Life expectancy at birth (total) (in years) in Nigeria compare with selected African countries (composed from world development indicators 2021).
\r\n\t
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\nDue to catastrophic failures, industrial maintenance has been evolved to prevent machines from failures, which looks for symptoms in machines that allow determining the most appropriate time for doing maintenance, and even more important, determining the exact failure occurring in a machine [2, 3].
\nThis new form of industrial maintenance development, called “predictive maintenance,” requires new methodologies and expert analysis, which can act as “machine physicians,” able to determine a machine’s health condition based on those symptoms [4].
\nOne of the most accurate predictive methods is vibration analysis [5–7], which implies the study of machine vibration signals as a symptom allowing to determine eventual failures in an incipient state [8], thus avoiding a possible catastrophic failure. A significant problem associated with this study has to do with cost, currently ranging from US$ 12,000 to US$ 40,000 [5]. On the other hand, MATLAB is a very powerful calculation tool that, among many other remarkable features, can be used to create matrix-type databases, perform complex calculations, and generates graphs, allowing the creation of graphical interfaces, etc., so undoubtedly we can use it to develop a software for storing vibration analysis data in a database and tools that permit the analysis of data stored in the same software, this being a first step toward the creation of a low-cost “virtual instrument” [9]. This software is limited, in this first development stage, to data acquisition from an Excel spreadsheet, along with the recording and analysis of the acquired data, leaving aside for the time being the capture of the machine’s vibrations stage through a transducer, the conditioning of the captured vibrations, as well as the subsequent data acquisition [10, 11].
\nIn this chapter, we present the development of a virtual analyzer of mechanical vibrations to be used in industry. This software was developed on MATLAB/Simulink due to that software’s calculation capacity and because it has a visual programming tool called GUIDE, which allows an easy development of a graphical interface for vibration analysis [12].
\nThe database is called “basedatos,” and it is created as a variable in MATLAB’s Workspace and stored in the same place. To access it, we must load the database through the command “Load” at the time of starting the program.
\nThe database is a structure where we include operation conditions and measurement data, such as date, observations, etc., and inside this structure, one of the fields is an arrangement called “signal,” where we include width, frequency, phase, and harmonics attenuation coefficient of the vibrational signal.
\nAnother important feature of MATLAB is a compiler that creates an “.exe” file that allows the execution of the program without the need to have it previously installed, therefore allowing to run the vibration analyzer on any PC.
\nSeveral screens are created for the different “analyzer features” and for the “implementable tools” that can be accessed through buttons arranged on a main screen called “Main” for the program root, and “Vibration analysis” for the developed tools, as shown in Figure 1.
\nThose screens or graphical interfaces have many components, such as buttons, selection boxes, dialog boxes, etc., that must be named first. In order to do that, inside the option “property” of the “tag” section of the interface elements, the names that those components will have are entered by the user. The names should be easy to remember, so we commonly use abbreviations referring to names of the corresponding functions or components. The importance of naming the components is that, at the time of creating the program’s code, those components are called through the “Callbacks” function, for editing or capturing their values through the “set” and “get” functions, respectively.
\nVibration analysis software structure.
This function allows importing vibration data from an Excel spreadsheet, in this way filling the database more quickly than entering the data one by one.
\nManual entry allows entering specified data step by step with respect to the machine, the measurement point, sensor arrangement, the values of the measurement’s representative peaks, etc.
\nWith this function, we can look for the already existing data inside the database and modify them, allowing the correction of possible errors.
\nTwo measurements can be compared in parallel, to see their frequency spectra and the operation conditions at the time the measurement was made.
\nThis function makes it possible to see how entering another vibration with a different phase and/or damping coefficient will affect the frequency spectrum of a given signal, as well as to simply see the frequency spectrum of a designed signal.
\nThis is the software’s main function, where we can access different kinds of vibration analysis that can be carried out with discrete data, as is the case of these data.
\nThe machines that can be analyzed with this software are as follows: DC motors, AC motors, rotodynamic pumps, hydraulic generators, steam generators, and SAG mills.
\nThis software’s basic tools allow capturing data from an Excel spreadsheet, store the data manually in the database, edit the data, compare fast Fourier transform (FFT) graphics, and simulate vibrations, looking at how they affect the data previously stored in the database. All those tools are part of the main features of the analyzer.
\nThe fact that this software works with data entered in a discrete way limits the kind of vibration analysis tools that can be adapted to MATLAB. The tools that could be adapted to MATLAB are the following:
\nWith this analysis, we can see the frequency spectrum of a vibration signal stored in the database, by varying the sampling frequency, and we can also see the spectrum in the form of a bar graph with a frequency error of 10−3, which allows a very good resolution and shows the peaks clearly. This technique uses the Fast Fourier Transform (FFT) [9, 13].
\nThe “frequency analysis” screen has a signal finder, a sector where the values of operational conditions are printed once the “Load” button is pressed, and a sector where the kind of graph is chosen and the sampling frequency in the case of choosing an FFT graph is determined.
\nTo carry out this kind of analysis, we must take a reference value that will be 1X, and, from this reference, the other frequencies will be expressed as multiples of it, where this value is usually the machine speed [13].
\nTo do this, we will take a reference value in (KCPM) by which every frequency of the spectrum to be analyzed will be divided.
\nThis screen is very similar to that of the “frequency analysis,” but instead of entering the sampling frequency, we can choose a reference frequency to generate the orders, and those frequencies can be the speed or the net frequency stored for that datum in the database, or any other that can be written and selected.
\nWith this function, we can see the evolution over time of a given frequency value in a specific machine, at a specific measurement point, and with a specific sensor arrangement.
\nBecause of this, it is necessary to determine which are the machine, the point, and the arrangement from which we want to extract a given frequency to see its evolution in time. Hence, on this screen, there is a sector for determining each of those parameters, and another sector for determining the central frequency in (KCPM) that we are searching, along with a tolerance value in this same unit allowing a search range around the central frequency. There is also another sector for determining whether we want to look for frequencies from all the existing measurements in the database, or if we only want to graph the last “X” data from the database, with respect to date and time from the last measurement to the first stored measurement.
\nOn this screen, we can search for data stored in the database and determine the RMS value of the vibration rate and the crest factor (CF), a value allowing to see the influence of the complete vibration signal over the signal’s highest peak [14].
\nThrough this analysis, we can see the evolution in time of the complete vibration signal [13], and it is similar to the histogram analysis, but considering all the frequencies of the signals.
\nIn order to do that we arrange data in the same way as on the “histogram analysis” screen, only varying the way the chart is created, since we must capture all the frequency-width pairs of all the data or of the last “X” data, which can be selected at will, and graph them next to one another to form a three-dimensional (3D) surface.
\nFor this analysis, we considered two kinds of charts, a two-dimensional (2D) one that permits a simpler analysis of vibration evolution, and a 3D one that allows the signal peaks to be seen, but making the determination of the coordinates of the points more complex. The 2D chart is generated after pressing the “CONTOUR GRAPH” button and the 3D chart by pressing the “3D TFT CHART.”
\nIn order to see the operation of this analyzer based on real measurements, we invented a series of measurements to test the performance of the analysis tools in order to see the evolution in time of the measurements.
\nThe data exported from Excel have a structure that facilitates their storage in the software’s database. This structure is shown in Figure 2.
\nWorksheet for data exportation to the analysis software.
From the “Main” screen, we access, pressing the corresponding button, the “Vibration Analysis” screen, as shown in Figure 3.
\n“Vibration Analysis” screen.
