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Mohammed Hussien,1 Muluken Azage2 1Department of Health Systems Management and Health Economics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia; 2Department of Environmental Health, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, EthiopiaCorrespondence: Mohammed HussienDepartment of Health Systems Management and Health Economics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, P.O. Box: 79, Bahir Dar, 6000, EthiopiaTel +251 588209834Email muhamedun@gmail.comPurpose: A growing number of low- and middle-income countries are implementing small-scale community-based health insurance schemes to tackle the burdens posed by direct out-of-pocket payments. Apart from a few successful experiences, such schemes suffer from the problem of persistent low membership which could be attributed to either initial low enrollment or low renewal rate. However, there is a lack of comprehensive information on the factors that influence subscribers’ policy renewal decisions. Hence, we systematically synthesize information to answer the review question ”what are the barriers and facilitators of community-based health insurance policy renewal in low and middle-income countries?”.Methods: We searched PubMed, Scopus, and Hinari electronic databases in line with the PRISMA guidelines. Our search was limited to studies published from January 2005 to February 2020 in the English language. Additional studies and grey literature were searched using Google Scholar. We included quantitative, qualitative, and mixed-method studies in the review. We assessed the methodological quality of the studies using standardized appraisal tools. The findings were synthesized inductively using a thematic analysis approach.Results: Our searches retrieved 2386 records among which 27 were included in the review. The thematic synthesis identified six major themes that influence the decision to renew scheme policy: socio-demographic factors; scheme-related awareness and understanding; participation in scheme and other voluntary groupings, need and benefit factors; health-care quality; and scheme operation and policy.Conclusion: Lower socioeconomic status, poor quality of health care, lack of benefit from the scheme, lack of trust in scheme management, and dissatisfaction with scheme services are important barriers for community-based health insurance policy renewal. Better education, understanding the principles of the scheme, active participation in the scheme, and long-term illness experience of member households facilitate renewal decisions. These are important areas of intervention for governments and other relevant stakeholders to retain members and maintain the sustainability of the schemes.Registration: The review protocol was registered in PROSPERO international prospective register of systematic reviews (ID = CRD42020168971).Keywords: universal health coverage, community-based health insurance, barriers and facilitators, renewal, low- and middle-income countries

Alemwork Desta Meshesha,1 Muluken Azage,2 Endalkachew Worku,3 Getahun Gebre Bogale4 1ART Clinic, Dessie Referral Hospital, Dessie, Amhara Regional State, Ethiopia; 2Department of Environmental Health, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia; 3Department of Reproductive Health and Population Studies, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia; 4Department of Health Informatics, College of Medicine and Health Sciences, Wollo University, Dessie, EthiopiaCorrespondence: Getahun Gebre Bogale P.O. Box: 1145 Tel +251914715992Email getahungebre21@gmail.comAlemwork Desta Meshesha P.O. Box: 15478 Tel +251914614994Email alemworkd21@gmail.comBackground: Globally, every year, 2.5 million infants die within their first month of life. Birth asphyxia is one of the leading causes in all low- and middle-income countries and the leading single cause of neonatal mortality in Ethiopia. Therefore, the aim of this study was to identify the determinants of birth asphyxia among newborns admitted to neonatal intensive care units (NICU) in Amhara region referral hospitals, Ethiopia. Methods: Facility-based unmatched case-control study was employed fromMarch 1 to April 30, 2018. Cases were newborn babies admitted to neonatal intensive care units with an admission criteria of birth asphyxia with APGAR score of < 7 at five min of birth and controls were newborn babies admitted to NICU with an admission criteria of other complications (such as jaundice, congenital anomalies, sepsis, hemorrhagic diseases) with APGAR score of ≥7 at five min of birth. Using SPSS version 20, bivariate logistic regression model was fitted to check the relation of each independent variable to the outcome variable. Variables with p < 0.2 in bivariate analysis were transferred to multivariable logistic regression model for final analysis. Variables with an adjusted odds ratio (AOR) of 95%CI and p < 0.05 were reported as determinants of birth asphyxia. Results: Data were collected from 193 cases and 193 controls with a response rate of 100%. Low birth weight (AOR: 8.94, 95%CI: 4.08, 19.56), born at health centers (AOR: 7.36, 95%CI: 2.44, 22.13), instrumental delivery (AOR: 3.03, 95%CI: 1.41, 6.49), and prolonged labor (AOR: 2.00, 95%CI: 1.20, 3.36) were significant determinants of birth asphyxia. Conclusion: Even though most of the identified variables are the common and familiar causes of birth asphyxia, neonates born at health centers were more exposed to birth asphyxia than neonates born in hospitals. This might be due to delay of referral process and lack of skilled professionals in health centers. Further research might be needed to identify the root causes of delays and follow-up issues by adding qualitative component. Keywords: birth asphyxia, cases, controls, case-control

Public health surveillance systems are critical for detecting and responding to health threats. This review aims to analyze international literature on the performance of these systems in terms of core, support, and attributes of surveillance system. Systematic review. Following the preregistered protocol (PROSPERO: CRD42022366051), a systematic search was conducted on PubMed/MEDLINE, CINHAL, CABI, Web of Science, and Google Scholar for articles evaluating Public Health Surveillance System performance from inception to July 21, 2023. Various study designs were included, and quality assessment was performed. Thematic analysis categorized findings into key surveillance system functions. Nine studies from different countries assessed core and supportive functions, as well as surveillance attributes. Performance varied among countries, with some excelling overall and others showing poor performance in specific areas. Many countries' surveillance systems had inadequate performance in key measures in terms of the core and supportive functions, as well as the attributes of the surveillance system. This review shows significant variations in the performance of public health surveillance systems across countries. Further research is needed to understand underperformance reasons and inform global policymaking for strengthening surveillance systems. [ABSTRACT FROM AUTHOR]