The Role Of Gamma Secretase And Its Effects On The Disease...

There has been much research over the last 30 years on the amyloid cascade hypothesis leading to substantial supporting evidence and clinical trials. A phase I and II study has shown that the inhibition of gamma secretase by semagacestat had caused a reduction in beta amyloid synthesis in patients with mild to moderate Alzheimer’s disease (Doody et al. 2013). Gamma secretase is a protease complex involved in the processing of amyloid precursor protein. Unfortunately, a phase III trial using semagacestat was stopped after worsening of cognition and the ability to do day-to-day activities was seen (Doody et al. 2013). This promising drug showed no benefit to participants with mild to moderate Alzheimer’s disease for it did not slow the progression of the disease. There was also more skin and subcutaneous-tissue disorders and more cancers when taking this drug (Doody et al. 2013). Due to this failed clinical trial and many others, some scientists are starting to question if amyloid is the direct cause of Alzheimer’s disease. Some scientists believe beta-amyloid accumulation might just be a downstream effect of Alzheimer’s. This observation has been seen in aging individuals without this disease. There have been a few alternative theories proposed to explain what directly causes Alzheimer’s. One called the Inverse Warburg effect focuses on age-induced energy deficiency seen in mitochondrial activity of neurons (Demetrius et al. 2015). Energy, produce mainly by mitochondria, isShow MoreRelatedAlzheimer s Disease And Its Effects On The American Population Essay1636 Words   |  7 PagesAlzheimer’s disease is one of the most devastating degenerative diseases affecting the American population. It is one form of dementia. Dementia is a group of conditions characterized by impairment of at least two brain functions, such as memory loss and judgment. Symptoms include forgetfulness, limited social skills, and thinking abilities so impaired that it interferes with daily functioning. Alzheimer has very few treatment options even though it is increasing globally. Recently environmentalRead MorePreventative Methods Of Alzheimers Disease1824 Words   |  8 PagesMethods of Alzheimer’s disease Now that the disparity between Alzheimer’s disease prevalence in men and women, as well as the different rates of incidence in different countries has been established, it is now applicable to discuss what can be done to prevent this disease. There are many ways that researchers believe people can use to prevent Alzheimer’s disease. Studies by researchers have found that cannabinoids could stimulate the brain cells and slow the progression of the disease. Conversely, someRead MoreAstrocytes Case Study6698 Words   |  27 PagesRegulation of astrocyte pathology by fluoxetine prevents the deterioration of Alzheimer phenotypes in an APP/PS1 mouse model Abstract Studies have implicated astrocytic dysfunction in Alzheimers disease (AD). However, the role of astrocytes in the pathophysiology and treatment of the disease is poorly characterized. Here, we identified astrocytes as independent key factors involved in several Alzheimer-like phenotypes in an APP/PS1 mouse model, including amyloid pathology, altered neuronal and synaptic

The Arms Trade Treaty Free Essays

string(238) " is to close loopholes in trade regulations and strengthen the effectiveness of legal frameworks to hinder the illicit arms market which provides weapons to end-users whom would normally be barred from acquiring them through legal means\." The Arms Trade Treaty Derek Matthews International Relations Abstract The Arms Trade Treaty is the result of an international consensus that there is a need for global arms regulation. This belief began to develop after the Cold War in response to consequences facing the international community from countries whom purchased arms unimpeded and used them towards aggressive and oppressive ends. The Arms Trade treaty has been applauded as an initial framework to begin practical implementation of effective arms regulations through the context of international consensus in a way that will reduce egregious human rights violations and increase weapons accountability as well as regional stability. We will write a custom essay sample on The Arms Trade Treaty or any similar topic only for you Order Now There are criticisms as to the future effectiveness of the treaty because the scope of the treaty covers arms sales, not other forms of arms transfer and because major arms exporters have abstained from participating in the treaty. These realities are staunch hurdles towards the future effectiveness of governing policies that may evolve from the treaty. Because the treaty has not reached the stage of ratification, an actual analysis of the impacts of this treaty have yet to be seen. Background The origins of the international arms regulation and thus, the Arms Trade Treaty (ATT) can be traced back to the start of the Cold War. NATO had an interest in slowing the transfer of advanced military technologies to the Soviet Union. They created the Coordinating Committee for Multilateral Export Controls (COCOM) to block arms, industrial technologies, and â€Å"atomic† technologies from being exported to the Soviet Union from countries in the Warsaw Pact. This was not a nonproliferation regime and its limited scope proved ill-equipped to handle the emerging problems of the Post-Cold War era. This was evident during the 1991 Persian Gulf War where the Iraqi military was able to build the world’s fourth-largest military with $40 billion in foreign weapons purchases. Lewis, 2005) After the war, western countries began working on international agreements aimed to