities. In conclusion, the heavy economic burden of diabetes pose major challenges to health policy makers in developing countries to assess the current approach in managing this chronic disease. Serious efforts should be made on focusing and up-scaling activities on health promotion and prevention of diabetes so that to provide a more cost-effective solution to this condition with huge and increasing economic loss.

Student's feedback is one of the most important considerations in health profession quality management. One of the most popular approaches for receiving feedback from students within individual institutions is the Student Satisfaction Approach. The aim of this study was to measure the satisfaction with educational services among health profession students and the determinants of satisfaction. Cross-sectional study was conducted in the main campus of the High Institute of Health Sciences in Yemen, including its eight branches. A self-directed questionnaire was distributed to 327 students who were randomly selected. The participation rate was very high: 94% (309/327); 57.9% were male and 42.1% were female. Overall, 59% of students were totally satisfied, 35% were partially satisfied; however only 6% of them were not satisfied. Results showed that personal development was the highest component of satisfaction among students, while the research subjects showed less–satisfaction with the learning resources. The findings provide valuable insights and offer recommendations for improvement in terms of quality management in health profession education.

Although the Ministry of Health Malaysia has been encouraging the practice of Traditional and Complementary Medicine (T&CM)1, 2, 3, 4 but patients/clients has not been able to apply it for their need of medical treatments and sometimes it leads to negative outcomes due to lack of knowledge on T&CM and its safe applications5,6’7,8 Most of the western-trained physicians are ignorant of risk and benefits of T&CM9,10,11. This study was aimed to determine the gap between knowledge regarding T&CM and perception on education in T&CM among the medical staffs in five selected hospitals in Malaysia. A cross-sectional survey was done at five public hospitals among medical staff in Malaysia by using quantitative methods. A total of 477 medical staffs were involved in this study. The study showed that the overall knowledge of T&CM among the medical staffs were poor (61.2%). Having good knowledge regarding T&CM were significantly higher in Hospital Duchess of Kent (52%, p=0.001), among the non-Malays (44%, p=0.047) and pharmacists (47.2%, p=0.030). Positive perception on health education in T&CM among medical staffs were high (85.3%) especially among females (88.1%, p=0.002) and pharmacists (93.7%, p<0.001). The use of T&CM among the general population is relatively high in Malaysia and many patients increasingly seek the information on T&CM therapies from medical staffs. Knowledge regarding T&CM was poor in this study because most of the medical staffs have not been exposed to T&CM education. This interesting scenario between poor knowledge and high positive perception on health education in T&CM shows the demand of urgent intervention in educating the medical staffs. We recommend that medical staffs must have some basic education and knowledge about T&CM before they could offer advice to their patients. Doctors are of the utmost important in this regard because they play a very important role in patient care. Providing T&CM education to medical staff may help to integrate T&CM into the mainstream medicine.
Medicine, Traditional ; Complementary Therapies

In a time of rising demands on hospital reimbursement levels, focus on efficient operations is becoming more imperative. In health care systems, the measurement of efficiency is usually the first step in auditing individual performance of production units, e.g. hospitals, health centers, etc. It constitutes the rational framework for the distribution of human and other resources between and within health care facilities. The term efficiency is broadly used in economics and refers to the best utilization of resources in production. Typical example of efficiency is technical efficiency, referring to the effective use of resources in producing outputs. In the Farrell framework, a hospital is judged to be technically efficient if it is operating on the best practice production frontier in its hospital industry. In general, there are two main frontier methods in measuring efficiency. The first is Data Envelopment Analysis (DEA), a linear programming method which enables the measurement of efficiency consistent with the theoretically based concept of production efficiency. DEA typically examines the relationship between inputs to a production process and the outputs of that process. The second technique for assessing efficiency that is employed is Stochastic Frontier Analysis (SFA). This is an econometric technique to estimate a conventional function; with the difference being that efficiency is measured using the residuals from the estimated equation. The error term is therefore divided into a stochastic error term and a systematic inefficiency term.

Indonesian government secures the access of the poor towards health services through subsidised schemes. This study is aimed to describe the pattern of health expenditure by households and to describe the pattern of health service utilisation across household’s socioeconomic level in the city of Padang after seven years of the introduction of subsidised schemes. A household survey was conducted involving 918 households, with multistage random sampling method. The proportion of out-of-pocket (OOP) health spending as a share of household’s capacity to pay was regressive across consumption quintiles. The proportion of households with catastrophic health expenditure was 1.6% while 1.1% faced impoverished health expenses. Among those who need health care, the utilisation among the rich was higher than the poor. Health insurance schemes in Padang provides financial protection, however with regards to household’s capacity to pay, the poor has the higher burden of health payment. The gap on health service utilisation between the poor and the better-offs was still apparent for outpatient services and it has been narrowed for inpatient care. This study suggests that the subsidised schemes for the poor are highly needed and the possibility of the leakage of subsidies to the rich should be considered by the government.

Occupational cancers, including mesothelioma and lung cancer are linked to the use of asbestos. Annually, at least 100,000 global deaths are attributed to asbestos exposure putting a heavy burden on national budgets. Expenses incurred on treatment of asbestos related diseases (ARDs) reduce households and national resource savings, while ARDs culminate in terminal burdens. The objective of this study is to measure the economic burden of ARDs and to assess the economic impact of asbestos consumption. The health and economic burden of asbestos was estimated in macro-global consumption-production model using production function frontier-based and generalized least squared approach for asbestos products and cost tabulation. Production, in metric tons (Mt) was adopted as a dependent variable among explanatory variables, including consumption. Information on treatment cost of asbestos related diseases (mesothelioma, asbestosis and lung cancer) was obtained from costing information and published literatures. Annual total economic burden of asbestos is at USD 11.92 billion. Out of this cost, USD 4.34 billion per annum is the economic burden of managing three common ARDs. The cost of compensation for patients suffering ARDs is USD 4.28 billion. From the remaining USD 3.3 billion, USD 2.93 billion is the value of asbestos consumed in 2003 and USD372.15 million is the loss of earning due to hospital visits and admissions. For every USD 1 spent on consumption of asbestos, global economy has to absorb almost USD 4 due to health consequences of ARDs. Banning of asbestos production and usage in production of goods has far-reaching impacts on household welfare, health and economic development. The insights revealed are expected to inform decision makers the need to ban all forms of asbestos, especially in developing countries where usage is increasing.