By means of the “Frequency Analysis” tool, we can get an FFT graph of a specific datum, or a representation of this FFT on a bar graph, as shown in Figures 4 and 5.
\nFFT chart of data to be analyzed.
Bar chart of frequency analysis.
The tool “Spectral Analysis in Orders” allows the generation of a chart in orders taking as base frequency the machine’s recorded speed, the net frequency, or any desired value, and the graph obtained is an FFT chart or a representation of the FFT on a bar graph, as shown in Figure 6.
\nBar graph of orders taking as base frequency the machine’s recorded speed.
The “Histogram Analysis” tool allows seeing the evolution of a given frequency of the vibration spectrum. Here, we choose the machine, the point and the sensor arrangement, when the measurement was made, selecting the frequency we want to survey, along with a tolerance range in case the exact desired value is not found. Figure 7 shows this screen, where we are looking for the 12 KCPM with a frequency tolerance of 0.5 KCPM.
\n“Histogram Analysis” screen. Searching 12 KCPM frequency.
The exact frequency obtained and the dates of the measurement are shown above the histogram bars.
\nWith the “RMS and CF value” tool, we can calculate the RMS value and the CF, displaying the signal’s FFT or the signal as a function of time, so we can see the location of those values inside the vibration spectrum, as shown in Figure 8.
\n“RMS Value and CF” screen.
The “Time-Frequency Transform (TFT)” tool allows getting two kinds of graphs that represent the frequency, width, and time variables of the measured vibration spectra. One of the graphs is a 3D presentation of those variables (see Figure 9), and the other is a 2D contour line presentation of the 3D image, allowing a better analysis (see Figure 10).
\n3D and 2D TFT graphs.
2D TFT graphs.
With the tool “Comparison with Rules and Standards,” we can, after calculating the rms value, get a vibration severity evaluation, according to ISO 2372, ISO 2373, and ISO10816 standards. In this function, we select the rule with which we want the data to be compared, selecting the machine’s classification in accordance with the chosen rule, and then pressing the “Compare” button. This gives an evaluation of the vibration severity of the machine, according to the selected standard. This is shown in Figure 11.
\nScreen “Comparison with Rules and Standards.”
A powerful software for vibration analysis was developed, with a very low cost compared with the tens of thousand dollars that a system for acquisition and analysis of mechanical vibrations can effectively cost.
\nThis software, developed in MATLAB, has powerful tools like the creation of FFT graphs or bar graphs allowing to see more clearly the FFT peaks, order charts, histograms of some frequencies in a given time period, calculation of the RMS value and CF of a given frequency spectrum, creation of TFT graphs in 3D and 2D, and comparison of frequency spectra with ISO 2372, ISO 2373, and ISO 10816 standards.
\nThis is a first stage in the development of this kind of “virtual instrument,” since many parts still remain unsolved, like direct data acquisition from the machine, capturing and conditioning vibration signals for further storage in the database of the designed software, and this is an actual challenge to be faced in the short term.
\nAnother interesting point for further development is the creation of an intelligent system (expert system, neural net, artificial intelligence, etc.) able to determine which is the possible failure appearing with vibration as a symptom.
\nThe main file that contains the folders with the programming codes of the computational simulator (virtual instrument) presented in this chapter can be downloaded directly from the following website: http://www.mathworks.com/matlabcentral/fileexchange/56693-virtual-instrument-for-the-analysis-of-vibrations-in-rotary-machines
This work was supported by Proyectos Basales and the Vicerrectoría de Investigación, Desarrollo e Innovación of the Universidad de Santiago de Chile, Chile.
\nIn 2005, the pervading global inequality in access to healthcare prompted the World Health Assembly to pronounce a resolution on Universal Health Coverage (UHC) [1]. UCH rests on two essential bedrocks: equitable access to quality healthcare and protection from financial risk. UHC forms target 8 of the United Nation’s Sustainable Development Goal 3 (SDG 3). It also plays a crucial role in achieving other important SDGs, such as poverty reduction (SDG 1), gender equality (SDG 5), inclusive economic growth (SDG 8) and reduced general inequalities (SDG 10) [2, 3, 4, 5].
The prevailing poor health indices and extreme poverty in the sub-Sahara African region, especially in Nigeria, have been attributed to inequality in access and financial protection in healthcare utilisation [4, 6, 7]. In 2000, Nigeria was ranked by the WHO as the fourth country with the worst health system, only topping three war-torn nations [8]. After two decades, Nigeria still has one of the worst health indices in Africa (see Tables 1–3), despite being Africa’s largest economy in terms of Gross Domestic Product (GDP) and most populous country with an abundance of both human and material resources [5, 9, 10, 11]. For instance, while Nigeria’s infant mortality rate in 2015 was 69 deaths in every 1,000 live births, the respective figures for neighbouring Africa countries like Ghana, Niger and Cameroon were 43, 57 and 57 per 1,000 live births [12]. The maternal mortality ratio of 814 per 100,000 live births in Nigeria exceeds only those of three countries in Africa [5, 12]. Moreover, the country has the highest number of extremely poor people worldwide after India [13]. Although these abysmal indices were derived from multiple factors, the issue of poor equitable access and exposure to financial hardship arising from catastrophic healthcare costs is the most significant.
Country Name | 1975 | 1980 | 1985 | 1990 | 1995 | 2000 | 2005 | 2010 | 2015 |
---|---|---|---|---|---|---|---|---|---|
Ghana | 50.811 | 52.277 | 54.127 | 56.776 | 57.528 | 57.002 | 58.719 | 61.03 | 62.772 |
Nigeria | 43.187 | 45.333 | 46.127 | 45.9 | 45.854 | 46.267 | 48.252 | 50.896 | 53.112 |
Rwanda | 45.315 | 48.527 | 51.685 | 33.413 | 31.037 | 48.649 | 55.254 | 63.433 | 67.45 |
South Africa | 55.428 | 58.107 | 60.946 | 63.307 | 61.561 | 56.048 | 53.447 | 57.669 | 62.649 |
Cote d’Ivoire | 48.147 | 51.072 | 52.922 | 53.254 | 51.569 | 49.635 | 50.12 | 52.964 | 56.065 |
Life expectancy at birth (total) (in years) in Nigeria compare with selected African countries (composed from world development indicators 2021).
Country Name | 1975 | 1980 | 1985 | 1990 | 1995 | 2000 | 2005 | 2010 | 2015 |
---|---|---|---|---|---|---|---|---|---|
Ghana | 186.5 | 166.8 | 154.7 | 127.2 | 114 | 99.4 | 82.9 | 69.1 | 54.6 |
Nigeria | 241.5 | 211.8 | 206.9 | 209.5 | 204.1 | 183.1 | 155.5 | 136 | 126.8 |
Rwanda | 246.2 | 218.4 | 159.6 | 149.8 | 249.7 | 178.7 | 109.3 | 63.7 | 41.5 |
South Africa | 121.7 | 92.2 | 71.1 | 57.3 | 59.4 | 71.1 | 79.1 | 51.2 | 37.1 |
Cote d’Ivoire | 202.6 | 168.2 | 154.1 | 152.3 | 152 | 142.3 | 125.3 | 106.4 | 90.6 |
Mortality rate, under-5 (per 1,000 live births) in Nigeria compare with selected African countries (composed from world development indicators 2021).