stop destabilizing accumulations like the arms transfer component in the Middle East. (Collina, 2012) The idea for these international agreements was proposed by the United Kingdom which wanted a global regime aimed at â€Å"avoiding arms transfers that could destabilize a region, put human rights at risk, or provide inappropriately advanced technology. (Lewis, 2005) The language set forth in this goal would lead to a chain of international agreements and guidelines aimed at reducing illicit arms trade and defining the parameters of what illicit arms trade entailed; the United Nations (UN) Registry for Conventional Arms in 1991, the US begins work on the US Code of Conduct Bill in 1993, the Warsenaar Agreement in 1996, UN Guidelines for International Arms Transfers in 1996,Oscar Arias and a group of Nobel Laureates produce first draft of the International Code of Conduct on Arms Transfers in 1997, European Code of Conduct in 1998, US passes International Code of Conduct in 1999, UN Programme of Action to Prevent, Combat and Eradicate the Illicit Trade in Small Arms and Light Weapons in All Its Aspects in 2001, Organization of American States (OAS) Model Regulations for the Control of the International Movement of Firearms, their Parts and Components and Ammunition in 2003, Great Lakes and Horn of Africa region adopt the Nairobi Protocol for the Prevention, Control and Reduction of Small Arms and Light Weapons in 2004, UN begins work on a global arms trade treaty in 2006, the General Assembly of the UN votes overwhelmingly for approval of the global Arms Trade Treaty on April 2, 2013. Shah, 2008)(Charbanneau, 2013) For the two decades following the end of the Cold War, the world has been moving in the direction towards a global consensus on how we should provide accountability and responsibility to the selling of weapons culminating with an almost unanimous agreement laid out in the Arms Trade Treaty of 2013 which was passed through the General Assembly of the United Nations with a vote of 155 for, 3 against, and 22 abstained. (Charbanneau, 2013) Reason for the ATT The trade of goods internationally has long been subject to regulation. The import and export of cars and clothes has more restrictions on trade than Ak-47s and rocket launchers. So when the discussion surrounding arms trade regulation b egan, it was initially just a way for western nations to stem the unfettered growth of aggressive militaries which caused regional instability such as Iraq in the Persian Gulf War. However, once these discussions entered the international arena, it was easy to see the practicality in implementing arms regulation and to contextualize the benefit that regulation would have on preventing numerous other instances of international instability. (UN Conference, 2013) From the Contras in Nicaragua, to the Khmer Rouge in Cambodia, to the Lord’s Resistance Army in Uganda, it is easy to see the potential social and human impact of effective restrictions on the sale of weapons. The reason behind arms trade regulations is to stop weapons from falling into the hands of criminals, gangs, warlords, and terrorists who would use them to oppress human rights and destabilize the region. There are economic impacts as well. The unrestricted sale of weapons results in damages through crime, gang violence, and piracy that vastly exceed the initial profits from selling them. UN peacekeeping missions alone cost the world over $7 billion a year and the global burden of armed violence stands at $400 billion. (UN Conference, 2013) ATT Policy Goals To address the lack of international oversight on arms trade, the UN formulated language designed to codify the growing international consensus of what responsible arms trade should look like. Through various concessions to accommodate differing opinions, they formulated a treaty with two rationales in mind. The first was to stop sales to state end-users that would use them to undermine global peace and security, violate international human rights laws, impair socio-economic development, or are at risk to re-export those weapons which then might come into the hands of organized criminals or terrorists. The second rationale is to close loopholes in trade regulations and strengthen the effectiveness of legal frameworks to hinder the illicit arms market which provides weapons to end-users whom would normally be barred from acquiring them through legal means. You read "The Arms Trade Treaty" in category "Papers" (Kimball, 2011) The idea behind this rationale is to end the prevalence of weapons smugglers like Viktor Bout, whose actions inspired the film â€Å"Lord of War†. These smugglers effectively exploit loopholes in national and international laws to provide illegal arms around the world. (Austin, 2012) The Arms Trade Treaty would also seek to strengthen transparency and reporting on arms trade transfers and the production of munitions which will provide more accountability for State’s actions. (Kimball, 2013) The treaty was created with the original UN Charter Chapter 7 Article 51 in mind which reads, â€Å"Nothing shall impair the inherent right of individual or collective self-defense if an armed attack occurs†. The treaty was shaped to allow arms purchases justified through the realm of self-defense and to fight back against regimes that violate human rights. The vague nature of the language still leaves significant room for state differences on what acts will be deemed self-defense or political struggle. The language is also weak on providing a legal framework to deal with non-state actors and terrorism. The policies laid out by the Arms Trade Treaty are primarily aimed towards better control over the export sale of arms; however there is little language to account for the import of arms or for arms transfers which are labeled gifts, or trades. Impacts and Opinions There are 193 Member States of the UN General Assembly. The vast majority of them agree with the ATT, although most have varying reservations to the limitations of the treaty. The treaty is considered a floor of regulation from which to work with and not a ceiling. 