After microfinance, the missing middle is the new buzzword for SME development experts. And again finance is supposed to be the number one solution to support enterpreneurs. Klaas Molenaar recommends to take a look into the history of microfinance to question the hype.
MULTIFILE
This study investigates patients' access to surgical care for burns in a low- and middle-income setting by studying timeliness, surgical capacity, and affordability. A survey was conducted in a regional referral hospital in Manyara, Tanzania. In total, 67 patients were included. To obtain information on burn victims in need of surgical care, irrespective of time lapsed from the burn injury, both patients with burn wounds and patients with contractures were included. Information provided by patients and/or caregivers was supplemented with data from patient files and interviews with hospital administration and physicians. In the burn wound group, 50% reached a facility within 24 hours after the injury. Referrals from other health facilities to the regional referral hospital were made within 3 weeks for 74% in this group. Of contracture patients, 74% had sought healthcare after the acute burn injury. Of the same group, only 4% had been treated with skin grafts beforehand, and 70% never received surgical care or a referral. Together, both groups indicated that lack of trust, surgical capacity, and referral timeliness were important factors negatively affecting patient access to surgical care. Accounting for hospital fees indicated patients routinely exceeded the catastrophic expenditure threshold. It was determined that healthcare for burn victims is without financial risk protection. We recommend strengthening burn care and reconstructive surgical programs in similar settings, using a more comprehensive health systems approach to identify and address both medical and socioeconomic factors that determine patient mortality and disability.
This paper presents the development and construct validation of an instrument for identification of resilient and less-resilient middle adolescents in high school. Purpose of this identification is a qualitative in-depth interview study of perceptions of resilient and less resilient middle-adolescents on their school environment. The qualitative study will function as examination of contentvalidity of the presented instrument. A 33-item Resilient Behavior Questionnaire (VVL) and a 105-item personality questionnaire NPV-J (Dutch Personality Questionnaire- Youngsters) were administered to a sample of 400 middle adolescent high school students (age range 14-16). It was hypothesized that scores on specific components in the VVL would correlate highly with relevant factors of personality in the NPV-J. Principal Component Analysis and Correlation Analysis served as methods of investigation. Results of the quantitative study reveal three components in the VVL and a high correlation between the scores on these components and the resilient personality factor perseverance and non-resilient factor inadequacy in the NPV-J. Discussion focuses on explanation of the results and implications for further development of the VVL.