Country | Demographic Indicators | Health Indicators | Health Expenditure Indicators | ||||
---|---|---|---|---|---|---|---|
Population (total) | GDP per capita (US$) | Life expectancy at birth (years) | Infant mortality rate (per 1,000 live births) | Under-5 mortality rate, (per 1,000 live births) | General government health expenditure (% of GDP) | Out-of-pocket expenditure (% of current health expenditure) | |
Ghana (2016) | 28,481,946 | 1931.389 | 63.124 | 37.4 | 52.2 | 1.327 | 37.823 |
Nigeria (2016) | 185,960,289 | 2176.002 | 53.541 | 78.5 | 125 | 0.475 | 75.187 |
Thailand (2016) | 68,971,331 | 5994.231 | 76.403 | 8.9 | 10.3 | 2.858 | 11.345 |
Ghana (2017) | 29,121,471 | 2025.932 | 63.463 | 36.1 | 50 | 1.087 | 41.212 |
Nigeria (2017) | 190,873,311 | 1968.564 | 53.95 | 77.3 | 122.8 | 0.532 | 77.224 |
Thailand (2017) | 69,209,858 | 6592.914 | 76.683 | 8.4 | 9.9 | 2.934 | 10.898 |
Key demographic, health and economic indicators- Nigeria, Ghana and Thailand (2016–2017).
A proven mechanism for achieving the objectives of UHC is the institution of a suitable mechanism of health financing [14]. Health Financing is a mechanism by which funds are generated, mobilised and utilise for healthcare [1, 15]. An effective healthcare financing mechanism gives people adequate financial protection from impoverishment arising from health services utilisation [14]. In Nigeria, health financing has been predominantly through out-of-pocket (OOP) spending - a regressive form of health financing. OOP payment accounts for about 69% of total healthcare expenditures in Nigeria [16]. As a result, poor households in Nigeria are either unable to access quality healthcare or face financial hardship from healthcare spending [1, 2]. More often than not, OOP payment makes people refrain from utilising health services, present late to health facilities, or patronise sub-standard healthcare facilities. OOP expenditure produces inequity because quality healthcare is only available to those who can pay and not those who need it. In most instances, the poor and vulnerable groups, most in need of the services, have to sell their valuables, incur debts, or spend the family savings to access healthcare, resulting in further impoverishment. This phenomenon is referred to as catastrophic health spending [1, 17, 18, 19, 20].
A household is usually classified as having incurred catastrophic expenditure “if it spends 40% or more of its discretionary (non-food), or 10% or more of its total expenditure on healthcare” [21]. Catastrophic health expenditures arise not only from direct spending on transportation to health facilities, treatment, investigations, medication and hospitalisation, but also from indirect costs resulting from depreciating health status and a resulting reduction in productivity [16]. Consequently, a household is caught up in a cycle of perpetual poverty (Figure 1). Ilesanmi et al. show an increase in poverty of 66.2% due to OOP spending on healthcare, especially among households in the rural communities in Nigeria [23]. Since more than 50% of Nigerians, representing more than 100 million people, live below the poverty line, catastrophic health expenditure is endemic [16, 20, 24]. This situation, therefore, calls for an urgent need to break this cycle of poverty and health-related misery by eliminating OOP payments.
Cycle of impoverishment due to out-of-pocket (OOP) health spending by poor households. (Adapted from Han [
Healthcare in Nigeria is financed through government budgetary allocation, donor funding, NHIS and private funding. The Nigeria 1999 Constitution empowers all the three tiers of government (federal, state and local) to mobilise and deploy resources to provide healthcare in their jurisdiction [24, 25]. The Nigerian government expenditure on health is less than nearly those of any country in the world (see Figures 2–5) [27, 28]. For example, only 4% of the federal budget was allocated to health in 2018 (below the 15% commitment of the 2005 Abuja Declaration). The situation is worse in the states and local government, where even less is allocated to health [1, 3]. This reflects the value the government places on health and it is the most significant challenge faced in achieving UHC by Nigeria [15, 25].
Public health expenditure (% of total expenditures) in selected African countries. (Source: World Development Indicators).
Breakdown of THE by private financing sources, 2006, 2007, 2008 and 2009. (Source: National Health Accounts 2006-2009).
Health Funding in Nigeria. (Source: National Health Account 2006-2009).
Capital budget implementation across selected Ministries Departments and Agencies (MDas), 2016 [
Even though Nigeria is the leading recipient of Developmental Assistance for Health (DAH) in Sub-Sahara Africa, the fund constitutes only about 4% of the county’s total health spending [18, 29]. Moreover, the funding administration is bedevilled with numerous challenges such as a high technical assistance cost, unevenness in sponsored activities, poor fund tracking, and counterpart funding issues [18]. In essence, DAH is not a reliable mechanism of healthcare financing in the country.
To achieve UHC, Nigeria adopted a social health insurance scheme known as the National Health Insurance Scheme (NHIS) in 2005 through an Act of Parliament. This is now known as Cap N42 Laws of the Federation of Nigeria, 2004 [11, 30]. However, after more than a decade, this scheme has not covered more than 4% of Nigerians [3, 16]. Despite its enormous potential in Africa, Nigeria’s NHIS has performed worse than many countries on the continent [4, 5, 31]. This poor performance can be attributed to several policy deficiencies. First, the scheme is fragmented, being divided into Formal Sector, Informal Sector and Vulnerable Group categories and other sub-categories [32]. Second, despite commencing operation with the formal sector, it has not moved beyond the federal civil servants (constituting only 4% of the country’s population). These federal employees have refused to contribute their 5% counterpart share of the 15% required. Therefore, the federal government is subsidising the health of a more affluent segment of the population by 10% at the expense of the poor and vulnerable people, the informal sector and the state employees, worsening the inequality situation [16, 17, 33]. Third, many states have not embraced the NHIS because the Act that set up the scheme did not capture the states in its operation [3, 14]. Even the Community Based Health Insurance (CBHI) that was recently inaugurated to cover the rural population and the informal sector has fared poorly with less than 3% enrolment. This insufficient enrolment has been attributed to unaffordable premiums, lack of trust, and poor quality of health [14, 34, 35]. Fourth, the Act that established NHIS made it voluntary for enrollees. It stripped the NHIS of the power to enforce the regulation guiding its operations, thereby causing poor participation and ineffective functioning of NHIS [33]. Fifth, the vulnerable group has not yet been covered. For example, Raji et al. discovered that retirees were not covered [36]. Sixth, the scheme’s fragmentation has prevented it from having adequate resource pooling [3]. Therefore, these problems are possibly responsible for the failure of NHIS to fulfil its goal of saving Nigerians from regressive OOP health spending, which stands at 95% of the private health expenditures and 69% of the Total Health Expenditures (THE) (see Figure 4).
Substantial evidence has proven that OPP health expenditures, rampant in LMICs, are the most regressive, inefficient and inequitable healthcare financing method [2, 24, 37]. While there is a concession that LMICs need to discard OPP expenditure, the debate is about which of the pre-payment health financial mechanisms will be the best. There is no silver bullet mechanism since each country’s challenges are different [38, 39]. Moreover, each country is unique in its socio-demographic, economic and political structure. However, a health finance mechanism that can produce equitable access in LMICs must be based on compulsory pre-payment, fund pooling/risk-sharing and subsidisation, for those who cannot afford to pay [39, 40, 41]. Fund pooling and risk-sharing involves aggregating funds and redistributing them equitably between the rich and the poor, the employed and the unemployed, and the healthy and the sick [6, 14, 41]. Therefore, an exploration of different health financing mechanism follows in the next section.
External funding in the form of DAH is becoming a vital funding mechanism in LMICs, especially in SSA [42]. As pointed out earlier, it is an unreliable mechanism of funding. Although DAH has decreased in the last two decades, there has not been a commensurate increase in SSA domestic financing [29]. This development could worsen the existing access, equity and financial risk problem in those countries [42]. However, DAH may be required, in the short to medium term, as complementary or supplementary funding for UHC in LMICs [40].