155 States voted in favor of the treaty, the most impactful vote came from the US. The development of this treaty was coming to a close in 2008 after the US Senate voted their intention to deny ratification of a ATT treaty. The withdrawal of support from the top arms exporter in the world would have vastly diminished the prospects for any meaningful implementation without the support of the US. The US has come out in support of this treaty since 2009, and the renewed support by the US fundamentally changes the effectiveness that implementation of the treaty will have. The US did influenced language in the treaty to ensure that the regulations will not impede on State’s domestic gun rights and will not lower the bar of States that already practice a high level of arms control. Despite this accommodation made specifically for the US, the National Rifle Association (NRA), a powerful interest group within America, is against the ATT and threatens to stop ratification in the Senate on the grounds increased regulation will affect domestic gun ownership. (MacFarquhar, 2013) The UN Association (UNA) which lobbies on behalf of the UN in America, stands in strong support of the ATT and is working to combat poorly informed opinions on the nature and language contained within the ATT. (UNAUSA, 2013) Proponents on both sides of the Syrian conflict voted against or abstained from the ATT. Syria and Iran voted against the proposal while China and Russia abstained because of â€Å"the lack of an explicit prohibition on the supply of weapons to non-state actors that would, for example, restrain the ability of Syria’s armed opposition from building up its stockpile. † (Lynch, 2013) Many of the Persian gulf powers which support the Syrian opposition, such as Saudi Arabia, Qatar, and Yemen abstained from the vote as well. The vague language in the ATT allows for political pressuring to frame either the Syrian opposition as terrorist groups or the Syrian regime as human rights oppressors and potentially justify a moratorium on arms exports to those organizations. This is one of the main criticisms of the ATT. India also abstained from voting for the treaty, stating that the language was â€Å"the draft treaty was â€Å"tilted† in favor of the world’s leading arms exporters. † Other abstentions came from the Latin American sect of countries that generally vote against all US led initiatives in the UN. These countries include Bolivia, Ecuador and Nicaragua. However, the treaty was met with tremendous support in the rest of Latin America and Africa, countries that have seen a tremendous amount of instability at the hands of organizations who receive their arms through illicit arms trafficking such as the drug cartels and the Muslim resistance movements. These countries mainly asserted that in the long run, the treaty would curb the arms sales that have fueled many conflicts. MacFarquhar, 2013) The cumulative sum of opposition and abstention for various reasons creates a reality where some of the top arms exporters have chosen not to adhere to the new treaty. This creates concerns on the ultimate effectiveness of the treaty, because a large part of the export nations the treaty was designed to add transparency and regulation to are not participants. America and the Western nations make up a tremendous percentage of global arms sales the percentage fluctuates annually, but America generally represents around half of all arms sales and the UK, France, and other European countries account for between 10 and 15 percent of global sales. Shanker, 2012) So the impact of this treaty will be felt through close to three quarters of global sales, and the hope is that as international norms strengthen, the outlier nations will feel the pressure to conform to these new international standards as well. Success of the treaty Impact analysis over the next decade will truly define the success of this treaty. In fact, ratification will not even begin until June 3, 2013. Every state will define the standards to which they want the treaty to measure up to and view succ ess through that lens. Pertinent questions might arise over the next decade, about how the ATT shifted geopolitical power, how it will enforce arms transfers for conflicts where the consensus is split such as Syria, and whether it will have the teeth to prevent the widening of the black market which generally occurs when more stringent legal precedents are set. At the bare minimum, this treaty must succeed at stopping the supply of weapons to regions of conflict where there is an overwhelming international consensus about the extent of human rights violations being carried out under a particular regime. There will always be political conflict, but through the ATT the ultimate success will be when it succeeds in ensuring that conflict does not manifest into disproportionate violence and perhaps alter the path of least resistance to a point where it is more expedient to resolve conflict through nonviolent means. References Austin,  K. L. (2012, August 20). What Mauritius Can Teach Us About the Global Arms Trade – NYTimes. com. Retrieved  April  11, 2013, from http://atwar. blogs. nytimes. com/2012/08/20/what-mauritius-can-teach-us-about-the-global-arms-trade/? ref=viktorbout Charbonneau,  L. (2013, April 2). U. N. verwhelmingly approves global arms trade treaty| Reuters. Retrieved  April  11, 2013, from http://www. reuters. com/article/2013/04/02/us-arms-treaty-un-idUSBRE9310MN20130402 Collina,  T. (2012, October). The Wassenaar Arrangement at a Glance | Arms Control Association. Retrieved  April  11, 2013, from http://www. armscontrol. org/factsheets/wassenaar Kimball,  D. G. (2013, March 27). ‘Final’ Arms Trade Treaty A Good Step Forward | Arms Control Association. Retrieved  April  11, 2013, from http://www. armscontrol. org/pressroom/Final-Arms-Trade-Treaty-A-Good-Step-Forward Kimball,  D. G. (2011, October). The Arms Trade Treaty At a Glance | Arms Control Association. Retrieved  April  11, 2013, from How to cite The Arms Trade Treaty, Papers

