The National Family Health Survey of India
The National Family Health Survey of India emphasises the need to hydrate children who have diarrhoea, but there is no evidence to show that such an intervention in the home setting improves mortality. The eight out of ten practitioners who are unaware of childhood pneumonia symptoms in the developing world represent a similar example, whereby medical education seminars and rigorous tutorials can improve the situation.
Thus, the major dilemma seems to be in the implementation of rather than access to health-care information. Although we strongly believe that health information should be available to all, several fundamental questions need to be answered. To ensure such a provision, funding needs to be made available. Where would this Tariquidar funding come from? These funds would be redirected from the health budget and research allocations. For example, in 2012, the research council in the UK spent US$161 million to provide gold open access in the UK. Whether cutting down on medical research (with a proven potential to save human lives) to ensure health-care access to all is justified poses great ethical considerations.
We thank Haris Riaz and colleagues for their interest in our Comment. The term access in the context of our Comment not only implies open access to newly generated research findings, but also incorporates making pre-existing knowledge available to health-care workers and caregivers. Making essential health-care information available at the end-user level through seminars and tutorials, among other modalities, is indeed an indispensible part of ensuring access in the truest sense of the term. As mentioned by Riaz and colleagues, continued medical education and recertification procedures are necessary, which are basically structured methods to assure information dissemination, reinforcement, and retention. We advocate the very same outcomes, not only for medical professionals, but also for health-care providers and caregivers at all levels. We wonder however why Riaz and colleagues state that “there is no evidence to show that such an intervention in the home setting improves mortality”. Substantial rigorous evidence shows that use of oral rehydration solution, even in the home or community settings, can reduce mortality from diarrhoea. Evidence for other recommended home fluids is scare, but in areas with low coverage of oral rehydration solution, home fluids are still recommended for rehydration.
Lancet Glob Health —This Comment (published online July 29) was originally published with the wrong creative commons copyright owner, the copyright should read Bassat et al. This correction has been made to the online version as of August 23.
Introduction Investigation of stroke burden by its major pathological types, and study of their secular trends in different regions of the world, is important for targeted region-specific health-care planning in stroke (eg, estimation of resources needed to care for patients with stroke, by type) and can inform priorities for type-specific prevention strategies. These data are also important for improving understanding of the health consequences and patterns of epidemiological transitions reported worldwide. Findings from systematic reviews suggest that low-income and middle-income countries have a greater proportion of haemorrhagic stroke than do high-income countries, that geographical variation is high in the incidence of major pathological types of stroke, and that no substantial changes have taken place in the incidence of haemorrhagic stroke in the past three decades. However, no detailed and systematic comprehensive estimates have been made of the global and regional incidence, case-fatality, disability-adjusted life-years (DALYs) lost, and secular trends of incidence of ischaemic or haemorrhagic stroke, especially for low-income and middle-income countries. We report estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD 2010) for incidence, mortality, mortality-to-incidence ratio, and DALYs lost in ischaemic or haemorrhagic stroke in all 21 regions of the world in 1990, 2005, and 2010.