CBHI is a form of private health insurance in which a group of people in a community contributes to financing their healthcare. It is used in LMIC to cater for the rural population and the informal workers usually not covered by other health insurance. CBHI suffers adverse selection and low participation and retention, resulting in low fund pooling and risk-sharing like any voluntary insurance scheme. The poor resource pooled also produces high administrative costs and sustainability issues. Moreover, no matter how small, the premium may be unaffordable for the poorest members of the community [18, 42]. Although CBHI can potentially protect the enrollee from OOP spending, the very poor, who are not covered suffer financial risk, poor access and inequity. Therefore, CBHI is only helpful as a short-term measure against OOP spending [35, 42].
Most developed countries have protected people from financial risk using social health insurance (SHI) or a tax-based funding mechanism [37]. SHI is a scheme in which the government mandates people to contribute to financing their health. It is usually funded jointly by the employees and their employers. The government pays for those who cannot pay, such as the poor, unemployed and vulnerable. SHI became the predominant health financing method in LMICs having been adopted by the African Union Conference of health ministers in 2007 [1, 37, 42]. While some countries such as Kenya, Tanzania and Nigeria introduced their SHI beginning with the formal sector and planned to expand it later, others like Ghana, Rwanda and Mali began with the entire population. Generally, countries in the latter group have successfully covered a more significant population, while the former has been unable to move beyond the formal sector. This issue has generated a severe equity problem of leaving behind the poor community of informal employees [42]. Consequently, a bottom-up approach, starting with the poor and vulnerable group and then the informal sector, has been suggested if this scaling-up approach is adopted [43].
SHI’s success story in high-income countries like Germany has not been replicated in LMICs because of the mostly poor, unemployed and informal population. Moreover, LMICs cannot wait the length of time usually required for SHI to achieve UHC. Germany had to wait for 127 years [40]. Ghana and Rwanda’s success stories with SHI have been made possible by subsidising mandatory enrolment for the poor and vulnerable group, a large percentage of their population, through tax revenue and donor funds [42].
A mechanism in which government funds healthcare mainly from its revenue or general taxation is called tax-based health financing [1, 18]. by Wagstaff et al. in their study of thirteen OECD countries, proved that direct taxes are progressive and indirect taxes are regressive in all the countries. It, however, shows that SHI is only progressive in eleven countries [44]. In contrast, a global review by Aurelio Mejía shows that direct and, even, indirect tax-funded systems are generally more progressive than SHI in LMICs [45].
A growing body of evidence has shown that tax-generated revenue is a significant potential source for expanding domestic fiscal space for health (DFSH) [42, 46]. Some consumption taxes on products (such as tobacco, alcohol and sugar) that are harmful to health (the so-called “sin tax”) could be earmarked for healthcare financing as has been carried out in Thailand [42, 47]. Mobile phone usage tax is another revenue source for healthcare, considering the sizeable mobile phone subscriber base in Nigeria [48]. Subsidy from petroleum products can also be used to fund healthcare as is done in Indonesia [49]. It has been established that an increase in health expenditure can increase the economic growth of LMIC by 0.4 [10]. However, governments in LMIC must prioritise health financing following the example of countries like China, Cuba and South Korea [29, 50].
Two approaches to healthcare financing have shown consistent results in LMICs. First, the adoption of a tax-based health financing mechanism for population coverage as used with great success in Sri Lanka, Malaysia and Brazil. Second, SHI and general tax use to target the formal sector and the rest of the country, respectively. This approach was employed to achieve UHC in Thailand, Mexico and Kyrgyzstan [40].
Ghana is a middle-income country in West Africa with a total population of 28,207,000 in 2015 and gross national income per capita of $3,880 in 2013 [51]. It is noteworthy that Ghana and Nigeria operate SHI (both known as National Health Insurance Scheme. Ghana began its SHI in 2004, just a year before Nigeria. Although Ghana has not achieved the recommended 90% UHC, it has become a success story in Africa within two decades of commencing the scheme, having covered about 64% of its total population. It has gone through different phases and challenges to reach this pedestal [6, 40]. Therefore, Nigeria can learn from Ghana how it was able to achieve this success, despite limited economic and human capital resources compared to Nigeria [11, 17]. Although, Ghana has not reached the targeted UCH goal, but it prides itself on achieving better health outcomes than Nigeria (see Table 4). This is not unrelated to its achievement so far with universal health coverage [33, 52]. While Nigeria’s NHIS coverage stands at less than 5%, Ghana’s rose exponentially from 6.5% in 2005 to 36% in 2010, then 40% at the close of 2015, and about 64% in 2018 [5, 6, 31]. In 2012, the previous National Insurance Act 2003 that established Ghana’s NHIS was amended to accommodate some efficient changes, including merging all previously existing schemes into a unifying scheme under NHIS [5]. This ‘umbrella’ mechanism contrasts with the mostly fragmented NHIS in Nigeria, as discussed earlier.
Country | Demographic indicators | Hearth | Health expenditure indicators | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Population (millions) | GDP (p.cap) | LE (Male) | LE (Female) | IMR | U-5 year MR | p-HIV (% pop) | i-TB (cases) | THE | THE (% GDP) | Public HE (%THE) | OOP HE (% private) | |
123.7 | 371 | 48 | 47 | 116 | 186 | 3.9 | 172 | 17 | 4.7 | 33 | 93 | |
Ghana 2000 | 192 | 260 | 58 | 59 | 64 | 99 | 2.3 | 152 | 19 | 7.2 | 41 | 80 |
129.8 | 455 | 47 | 48 | 107 | 177 | 3.8 | 182 | 18 | 4.0 | 26 | 90 | |
Ghana 2002 | 20.1 | 306 | 58 | 60 | 61 | 94 | 2.2 | 138 | 20 | 6.5 | 36 | 80 |
136.4 | 644 | 48 | 49 | 102 | 168 | 3.7 | 180 | 44 | 7.0 | 32 | 95 | |
Ghana 2004 | 21.1 | 420 | 60 | 61 | 58 | 88 | 2.1 | 125 | 26 | 6.3 | 35 | 80 |
143.3 | 1,014 | 49 | 50 | 97 | 159 | 3.6 | 168 | 59 | 5.7 | 34 | 96 | |
Ghana 2006 | 21.1 | 920 | 61 | 63 | 55 | 83 | 1.9 | 112 | 48 | 44 | 57 | 65 |
150.7 | 1,374 | 50 | 51 | 93 | 151 | 3.6 | 145 | 80 | 5.7 | 41 | 95 | |
Ghana 2008 | 233 | 1,226 | 62 | 64 | 53 | 79 | 1.8 | 99 | 68 | 5.6 | 58 | 67 |
158.4 | 1,278 | 51 | 52 | 88 | 143 | 3.6 | 133 | 63 | 5.1 | 38 | 95 | |
Ghana 2010 | 24.4 | 1,325 | 63 | 65 | 50 | 74 | 1.8 | 86 | 67 | 60 | 66 | |
Key demographic, health and economic indicators - Nigeria, Ghana and OECD mean 2000–2010.
