Can a Sector‐Wide Approach Underpin and Advance Universal Health Coverage?

Fragmented management approach makes the provision of comprehensive health care for achieving universal health coverage very unlikely. This article aims to explore the potential contribution of a systemic approach—the sector‐wide approach (SWAp)—to achieving universal health coverage (UHC), using the Mongolian context as an example. The paper describes UHC and factors that hinder its achievement in developing countries, based on the Mongolian experience. The analysis focuses on the root factors hindering the achievement of UHC and examines how these affect system and local capacity critical for achieving UHC. Two principally different approaches, a sector‐wide (holistic) approach and a standalone project (fragmented) approach are compared in terms of their contribution to the main indicators of achieving UHC. The current stage of the Mongolian health SWAp is identified and early rewards of a SWAp are presented. The paper proposes a SWAp as a potential approach to tackle these root factors to help in achieving UHC, because it is a promising instrument that promotes a systems‐strengthening and capacity‐building approach to enable effective coordination of standalone projects in alignment with the national priorities.     

A case study of green tree frog population size estimation by repeated capture–mark–recapture method with individual tagging: a parametric bootstrap method vs Jolly–Seber method

This paper deals with estimation of a green tree frog population in an urban setting using repeated capture–mark–recapture (CMR) method over several weeks with an individual tagging system which gives rise to a complicated generalization of the hypergeometric distribution. Based on the maximum likelihood estimation, a parametric bootstrap approach is adopted to obtain interval estimates of the weekly population size which is the main objective of our work. The method is computation-based; and programming intensive to implement the algorithm for re-sampling. This method can be applied to estimate the population size of any species based on repeated CMR method at multiple time points. Further, it has been pointed out that the well-known Jolly–Seber method, which is based on some strong assumptions, produces either unrealistic estimates, or may have situations where its assumptions are not valid for our observed data set.     

ASYMPTOTIC PROPERTIES OF AN OPTIMAL ESTIMATING FUNCTION APPROACH TO THE ANALYSIS OF MARK RECAPTURE DATA

ABSTRACT

A drawback of non parametric estimators of the size of a closed population in the presence of heterogeneous capture probabilities has been their lack of analytic tractability. Here we show that the martingale estimating function/sample coverage approach to estimating the size of a closed population with heterogeneous capture probabilities is mathematically tractable and develop its large sample properties.     

Inference for a binomial proportion in the presence of ties

We suppose a case is to be compared with controls on the basis of a test that gives a single discrete score. The score of the case may tie with the scores of one or more controls. However, scores relate to an underlying quantity of interest that is continuous and so an observed score can be treated as the rounded value of an underlying continuous score. This makes it reasonable to break ties. This paper addresses the problem of forming a confidence interval for the proportion of controls that have a lower underlying score than the case. In the absence of ties, this is the standard task of making inferences about a binomial proportion and many methods for forming confidence intervals have been proposed. We give a general procedure to extend these methods to handle ties, under the assumption that ties may be broken at random. Properties of the procedure are given and an example examines its performance when it is used to extend several methods. A real example shows that an estimated confidence interval can be much too small if the uncertainty associated with ties is not taken into account. Software implementing the procedure is freely available.     

轮机英语词汇的量化特征

运用容量为100万单词的轮机英语语料库,研究轮机英语词汇的量化特征,其中包括:轮机英语的词汇密度、零阶单词熵和复杂度、大学英语四级和六级词汇对轮机英语的单词覆盖率、HERDAN-HEAPS等数学模型对轮机英语词汇增长曲线的拟合度。     

Simultaneous confidence intervals for comparing several inverse Gaussian means under heteroscedasticity