Health System in Developing Countries for Practice - myassignmenthelp

Question: Discuss about theHealth System in Developing Countries for Dual Practice. Answer: Introduction Health system is a collection of institutions, group of people and accumulation of supplies that can be used to meet the health needs of the target group. Decentralization is the distribution of people, things, and power in different locations. According to the proposal, the health system is in the process of being distributed to different districts in developing countries. Decentralization comes up with several benefits and challenges which organization should come up with a solution to solving. Kenya is among developing countries that has encouraged decentralization of health sector. Health services have been distributed to different counties. Private health institutions have increased at a high rate. Most of Kenyan citizens use private hospitals because they offer quality services compared to public sector. Kenya has come up with rules that govern the operation of both private and public health institutions. The rules help in offering quality services to the patients. Public health institutions in Kenya offer low quality services because of low pay they receive. Also, public health workers are not given incentives to encourage them to offer quality services. Public sector in Kenya is facing a lot of negative impacts and most people prefer using the private sector. Benefits of Decentralization Decentralization helps in distribution of resources to different areas. Also, it assists in the fair and equitable distribution of health services in different locations. People who were unable to receive government health services are able to access. Local people participating in government health services will assist in communicating with the people involved on what they need the government to supply to them. Health services decentralization will also help in creating more jobs to the unemployed health worker (Cobos et al., 2017). Below is the discussion the challenge of decentralization in an area where health workers engaged in both private and public health services and the solution. Impacts of Dual Practice at District Dual practice is the idea of operating both private and public hospital by health workers. There is an increase in the percentage of the number of private health units in the low-income countries. The private sector includes non-government organization, individual doctors, nurses and midwives and unqualified individuals who sell medicines on market stalls. The increase in the private sector has increased due to increase in the number of qualified staff, failure of the public sector to meet the expectations and low payment of the staff in public sector. The increase in the private health sector has led to the idea of enabling of access to the services, shortages, and distribution of the resources. Also, individuals argue on the need to increase the supply of drugs. Public health workers have two sources of income due to low pay. Workers in public health institutions are not provided with incentives for good performance. Lack of incentives leads to them providing low quality of services and having an uncaring and unresponsive attitude towards their patients. The public health workers open a private hospital and continue to work in the public sector. In addition, the public resources are distributed unfairly. The middle-class people are the one who benefits from the resources distributed to the health institutions. Private health institutions operate with the main aim of getting profits as opposed to public health institutions. Patients lack of knowledge leads to patients receiving low-quality treatment at private health services at high prices. Governments in developing countries are turning their resources to the private health institutions with the idea of making profits (Abimbola et al., 2014). Therefore, the government fails to provide enough resources to the public health institutions and thus many patients are experiencing difficulties in finances to get quality health service. The poor in the low-income countries are forced by the situation to visit private health institutions for treatment. Moreover, other challenges faced by low-income countries are lack of finances, poor infrastructure and service delivery. The government has not improved the roads and systems of communications in the interior, and this leads to facing problems in operation of public health institutions in district level (Coarasa et al., 2017). However, it is simple for the private health institutions to operate from the interior because all their employees and information needed will be given by an individual in the place. The public sector has few qualified individuals, and those individuals operate on an hourly system. Therefore, the qualified medical workers open their own hospitals to add on their income. This leads to qualified staff dedicating most of their time in their clinics. In addition, they influence their patients to tranfer to