One approach that helped Ghana to scale up coverage within a short time is the level of awareness and advocacy in the mass and electronic media [5]. Oni et al. has shown that the level of awareness of and access to NHIS has significant impact on service delivery [6]. The compulsory enrollment into NHIS by all residents of Ghana is another important reason why the scheme has been able to cover the country widely. This is in sharp contrast to Nigeria, where it is statutorily voluntary. Although Ghana’s implementation of NHIS is faced with the problem of poverty like Nigeria, it has exempted the poor and other vulnerable groups from paying an insurance premium. This exemption resulted in increasing access and equity in healthcare. Although Nigeria NHIS made provision for the vulnerable group to include the physically and mentally challenged, prisoners, pregnant women, under-five children, and the aged, the reality in Nigeria is that no such exception is provided [5, 31, 52].
Moreover, enrollees of Nigeria NHIS still pay some hidden charges, co-payments and deductibles at the point of care, in contrast to Ghana, where no additional payment is required from their counterparts. Besides, there is a variable benefits package offered by Nigeria NHIS depending on the membership category. This is not the case in Ghana, where all benefit packages are uniform across the board using the diagnosis-related group (DRG). The most important factor contributing to the achievement recorded by Ghana is the fact that there has been an increase in total health expenditure as a percentage of total government expenditure to meet the 15% Abuja target. Moreover, Ghana finances 70% of its NHIS from taxation, used mainly for those exempted from paying the premium. The situation in Nigeria is the opposite [4, 5, 31, 52]. All these benefits offered by Ghana NHIS have contributed to expanding equity in access and provision of healthcare. Recently, Ghana is proposing a one-time payment for healthcare services known as the “One-time Premium Payment Policy” to mainly serve those in the informal sector [14, 15]. This step has the potential of boosting NHIS coverage and in turn, reducing OOP.
Thailand is a middle-income country in South-East Asia, with a population of 69 million and a GDP per capita of $7,792. About 56% of its population is in rural area [51]. Thailand’s health financing is worthy of consideration because of its long history of challenges similar to Nigeria, and its eventual rapid success which has become a global reference [53, 54]. The quest of Thailand toward achieving UHC began as early as 1975. After several trials with several health insurance mechanisms, Thailand achieved UHC in 2002 after commencing its Universal Coverage Scheme (UCS) the previous year [55]. By 2015, Thailand had been able to provide health coverage for 98% of its population [54]. Before 2001, the formation of different health insurance types to cater for various risk pool resulted in the fragmentation and failure of those schemes. When UCS was introduced, against all the odds, other fragments were collapsed into UCS except the Civil Servant Benefit Scheme (CMBS) and the Social Security Scheme (SSS). CMBS is a tax-funded health insurance that provides coverage for the formal sector, while SSS is a form of SHI for the private sector, covering about 12.3 million people.
Three essential factors contributed to the success of UCS within just a year. First, it is funded exclusively through government tax except at the beginning of the scheme when patients were required to pay 30 Baht ($0.75) co-payment. Excise tax on alcohol and tobacco were earmarked to fund the scheme [43, 56]. Evidence has proven that tax-funded (especially direct-tax) health insurance is less regressive compared to SHI [45, 57]. Second, contrary to what operates in Nigeria, UCS uses a comprehensive medical package with only very few diseases not covered. This saw improvement in access and equity. Third, there is a purchase-provider split in the payment for health services. Capitations are paid for outpatient service, while DRG is used to pay for inpatient care [57]. Since UCS was introduced, there has been an improvement in health outcomes of the population reflected in Thailand’s positive health indices. Moreover, the number of households suffering from catastrophic health spending became insignificant [47, 53]. Thailand’s success story will not be complete without pointing out that the resilient political determination, community engagement, evidence-based research, and regular monitoring and evaluation employed by the Thai government were instrumental to achieving the feat [58].
This study has shown that about 70% of Nigerians pay for healthcare through OOP, hindering their access to quality healthcare. While the trend continues, many households in the country have been impoverished through catastrophic health expenditure. This has culminated in the poor health-seeking and consequent poor health indices. Therefore,
However, the country has the potential to reverse the trend by learning from other countries all over the globe which have achieved UHC by adopting either a tax-based insurance scheme or an SHI scheme. Consequent to this, it is recommended the scheme is overhauled and repositioned to promote equity and access to healthcare. This can be done using an excise tax or “sin tax”. The revenue generated could be used to finance the health of the entire country in combination with the existing NHIS. Moreover, this study recommends that the law that established the NHIS should be amended to make insurance mandatory to increase participation. However, adequate awareness should be created for the same reason. The currently fragmented NHIS should be amalgamated for efficiency, risk sharing and fund pooling. The benefits package should also be reviewed to be more comprehensive to attract and encourage enrollees. Enrolment could also be boosted by providing free healthcare to the poor and the vulnerable group, thereby removing inequality and inaccessibility. Finally, in line with the 15% Abuja declaration, there is a need for the government to demonstrate political commitment toward UHC by increasing budgetary allocation to health.
I would like to take this opportunity to express my immense gratitude to the many wonderful people who have given their invaluable support and assistance during the preparation of this work.
First and foremost, I am profoundly indebted to my supervisor and mentor, A/Prof Khurshid Alam who has provided unalloyed support and guide for me during my study at Murdoch University. His enthusiasm and encouragement are instrumental to the success of this work.
I am deeply grateful to Ms. Sandra Crewes for painstakingly reviewing and editing this work, even at a very short notice.
I owe a special debt of gratitude to my darling wife, Abimbola Odunyemi and my daughters, Adebola Odunyemi and Adebusola Odunyemi for being always there for me through thick and thin.
I would like to thank the Australian Government, the Department of Foreign Affair and Trade that provided me the scholarship that allowed me to obtain this lifetime opportunity to acquire first-class learning experience in Australia.
Finally, my profound gratitude goes to God Almighty who is the ultimate source of wisdom and knowledge.
The author declares no conflict of interest.
