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See detailCan performance-based financing be used to reform health systems in developing countries?
Ireland, Megan; Paul, Elisabeth ULg; Dujardin, Bruno

in Bulletin of the World Health Organization (2011), 89(9), 695-698

Over the past 15 years, performance-based financing has been implemented in an increasing number of developing countries, particularly in Africa, as a means of improving health worker performance. Scaling ... [more ▼]

Over the past 15 years, performance-based financing has been implemented in an increasing number of developing countries, particularly in Africa, as a means of improving health worker performance. Scaling up to national implementation in Burundi and Rwanda has encouraged proponents of performance-based financing to view it as more than a financing mechanism, but increasingly as a strategic tool to reform the health sector. We resist such a notion on the grounds that results-based and economically driven interventions do not, on their own, adequately respond to patient and community needs, upon which health system reform should be based. We also think the debate surrounding performance-based financing is biased by insufficient and unsubstantiated evidence that does not adequately take account of context nor disentangle the various elements of the performance-based financing package. [less ▲]

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See detailSecular increase in the incidence of hip fractures in Belgium between 1984 and 1996: need for a concerted public health strategy.
Reginster, Jean-Yves ULg; Gillet, Pierre ULg; Gosset, Christiane ULg

in Bulletin of the World Health Organization (2001), 79(10), 942-6

OBJECTIVE: To determine the incidence of hip fractures (at the proximal end of the femur) in Belgium from 1984 to 1996. METHODS: Use was made of information from the national database on hospital bills ... [more ▼]

OBJECTIVE: To determine the incidence of hip fractures (at the proximal end of the femur) in Belgium from 1984 to 1996. METHODS: Use was made of information from the national database on hospital bills, which fully covers the annual hospital stays in the whole of the country. FINDINGS: The mean annual incidence of hip fractures increased from 107.8 to 140.5 per 100,000 inhabitants between 1984 and 1996. The incidence of fractures of the femoral shaft (diaphysis), taken as a control, remained stable. The female to male ratio of these hip fractures was 2.3:1. Although the incidence by age group was identical for males and females, the fractures occurred approximately seven years earlier in women than in men. The demographic changes observed in Belgium during this period accounted for only 10% of the observed increase in the number of hip fractures. CONCLUSION: If no comprehensive preventive policy is set up promptly, there will be a sevenfold increase in the incidence of hip fractures between now and the year 2050 in Belgium. [less ▲]

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