Challenges in the Era of Globalization - iaabd

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Proceedings of the 12th Annual Conference © 2011 IAABD Ghana (2009-2013) and World Health Organization (WHO) Publications. The results of the study were analyzed using descriptive statistics and discussed in a narrative form. Analysis and Discussion of Results With respect to the challenges of managing TB at the ZTH Hospital, the results of the study indicate that TB case detection and notification is low as a result of late presentation of condition, late diagnosis, and late referral. This accounts for the high mortality rate among TB patients since cases are diagnosed late at the hospital. According to physicians and experts, TB is a complicated disease and therefore late reported cases lead to late diagnosis. Also referral from the lower hospitals result in high mortality rate at the ZTH Hospital (See table 1). From figure 1, the mortality rate remains at about 25%. Interviews with some patients suggest that they do not want to report to facilities because of several reasons. This includes stigmatization since HIV patients suffer more from TB. Some patients complained that their family members are not willing to accompany them to the facilities. Some patients also seek treatment from prayer camps and through other spiritual and traditional means, and therefore report late to the hospital in very bad condition. Table 1: Referrals 2007 2008 2009 2010 (3quarter) TOTAL 778 880 743 651 NSP 226 212 187 121 NSN 274 312 185 155 EPTB 242 274 214 186 RTR 36 27 26 35 CHILDREN - 50 131 154 Figure 1: TB Success and Mortality Rates One of the challenges faced by ZTH Hospital in managing TB is that, newly qualified health workers are reluctant to work with TB patients because of the weak screening system and close proximity to the patients. In terms of medication, only first line drugs are mostly available at the ZTH Hospital. This is because of the high cost and non-availability of second line drugs, for which access is strictly controlled by the International Green Light Committee. Therefore, patients who fail the first line of treatment are not 396
Challenges in the Era of Globalization Edited by Emmanuel Obuah able to get access to the second line therapy which is the treatment for multi drug resistant TB. Also, experts complain that the infrastructure available is not the best. In terms of the impact of the Global Fund on TB management at the ZTH Hospital, a number of interesting observations were made. In the financial year of 2010 about 4,800 TB cases were reported at the ZTH Hospital. The Global Fund has been instrumental in providing resources to ZTH Hospital to aid in the fight against TB. The results as shown on figure 2 indicate that funds provided to the ZTH Hospital by the Global Fund have exceeded GHC 50,000 in any given year over the past four years. The Global Fund has made significant contributions to the management of TB by providing enablers to CBTC (Community Based Treatment Care) givers and supporters. CBTC helps TB patients to access free care and supervised treatment. Funds from the Global Fund are used by national programme to purchase drugs which are made available free to TB patients. Also, within the enablers package is included provision of logistics (such as vehicles) to the facilities, support in training of staff, creating awareness on TB (through the World TB Day), as well as providing enablers to community volunteers and TB patients. Figure 2: Fund Allocation from the Global Fund to ZTH Hospital, 2007-2010 Global health initiatives are faced with human resources issues as a major, system-wide constraint (Drager et. al, 2006). The Global Fund provides opportunities to strengthen human resource interventions, and countries will fare better by linking their activities to a long-term development of their human resources for health (Drager et. al, 2006). The Global Fund has contributed immensely towards improving human resource capabilities at the ZTH Hospital. Figure 3 shows the allocation or disbursement of funds at the ZTH Hospital. The analysis shows that the bulk of funds (representing 81%) are spent on providing the needed treatment to TB patients. The Global Fund has helped improve infrastructure at the ZTH Hospital. This includes for example the extension and renovation of the TB laboratory. 397
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Challenges in the Era of Globalizat
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Table of Contents Challenges in the
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Lennart Bangens, Goteborg, Sweden C
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Local Steering Committee Jacob Musi
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Track 1: Accounting, Finance, and I
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Abstract Challenges in the Era of G
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Abstract Determinants of Bank Lendi
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Empirical Results Challenges in the
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Table 3 Determinants of Competitive
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Research Findings Challenges in the
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Abstract: Study on Africa Governmen
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Abstract Challenges of Oil Revenue
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Abstract Land Based Sources of Poll
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Abstract On the Mitigation of Rever
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⎧κ ( ω) − ( 1− p) β ( ω)
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Assessment of pollutants in nigeria
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Figure 1: Lagos off shore survey po
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Table: Model Fitness Regression Sta
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Conclusion Challenges in the Era of
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37. Provision of sound education fo
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The cost structure Challenges in th
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Empirical Analysis Challenges in th
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Variable Coefficient Std. Error t-S
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Abstract The Changing Requirements
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The Model, Data and Variable Defini
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Track 8: Gender and Economic Develo
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Empirical results Challenges in the
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Abstract Gender, poverty and sustai
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Figure 1.1: Spread of directorships
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Theoretical Framework Challenges in
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Single 18.1 Masters and above 35.3
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Source: Field survey, 2010 Table 3:
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Track 9: Global Studies and Politic
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Conceptual Definitions Challenges i
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Table 1: A Summary of Operating Ban
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Discussion and Conclusion Challenge
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Abstract What does Globalization me
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7. I see globalization as providing
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Research Methods approach Challenge
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Statement of the Problem Challenges
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Convenient location of banks Challe
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Figure 1.Framework for Bank selecti
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Banks in Ghana Challenges in the Er
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References: Challenges in the Era o
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The study seeks to: • examine typ
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Relationship Commitment Total 1264.
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Abstract Marketing Nigerian medicin
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References Challenges in the Era of
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Conclusion Dissatisfied 6 3.4 3.6 7
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Abstract Customer satisfaction with
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Discussion Challenges in the Era of
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GOVERNMENT MoFED SECTORS Structure
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Football Spectatorship Challenges i
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