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His studies in robotics lead him not only to a PhD degree but also inspired him to co-found and build the International Journal of Advanced Robotic Systems - world's first Open Access journal in the field of robotics.",institutionString:null,institution:{name:"TU Wien",country:{name:"Austria"}}},{id:"441",title:"Ph.D.",name:"Jaekyu",middleName:null,surname:"Park",slug:"jaekyu-park",fullName:"Jaekyu Park",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/441/images/1881_n.jpg",biography:null,institutionString:null,institution:{name:"LG Corporation (South Korea)",country:{name:"Korea, South"}}},{id:"465",title:"Dr",name:"Christian",middleName:null,surname:"Martens",slug:"christian-martens",fullName:"Christian Martens",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"479",title:"Dr.",name:"Valentina",middleName:null,surname:"Colla",slug:"valentina-colla",fullName:"Valentina Colla",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/479/images/358_n.jpg",biography:null,institutionString:null,institution:{name:"Sant'Anna School of Advanced Studies",country:{name:"Italy"}}},{id:"494",title:"PhD",name:"Loris",middleName:null,surname:"Nanni",slug:"loris-nanni",fullName:"Loris Nanni",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/494/images/system/494.jpg",biography:"Loris Nanni received his Master Degree cum laude on June-2002 from the University of Bologna, and the April 26th 2006 he received his Ph.D. in Computer Engineering at DEIS, University of Bologna. On September, 29th 2006 he has won a post PhD fellowship from the university of Bologna (from October 2006 to October 2008), at the competitive examination he was ranked first in the industrial engineering area. He extensively served as referee for several international journals. He is author/coauthor of more than 100 research papers. He has been involved in some projects supported by MURST and European Community. 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From 1985 to 1986, he was a Research Fellow in the Research Institute for Electronic Equipment, ZZU AD, Plovdiv, Bulgaria. In 1986, he joined the Department of Control Systems, Technical University of Sofia at the Plovdiv campus, where he is presently a Full Professor. He has held long-term visiting Professor/Scholar positions at various institutions in South Korea, Turkey, Mexico, Greece, Belgium, UK, and Germany. And he has coauthored one book and authored or coauthored more than 80 research papers in conference proceedings and journals. 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Aalborg University has Two Satellite Campuses, one in Copenhagen (Aalborg University Copenhagen) and the other in Esbjerg (Aalborg University Esbjerg).\n· He is a member of prestigious IEEE (Institute of Electrical and Electronics Engineers), and IAENG (International Association of Engineers) organizations. \n· He is the chief Editor of the Journal of Software Engineering.\n· He is the member of the Editorial Board of International Journal of Computer Science and Software Technology (IJCSST) and International Journal of Computer Engineering and Information Technology. \n· He is also the Editor of Communication in Computer and Information Science CCIS-20 by Springer.\n· Reviewer For Many Conferences\nHe is the lead person in making collaboration agreements between Aalborg University and many universities of Pakistan, for which the MOU’s (Memorandum of Understanding) have been signed.\nProfessor Akbar is working in Academia since 1990, he started his career as a Lab demonstrator/TA at the University of Sussex. After finishing his P. hD degree in 1992, he served in the Industry as a Scientific Officer and continued his academic career as a visiting scholar for a number of educational institutions. In 1996 he joined National University of Science & Technology Pakistan (NUST) as an Associate Professor; NUST is one of the top few universities in Pakistan. In 1999 he joined an International Company Lineo Inc, Canada as Manager Compiler Group, where he headed the group for developing Compiler Tool Chain and Porting of Operating Systems for the BLACKfin processor. The processor development was a joint venture by Intel and Analog Devices. In 2002 Lineo Inc., was taken over by another company, so he joined Aalborg University Denmark as an Assistant Professor.\nProfessor Akbar has truly a multi-disciplined career and he continued his legacy and making progress in many areas of his interests both in teaching and research. 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Her research interests include archaea metabolism, enzymes purification and characterization, gene regulation, carotenoids and bioplastics production, antioxidant\ncompounds, waste water treatments, and brines bioremediation.\nRosa María’s other roles include editorial board member for several journals related\nto biochemistry, reviewer for more than 60 journals (biochemistry, molecular biology, biotechnology, chemistry and microbiology) and president of several organizing committees in international meetings related to the N-cycle or respiratory processes.",institutionString:null,institution:{name:"University of Alicante",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null},{id:"15",title:"Chemical Biology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/15.jpg",isOpenForSubmission:!0,editor:{id:"441442",title:"Dr.",name:"Şükrü",middleName:null,surname:"Beydemir",slug:"sukru-beydemir",fullName:"Şükrü Beydemir",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003GsUoIQAV/Profile_Picture_1634557147521",biography:"Dr. Şükrü Beydemir obtained a BSc in Chemistry in 1995 from Yüzüncü Yıl University, MSc in Biochemistry in 1998, and PhD in Biochemistry in 2002 from Atatürk University, Turkey. He performed post-doctoral studies at Max-Planck Institute, Germany, and University of Florence, Italy in addition to making several scientific visits abroad. He currently works as a Full Professor of Biochemistry in the Faculty of Pharmacy, Anadolu University, Turkey. Dr. Beydemir has published over a hundred scientific papers spanning protein biochemistry, enzymology and medicinal chemistry, reviews, book chapters and presented several conferences to scientists worldwide. He has received numerous publication awards from various international scientific councils. He serves in the Editorial Board of several international journals. 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He is a member of the Turkish Biochemical Society, American Chemical Society, and German Genetics society. Dr. Ekinci published around ninety scientific papers, reviews and book chapters, and presented several conferences to scientists. He has received numerous publication awards from several scientific councils. 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He worked on the structure-function relationships of glycoconjugates and his main project was the investigations on the biological roles of the de-N-glycosylation enzymes (Endo-N-acetyl-β-D-glucosaminidase and peptide-N4-(N-acetyl-β-glucosaminyl) asparagine amidase). From 2002 he contributes to the understanding of the Blood-brain barrier functioning using proteomics approaches. He has published more than 70 papers. 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Since then, he has been working as an Adjunct Professor in the same Department at the University of Pavia. His research activity during the first years was primarily focused on the purification and structural characterization of enzymes from animal and plant sources. During this period, Prof. Iadarola familiarized himself with the conventional techniques used in column chromatography, spectrophotometry, manual Edman degradation, and electrophoresis). Since 1995, he has been working on: i) the determination in biological fluids (serum, urine, bronchoalveolar lavage, sputum) of proteolytic activities involved in the degradation processes of connective tissue matrix, and ii) on the identification of biological markers of lung diseases. 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She gained considerable experience in developing and validating new methodologies whose applications allowed her to determine both the amount of biomarkers (Desmosine and Isodesmosine) in the urine of patients affected by COPD, and the activity of proteolytic enzymes (HNE, Cathepsin G, Pseudomonas aeruginosa elastase) in the sputa of these patients. Simona Viglio was also involved in research dealing with the supplementation of amino acids in patients with brain injury and chronic heart failure. She is presently engaged in the development of 2-DE and LC-MS techniques for the study of proteomics in biological fluids. The aim of this research is the identification of potential biomarkers of lung diseases. 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Buchholz and Erik J. Behringer",hash:"e373a3d1123dbd45fddf75d90e3e7c38",volumeInSeries:1,fullTitle:"Calcium and Signal Transduction",editors:[{id:"89438",title:"Dr.",name:"John N.",middleName:null,surname:"Buchholz",slug:"john-n.