Recently, Zhang [Simultaneous confidence intervals for several inverse Gaussian populations. Stat Probab Lett. 2014;92:125–131] proposed simultaneous pairwise confidence intervals (SPCIs) based on the fiducial generalized pivotal quantity concept to make inferences about the inverse Gaussian means under heteroscedasticity. In this paper, we propose three new methods for constructing SPCIs to make inferences on the means of several inverse Gaussian distributions when scale parameters and sample sizes are unequal. One of the methods results in a set of classic SPCIs (in the sense that it is not simulation-based inference) and the two others are based on a parametric bootstrap approach. The advantages of our proposed methods over Zhang’s (2014) method are: (i) the simulation results show that the coverage probability of the proposed parametric bootstrap approaches is fairly close to the nominal confidence coefficient while the coverage probability of Zhang’s method is smaller than the nominal confidence coefficient when the number of groups and the variance of groups are large and (ii) the proposed set of classic SPCIs is conservative in contrast to Zhang’s method.     

Length minimization for Poisson confidence procedures

We study Poisson confidence procedures that potentially lead to short confidence intervals, investigating the class of all minimal cardinality procedures. We consider how length minimization should be properly defined, and show that Casella and Robert's (1989) criterion for comparing Poisson confidence procedures leads to a contradiction. We provide an alternative criterion for comparing length performance, identify the unique length optimal minimal cardinality procedure by this criterion, and propose a modification that eliminates an important drawback it possesses. We focus on procedures whose coverage never falls below the nominal level and discuss the case in which the nominal level represents mean coverage.     

Medicaid expansion and ethnoracial disparities in health insurance coverage

ABSTRACT

Medicaid expansion, as part of the Patient Protection and Affordable Care Act (PPACA), was touted by many policymakers as a potentially powerful force for reducing ethnoracial disparities in health insurance coverage. Using a unique county-level dataset at two time points (before and after the passage of the PPACA), we test whether Medicaid Expansion predicted change in ethnoracial disparities. Specifically, we use fixed-effect regression models to predict the Black-white, Hispanic-white, and Asian-white disparities in health insurance coverage. Using states that did not expand Medicaid as a counterfactual, our models show that this policy expansion was not significantly associated with a decrease in ethnoracial health insurance disparities. Overall, these findings suggest the need for scholars and policymakers to be more cautious and tempered about Medicaid expansion’s relationship with ethnoracial disparities in health insurance coverage. We discuss the implications of these findings for research on ethnoracial health insurance disparities, as well as policy efforts to increase coverage in minority communities.     

Extending pension coverage in Cambodia: The governance and investment challenges of the Social Security Investment Fund

Rapid economic growth, declining fertility and changes in family structures have encouraged the Kingdom of Cambodia to reform its old-age pension system. The Government of Cambodia reached an important milestone in 2019, when the Law on Social Security was promulgated. The Law includes provisions for a compulsory defined benefit pension scheme, establishing a sound framework for extending compulsory pension coverage beyond the public sector to formal private-sector workers. As a future step, the compulsory pension scheme should be extended to informal workers. To accompany the reform, the investment policy for the pension scheme’s reserve funds, including the supervisory regime and investment strategy, will be essential for the modernization of the Cambodian social security system. In this regard, Cambodia has successfully sought policy advice. However, the country should continue to seek further advice, and to act on this. Otherwise, the necessary and increasingly pressing policy ambitions of Cambodia to develop an adequate and sustainable social protection system may not be fully realized.     

Poverty alleviation,coverage and fiscal sustainability: Investigating the effect of a new social pension in Hong Kong

This article synthesises the characteristics of social pensions across Asia and evaluates the effect of a new social pension in the Hong Kong SAR, the Old Age Living Allowance (OALA), on poverty alleviation, coverage rates and fiscal sustainability. We found that the effectiveness of the OALA in reducing old‐age poverty was limited, although it has led to an increase of retirement pension coverage by 6%. The OALA is projected to face substantial cost increases in the medium and longer term. Increasing the level of OALA benefits would be a direct means to enhance its poverty alleviation effect but may potentially be hampered by concerns about the fiscal sustainability of such changes. More obfuscated alternatives for Hong Kong policy makers to affect old‐age poverty alleviation include adjusting the indexing rules of benefit level payments and the eligibility criteria to reduce the stigma attached to the current policy choices.