their private clinics so that they may have quality treatment. This happens mainly because of poor payment of health workers. The private sector has a wide variety of qualified individuals. Patients are faced with the challenge of choosing the best health services to take. The confusion may lead to patient choosing the wrong medical services because they have very little information about health service. Also, private individuals are answerable to any services and outcomes, financial rewards and penalties and this leads to them been careful on delivering their services as opposed to when they are delivering the same service in the public sector. In the public sector there is no one to be answerable to, and therefore they will neglect their work and focus on the private investment they have. Moreover, decentralization of health services faces mismanagement of funds. Mismanagement of funds is caused by the top officials directing some of the allocated resources to their private institutions (Dutton, 2012). The top-level managers have no one to answer to in the district, and therefore they will allocate some of the government resources to their private hospital. In addition, there will be few qualified staffs to plan on the usage of the resources and this lead to poor planning. Also, the manipulation by the government officials at the district level leads to poor planning. Officials at the district level are corrupt and focus on how to improve their private health institution at no expense. Private Sector is Better Equipped The private sector has introduced technology in their operations. This has led to public sector losing patients to the private sector. There are two technologies used in health. The two technologies are e-health and m- health. E-health is the use of intergraded computer technologies while m- health is the use of mobile technology in delivering services. With the increased use of technologies in low-income countries people prefer to use technology in health services. However, the public sector has not acknowledged the use of technology, and it may be challenging to decentralize health services to district level using the traditional means. Addressing the Problem of Decentralization Solutions to the challenges faced due to the health workers engaging in dual practice include, the government should increase the payment they offer to public health workers. Increasing of payment will lead to encouragement of workers to perform their duties well. Health workers receiving good payment will not need a double income and thus will concentrate on delivering quality service in the public sector. In addition, public health workers should be given incentives according to their performance. Incentives will give motivation for offering quality service. The health workers will offer services of high quality with the interest of getting an incentive. In addition, with the help of government on training shopkeepers on ways of prescribing drugs, it will lead to quality delivery. Moreover, patients should be educated on the way to know quality medical services. This will help patients to receive quality services and discourage operation of health services with the interest of making more profits. Also, the government should offer subsidies to the public sector to reduce the cost of operation. Reduction in the cost of operation will lead to low prices in the public sector and also an improvement on the quality of services offered. Poor patients will be able to get health services at an affordable price (Mills, 2014). Also, health workers should be supervised to distribute the resources they have equally and fairly to both middle and low class. The public health sector should have someone who the health workers will be answerable to in case of misconduct. The government may enter into a contract with donors and non-government organization to assist with the finances and building of infrastructure to enable decentralization of health services into different districts. Also, the government may create a monopoly in the operation of health services to the public sector. The monopoly of the public sector will assist in making the health workers concentrate in only the public sector. The health workers will dedicate all their time to the public sector because they will not have any other job to run. In addition, the private sector may merge with public sector and provide services without facing any competition from each other. Merging will assist in sharing of expertise in different departments. The government should ensure the top officials are accountable to how the resources allocated to them are been used. They should also create a position for a person who will be supervising on the usage of the resources allocated to the district. The government should also increase the number of qualified staff in the planning department of the allocation of resources. Enough qualified staff will lead to proper allocation of resources. Top officials should be prohibited from owning private health hospital. They should also be monitored not to supply the allocated resources to other places. Corrupt district officials should be prohibited from participating in public health institutions activities. Public health sector may also introduce e-health and m- health to fasten the distribution of health sectors in different districts (Lewis et al., 2012). Also, use of technology is encouraged because most of the people in low-income countries are using technology to access different services. Technology gadgets have reduced prices because most of the people are using and therefore anybody can afford the gadgets. The use of technology will assist in minimizing the challenge of distribution of resources