Assessing public health sector performance in Bangladesh: Implications for health systems strengthening and universal health coverage - A secondary data analysis.

The Ministry of Health and Family Welfare has established a health systems strengthening initiative for measuring the performance of public sector health facilities in Bangladesh. The objective of the performance management initiative is to establish routine systems for measuring and scoring health facility performance and promote best practices in public health service management. The performance initiative includes a set of assessments conducted across the four tiers of the public health sector. The findings of assessments demonstrate improvements in the quality of health services and a sharp increase in the utilisation of services across all tiers during the period 2017-2019. The performance management initiative has also identified areas for improvement in the supply-side health system readiness, including ensuring an adequate supply of human resources, essential medicines, and functioning medical equipment and technologies. This initiative outlines the need to systematically address the issue of high health workforce vacancy rates through effective human resource planning and management strategies. The reporting of these ongoing health systems successes and challenges through the performance management initiative in Bangladesh provides an opportunity to develop evidence-based policy reforms for strengthening supply-side health systems. The initiative results, particularly in the context of growing public demand for services, also justifies a monitoring and evaluation mechanism focusing on the quality and coverage of frontline health facilities and the development of more integrated health systems. The performance management initiative will facilitate the maintenance of essential health services while addressing emergency health needs and tracking progress towards achieving the Universal Health Coverage goal.

Insights on feline infectious peritonitis risk factors and sampling strategies from polymerase chain reaction analysis of feline coronavirus in large-scale nationwide submissions.

OBJECTIVE: This nationwide study aimed to investigate risk factors associated with FIP and determine optimal sample submission strategies for its diagnosis. METHODS: A total of 14,035 clinical samples from cats across the US were analyzed by means of reverse transcriptase quantitative PCR to detect replicating feline coronavirus (FCoV). χ2 and logistic regression analyses were conducted to assess the association between FCoV detection rates and risk factors such as age, gender, breed, and types of submitted samples. RESULTS: Higher FCoV detection rates were observed in younger cats, particularly those aged 0 to 1 year, and in male cats. Purebred cats, notably British Shorthairs [OR: 2.81; P < .001], showed a higher incidence of FCoV infection than other cats. Peritoneal fluid (OR, 7.51; P < .001) exhibited higher FCoV detection rates than other samples, while lower rates were seen in blood samples (OR, 0.08; P < .001) than in other samples. High FCoV detection rates were found in urine, kidney, and lymph node samples. CONCLUSIONS: The study identified significant risk factors associated with FIP. Optimal sample submission strategies, particularly emphasizing the use of peritoneal fluid, kidney, and lymph node, were identified to improve FIP detection rates. Urine yielded a relatively high frequency of infection and viral loads compared with most other samples. CLINICAL RELEVANCE: Understanding the risk factors and optimizing sample selection for FIP diagnosis can aid in the early detection and management of the disease, ultimately improving outcomes for affected cats. These findings contribute valuable insights to FIP epidemiology and underscore the importance of continued research to enhance diagnostic strategies and disease management approaches.