-buchholz",fullName:"John N. Buchholz",profilePictureURL:"https://mts.intechopen.com/storage/users/89438/images/6463_n.jpg",institutionString:null,institution:{name:"Loma Linda University",institutionURL:null,country:{name:"United States of America"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null}]},subseriesFiltersForPublishedBooks:[{group:"subseries",caption:"Plant Physiology",value:13,count:1},{group:"subseries",caption:"Human Physiology",value:12,count:2},{group:"subseries",caption:"Cell Physiology",value:11,count:8}],publicationYearFilters:[{group:"publicationYear",caption:"2022",value:2022,count:1},{group:"publicationYear",caption:"2020",value:2020,count:4},{group:"publicationYear",caption:"2019",value:2019,count:5},{group:"publicationYear",caption:"2018",value:2018,count:1}],authors:{paginationCount:302,paginationItems:[{id:"198499",title:"Dr.",name:"Daniel",middleName:null,surname:"Glossman-Mitnik",slug:"daniel-glossman-mitnik",fullName:"Daniel Glossman-Mitnik",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/198499/images/system/198499.jpeg",biography:"Dr. Daniel Glossman-Mitnik is currently a Titular Researcher at the Centro de Investigación en Materiales Avanzados (CIMAV), Chihuahua, Mexico, as well as a National Researcher of Level III at the Consejo Nacional de Ciencia y Tecnología, Mexico. His research interest focuses on computational chemistry and molecular modeling of diverse systems of pharmacological, food, and alternative energy interests by resorting to DFT and Conceptual DFT. He has authored a coauthored more than 255 peer-reviewed papers, 32 book chapters, and 2 edited books. He has delivered speeches at many international and domestic conferences. He serves as a reviewer for more than eighty international journals, books, and research proposals as well as an editor for special issues of renowned scientific journals.",institutionString:"Centro de Investigación en Materiales Avanzados",institution:{name:"Centro de Investigación en Materiales Avanzados",country:{name:"Mexico"}}},{id:"76477",title:"Prof.",name:"Mirza",middleName:null,surname:"Hasanuzzaman",slug:"mirza-hasanuzzaman",fullName:"Mirza Hasanuzzaman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/76477/images/system/76477.png",biography:"Dr. Mirza Hasanuzzaman is a Professor of Agronomy at Sher-e-Bangla Agricultural University, Bangladesh. He received his Ph.D. in Plant Stress Physiology and Antioxidant Metabolism from Ehime University, Japan, with a scholarship from the Japanese Government (MEXT). Later, he completed his postdoctoral research at the Center of Molecular Biosciences, University of the Ryukyus, Japan, as a recipient of the Japan Society for the Promotion of Science (JSPS) postdoctoral fellowship. He was also the recipient of the Australian Government Endeavour Research Fellowship for postdoctoral research as an adjunct senior researcher at the University of Tasmania, Australia. Dr. Hasanuzzaman’s current work is focused on the physiological and molecular mechanisms of environmental stress tolerance. Dr. Hasanuzzaman has published more than 150 articles in peer-reviewed journals. He has edited ten books and written more than forty book chapters on important aspects of plant physiology, plant stress tolerance, and crop production. According to Scopus, Dr. Hasanuzzaman’s publications have received more than 10,500 citations with an h-index of 53. He has been named a Highly Cited Researcher by Clarivate. He is an editor and reviewer for more than fifty peer-reviewed international journals and was a recipient of the “Publons Peer Review Award” in 2017, 2018, and 2019. He has been honored by different authorities for his outstanding performance in various fields like research and education, and he has received the World Academy of Science Young Scientist Award (2014) and the University Grants Commission (UGC) Award 2018. He is a fellow of the Bangladesh Academy of Sciences (BAS) and the Royal Society of Biology.",institutionString:"Sher-e-Bangla Agricultural University",institution:{name:"Sher-e-Bangla Agricultural University",country:{name:"Bangladesh"}}},{id:"187859",title:"Prof.",name:"Kusal",middleName:"K.",surname:"Das",slug:"kusal-das",fullName:"Kusal Das",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSBDeQAO/Profile_Picture_1623411145568",biography:"Kusal K. Das is a Distinguished Chair Professor of Physiology, Shri B. M. Patil Medical College and Director, Centre for Advanced Medical Research (CAMR), BLDE (Deemed to be University), Vijayapur, Karnataka, India. Dr. Das did his M.S. and Ph.D. in Human Physiology from the University of Calcutta, Kolkata. His area of research is focused on understanding of molecular mechanisms of heavy metal activated low oxygen sensing pathways in vascular pathophysiology. He has invented a new method of estimation of serum vitamin E. His expertise in critical experimental protocols on vascular functions in experimental animals was well documented by his quality of publications. He was a Visiting Professor of Medicine at University of Leeds, United Kingdom (2014-2016) and Tulane University, New Orleans, USA (2017). For his immense contribution in medical research Ministry of Science and Technology, Government of India conferred him 'G.P. Chatterjee Memorial Research Prize-2019” and he is also the recipient of 'Dr.Raja Ramanna State Scientist Award 2015” by Government of Karnataka. He is a Fellow of the Royal Society of Biology (FRSB), London and Honorary Fellow of Karnataka Science and Technology Academy, Department of Science and Technology, Government of Karnataka.",institutionString:"BLDE (Deemed to be University), India",institution:null},{id:"243660",title:"Dr.",name:"Mallanagouda Shivanagouda",middleName:null,surname:"Biradar",slug:"mallanagouda-shivanagouda-biradar",fullName:"Mallanagouda Shivanagouda Biradar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/243660/images/system/243660.jpeg",biography:"M. S. Biradar is Vice Chancellor and Professor of Medicine of\nBLDE (Deemed to be University), Vijayapura, Karnataka, India.\nHe obtained his MD with a gold medal in General Medicine and\nhas devoted himself to medical teaching, research, and administrations. He has also immensely contributed to medical research\non vascular medicine, which is reflected by his numerous publications including books and book chapters. Professor Biradar was\nalso Visiting Professor at Tulane University School of Medicine, New Orleans, USA.",institutionString:"BLDE (Deemed to be University)",institution:{name:"BLDE University",country:{name:"India"}}},{id:"289796",title:"Dr.",name:"Swastika",middleName:null,surname:"Das",slug:"swastika-das",fullName:"Swastika Das",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/289796/images/system/289796.jpeg",biography:"Swastika N. Das is Professor of Chemistry at the V. P. Dr. P. G.\nHalakatti College of Engineering and Technology, BLDE (Deemed\nto be University), Vijayapura, Karnataka, India. She obtained an\nMSc, MPhil, and PhD in Chemistry from Sambalpur University,\nOdisha, India. Her areas of research interest are medicinal chemistry, chemical kinetics, and free radical chemistry. She is a member\nof the investigators who invented a new modified method of estimation of serum vitamin E. She has authored numerous publications including book\nchapters and is a mentor of doctoral curriculum at her university.",institutionString:"BLDEA’s V.P.Dr.P.G.Halakatti College of Engineering & Technology",institution:{name:"BLDE University",country:{name:"India"}}},{id:"248459",title:"Dr.",name:"Akikazu",middleName:null,surname:"Takada",slug:"akikazu-takada",fullName:"Akikazu Takada",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/248459/images/system/248459.png",biography:"Akikazu Takada was born in Japan, 1935. After graduation from\nKeio University School of Medicine and finishing his post-graduate studies, he worked at Roswell Park Memorial Institute NY,\nUSA. He then took a professorship at Hamamatsu University\nSchool of Medicine. In thrombosis studies, he found the SK\npotentiator that enhances plasminogen activation by streptokinase. He is very much interested in simultaneous measurements\nof fatty acids, amino acids, and tryptophan degradation products. By using fatty\nacid analyses, he indicated that plasma levels of trans-fatty acids of old men were\nfar higher in the US than Japanese men. . He also showed that eicosapentaenoic acid\n(EPA) and docosahexaenoic acid (DHA) levels are higher, and arachidonic acid\nlevels are lower in Japanese than US people. By using simultaneous LC/MS analyses\nof plasma levels of tryptophan metabolites, he recently found that plasma levels of\nserotonin, kynurenine, or 5-HIAA were higher in patients of mono- and bipolar\ndepression, which are significantly different from observations reported before. In\nview of recent reports that plasma tryptophan metabolites are mainly produced by\nmicrobiota. He is now working on the relationships between microbiota and depression or autism.",institutionString:"Hamamatsu University School of Medicine",institution:{name:"Hamamatsu University School of