In vitro genotoxicity assessment and 28-day repeated dose oral toxicity study of steady-calcium formula in rats.

Steady-calcium formula (SCF), a functional food mixture with potential of joint care, contains five major ingredients. However, the uncertain cross-reactivity among these included ingredients cannot be excluded. Hence, it is important to ensure the safety of this mixture. In this study, the safety of SCF was evaluated through in vitro genotoxicity assessment and 28-day oral toxicity study in rats. The bacterial reverse mutation test and mammalian chromosome aberration test displayed that SCF did not induce mutagenicity and clastogenicity. The 28-day repeated dose assessment of SCF in rats revealed no mortality and adverse effects in clinical signs, body weight, urinalysis, hematology, organ weight, and histopathology at all treated groups. Although some significant changes were observed in food intake and parameters of serum biochemistry at the highest dose in males, they were not dose-related and considered to be within normal range. These findings indicate that SCF does not possess genotoxic potential and no obvious evidence of subacute toxicity. These results demonstrate for the first time that the genotoxicity and subacute toxicity for SCF are negative under our experimental conditions and the no observed adverse effect level (NOAEL) of SCF may be defined as at least 5470 mg/kg/day.

Donor and Domestic Financing of Primary Health Care in Low Income Countries.

Abstract-This paper evaluates resource commitments to primary health care (PHC) by donors and selected governments between 1990-2011. Donor commitments to financing PHC are assessed by reclassifying OECD/CRS data on health assistance into spending on 'PHC Service Delivery' versus spending on 'Health System Strengthening'. Domestic spending on PHC is assessed using a case study approach and National Health Accounts for two major recipients of donor assistance, Ethiopia and Nigeria. Results are generally consistent with three simple hypotheses that guide the inquiry. First, though donor funding for health among LICs has mushroomed over the last decade, it remains a miniscule share of per capita spending targets prescribed by international forums to attain universal access to basic/essential PHC services. Relative to levels of domestic public spending in LICs, however, donor funding has considerably more significance as a potential lever to improve PHC efficiency. Second, as reflected in on-going debate in the literature, donor spending on broader 'health system strengthening' has not kept up with mushrooming financing of disease control programs. Third, at country level, where the 'rubber meets the road', allocative efficiency of donor and domestic spending on health is highly conditional on contextual factors, especially political will to improve financing and delivery of PHC services, and the process of managing and implementing public spending on PHC.

Hospital Public-Private Partnerships in Low Resource Settings: Perceptions of How the Lesotho PPP Transformed Management Systems and Performance.

Abstract-Public-private partnerships (PPPs) seek to expand access to quality health services in ways that best leverage the capacities and resources of both sectors. There are few examples of PPPs in the hospital sector in developing countries, and little is known about how the involvement of the private sector transforms the delivery of health services in this context. In 2006, the government of Lesotho adopted a PPP approach for the health sector, contracting out to design, build, and operate a hospital network in its capital district. This case study examines differences between a government-run hospital and the PPP-run hospital that replaced it, using in-depth interviews with key informants, observation of management systems, and document review. Key informants emphasized changes in infrastructure, communication, human resource management, and organizational culture that improved quality and demand for services. Important drivers of improved performance included better defined policies and procedures, empowerment and training of managers and staff, and increased accountability. Well-functioning support systems kept the hospital clean and equipment functioning, reduced stock-outs, and allowed staff to do the jobs they were trained to do. The Lesotho PPP model provides insight into the mechanisms by which public-private partnerships may increase access and quality of care.