fairly and equally. The government may also introduce classes on technology for the people who have not yet learned technology. Moreover, use of governance may assist in the management of health sector (Wickremasinghe et al., 2016). The management of health workers should come up with rules and code of conduct. The rules will direct the health workers on the management of resources supplied by the government and the operation of the health institutions. The laws should include the operation of private health services. With the help of rules, there will be no unhealthy relationship between private and public sector. Also, it will help in evaluation and understanding of health sector. Governance will also help in creating a good relationship between donors, non-government organization with the health sectors. The government in low-income countries may fail to concentrate on the operation of the health sector but with the help of rules corruption in the health sector will be reduced. Evaluation After implementation of the health system in district level they will be need of evaluation to ensure it is not affected by the challenge. The process of evaluation will require annual reviews, statistical report and program report and performance assessment. The performance evaluation will be achieved by surveying the community in the area. With the reports obtained from the survey and statistical and program, health institution will be able to check whether it is affected by the challenges. The annual review will assist in determining any changes that might occur in the specific year evaluated. Conclusion To conclude, health sector decentralization faces several challenges. One of the challenges is health workers involved in dual practice. The dual practice will lead to the conflict of interest between the private and public health sector. However, it may also lead to positive impacts regarding distribution of the service and reduction in shortages of medicines. Some of the reasons causing the dual practice are low payment and lack of incentives. Therefore, with an increase in payment and offering of incentives by the government, it will reduce the dual practice. Also, increase in working hours of the health workers will reduce dual workers. The government should also work on improving infrastructure, services delivery and the introduction of subsidies. Also, use of technology will strengthen the health sector. References Abimbola, S., Abimbola, S., Negin, J., Jan, S., Martiniuk, A., Abimbola, S., Jan, S., ... Martiniuk, A. (January 01, 2014). Towards people-centred health systems: A multi-level framework for analysing primary health care governance in low-and middle-income countries. Health Policy and Planning, 29. Bitton, A., Gummerson, E., Das, J., Coarasa, J. (April 12, 2017). A systematic tale of two differing reviews: evaluating the evidence on public and private sector quality of primary care in low and middle income countries. Globalization and Health, 13, 1, 1-7. Bigdeli, Myriam BM, Jacobs, Bart, Tomson, Goran, Laing, Richard RL, Ghaffar, Abdul AG, Dujardin, Bruno, Van Damme, W. (2013). Access to medicines from a health system perspective. Bwalya, K. J. (January 01, 2017). Knowledge Sharing for Healthcare and Medicine in Developing Countries. Cobos, M. D., Merino, A. P., Monzon, L. L., Martinez, H. D., Santos, S. J. M. (January 01, 2017). Decentralization of health systems in low and middle income countries: a systematic review. International Journal of Public Health, 62, 2, 219-229. Ettinger, K. M. (January 01, 2015). Open Issues and a Proposal forOpen-source Data Monitoring to Assure Quality, Reliability, and Safety in Health Care Devices Targeting Low- and Middle-income Countries. In Brown, G. D., In Patrick, T. B., In Pasupathy, K. S. (2013). Health informatics: A systems perspective. Lewis, T., Synowiec, C., Lagomarsino, G., Schweitzer, J. (January 01, 2012). E-health in low- and middle-income countries: findings from the Center for Health Market Innovations. Bulletin of the World Health Organization, 90, 5, 332-40. McCord, G. C., Liu, A., Singh, P. (January 01, 2013). Deployment of community health workers across rural sub-Saharan Africa: financial considerations and operational assumptions. Bulletin- World Health Organization, 91, 4, 244-253. Mills, A. (January 01, 2014). Health care systems in low- and middle-income countries. The New England Journal of Medicine, 370, 6, 552-7. Mutale, W., Balabanova, D., Chintu, N., Mwanamwenge, M. T., Ayles, H. (February 01, 2016). Application of system thinking concepts in health system strengthening in low-income settings: a proposed conceptual framework for the evaluation of a complex health system intervention: the case of the BHOMA intervention in Zambia. Journal of Evaluation in Clinical Practice, 22, 1, 112-121. Coarasa, J., Das, J., Das, J., Gummerson, E., Bitton, A. (April 12, 2017). A systematic tale of two differing reviews: Evaluating the evidence on public and private sector quality of primary care in low and middle income countries. Globalization and Health, 13, 1.) Dutton, P. V. (2012). Differential Diagnoses: A Comparative History of Health Care Problems and Solutions in the United States and France. Powell-Jackson, T., Macleod, D., Benova, L., Lynch, C., Campbell, O. M. R. (February 01, 2015). The role of the private sector in the provision of antenatal care: a study of Demographic and Health Surveys from 46 low- and middle-income countries. Tropical Medicine International Health, 20, 2, 230-239. Wickremasinghe, D., Hashmi, I. E., Schellenberg, J., Avan, B. I. (January 01, 2016). District decision-making for health in low-income settings: a systematic literature review. Health Policy and Planning, 31, 12.