Medicine",country:{name:"Japan"}}},{id:"137240",title:"Prof.",name:"Mohammed",middleName:null,surname:"Khalid",slug:"mohammed-khalid",fullName:"Mohammed Khalid",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/137240/images/system/137240.png",biography:"Mohammed Khalid received his B.S. degree in chemistry in 2000 and Ph.D. degree in physical chemistry in 2007 from the University of Khartoum, Sudan. He moved to School of Chemistry, Faculty of Science, University of Sydney, Australia in 2009 and joined Dr. Ron Clarke as a postdoctoral fellow where he worked on the interaction of ATP with the phosphoenzyme of the Na+/K+-ATPase and dual mechanisms of allosteric acceleration of the Na+/K+-ATPase by ATP; then he went back to Department of Chemistry, University of Khartoum as an assistant professor, and in 2014 he was promoted as an associate professor. In 2011, he joined the staff of Department of Chemistry at Taif University, Saudi Arabia, where he is currently an assistant professor. His research interests include the following: P-Type ATPase enzyme kinetics and mechanisms, kinetics and mechanisms of redox reactions, autocatalytic reactions, computational enzyme kinetics, allosteric acceleration of P-type ATPases by ATP, exploring of allosteric sites of ATPases, and interaction of ATP with ATPases located in cell membranes.",institutionString:"Taif University",institution:{name:"Taif University",country:{name:"Saudi Arabia"}}},{id:"63810",title:"Prof.",name:"Jorge",middleName:null,surname:"Morales-Montor",slug:"jorge-morales-montor",fullName:"Jorge Morales-Montor",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/63810/images/system/63810.png",biography:"Dr. Jorge Morales-Montor was recognized with the Lola and Igo Flisser PUIS Award for best graduate thesis at the national level in the field of parasitology. He received a fellowship from the Fogarty Foundation to perform postdoctoral research stay at the University of Georgia. He has 153 journal articles to his credit. He has also edited several books and published more than fifty-five book chapters. He is a member of the Mexican Academy of Sciences, Latin American Academy of Sciences, and the National Academy of Medicine. He has received more than thirty-five awards and has supervised numerous bachelor’s, master’s, and Ph.D. students. Dr. Morales-Montor is the past president of the Mexican Society of Parasitology.",institutionString:"National Autonomous University of Mexico",institution:{name:"National Autonomous University of Mexico",country:{name:"Mexico"}}},{id:"217215",title:"Dr.",name:"Palash",middleName:null,surname:"Mandal",slug:"palash-mandal",fullName:"Palash Mandal",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/217215/images/system/217215.jpeg",biography:null,institutionString:"Charusat University",institution:null},{id:"49739",title:"Dr.",name:"Leszek",middleName:null,surname:"Szablewski",slug:"leszek-szablewski",fullName:"Leszek Szablewski",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49739/images/system/49739.jpg",biography:"Leszek Szablewski is a professor of medical sciences. He received his M.S. in the Faculty of Biology from the University of Warsaw and his PhD degree from the Institute of Experimental Biology Polish Academy of Sciences. He habilitated in the Medical University of Warsaw, and he obtained his degree of Professor from the President of Poland. Professor Szablewski is the Head of Chair and Department of General Biology and Parasitology, Medical University of Warsaw. Professor Szablewski has published over 80 peer-reviewed papers in journals such as Journal of Alzheimer’s Disease, Biochim. Biophys. Acta Reviews of Cancer, Biol. Chem., J. Biomed. Sci., and Diabetes/Metabol. Res. Rev, Endocrine. He is the author of two books and four book chapters. He has edited four books, written 15 scripts for students, is the ad hoc reviewer of over 30 peer-reviewed journals, and editorial member of peer-reviewed journals. Prof. Szablewski’s research focuses on cell physiology, genetics, and pathophysiology. He works on the damage caused by lack of glucose homeostasis and changes in the expression and/or function of glucose transporters due to various diseases. He has given lectures, seminars, and exercises for students at the Medical University.",institutionString:"Medical University of Warsaw",institution:{name:"Medical University of Warsaw",country:{name:"Poland"}}},{id:"173123",title:"Dr.",name:"Maitham",middleName:null,surname:"Khajah",slug:"maitham-khajah",fullName:"Maitham Khajah",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/173123/images/system/173123.jpeg",biography:"Dr. Maitham A. Khajah received his degree in Pharmacy from Faculty of Pharmacy, Kuwait University, in 2003 and obtained his PhD degree in December 2009 from the University of Calgary, Canada (Gastrointestinal Science and Immunology). Since January 2010 he has been assistant professor in Kuwait University, Faculty of Pharmacy, Department of Pharmacology and Therapeutics. His research interest are molecular targets for the treatment of inflammatory bowel disease (IBD) and the mechanisms responsible for immune cell chemotaxis. He cosupervised many students for the MSc Molecular Biology Program, College of Graduate Studies, Kuwait University. Ever since joining Kuwait University in 2010, he got various grants as PI and Co-I. He was awarded the Best Young Researcher Award by Kuwait University, Research Sector, for the Year 2013–2014. He was a member in the organizing committee for three conferences organized by Kuwait University, Faculty of Pharmacy, as cochair and a member in the scientific committee (the 3rd, 4th, and 5th Kuwait International Pharmacy Conference).",institutionString:"Kuwait University",institution:{name:"Kuwait University",country:{name:"Kuwait"}}},{id:"195136",title:"Dr.",name:"Aya",middleName:null,surname:"Adel",slug:"aya-adel",fullName:"Aya Adel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/195136/images/system/195136.jpg",biography:"Dr. Adel works as an Assistant Lecturer in the unit of Phoniatrics, Department of Otolaryngology, Ain Shams University in Cairo, Egypt. Dr. Adel is especially interested in joint attention and its impairment in autism spectrum disorder",institutionString:"Ain Shams University",institution:{name:"Ain Shams University",country:{name:"Egypt"}}},{id:"94911",title:"Dr.",name:"Boulenouar",middleName:null,surname:"Mesraoua",slug:"boulenouar-mesraoua",fullName:"Boulenouar Mesraoua",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/94911/images/system/94911.png",biography:"Dr Boulenouar Mesraoua is the Associate Professor of Clinical Neurology at Weill Cornell Medical College-Qatar and a Consultant Neurologist at Hamad Medical Corporation at the Neuroscience Department; He graduated as a Medical Doctor from the University of Oran, Algeria; he then moved to Belgium, the City of Liege, for a Residency in Internal Medicine and Neurology at Liege University; after getting the Belgian Board of Neurology (with high marks), he went to the National Hospital for Nervous Diseases, Queen Square, London, United Kingdom for a fellowship in Clinical Neurophysiology, under Pr Willison ; Dr Mesraoua had also further training in Epilepsy and Continuous EEG Monitoring for two years (from 2001-2003) in the Neurophysiology department of Zurich University, Switzerland, under late Pr Hans Gregor Wieser ,an internationally known epileptologist expert. \n\nDr B. Mesraoua is the Director of the Neurology Fellowship Program at the Neurology Section and an active member of the newly created Comprehensive Epilepsy Program at Hamad General Hospital, Doha, Qatar; he is also Assistant Director of the Residency Program at the Qatar Medical School. \nDr B. Mesraoua's main interests are Epilepsy, Multiple Sclerosis, and Clinical Neurology; He is the Chairman and the Organizer of the well known Qatar Epilepsy Symposium, he is running yearly for the past 14 years and which is considered a landmark in the Gulf region; He has also started last year , together with other epileptologists from Qatar, the region and elsewhere, a yearly International Epilepsy School Course, which was attended by many neurologists from the Area.\n\nInternationally, Dr Mesraoua is an active and elected member of the Commission on Eastern Mediterranean Region (EMR ) , a regional branch of the International League Against Epilepsy (ILAE), where he represents the Middle East and North Africa(MENA ) and where he holds the position of chief of the Epilepsy Epidemiology Section; Dr Mesraoua is a member of the American Academy of Neurology, the Europeen Academy of Neurology and the American Epilepsy Society.\n\nDr Mesraoua's main objectives are to encourage frequent gathering of the epileptologists/neurologists from the MENA region and the rest of the world, promote Epilepsy Teaching in the MENA Region, and encourage multicenter studies involving neurologists and epileptologists in the MENA region, particularly epilepsy epidemiological studies. \n\nDr. Mesraoua is the recipient of two research Grants, as the Lead Principal Investigator (750.000 USD and 250.000 USD) from the Qatar National Research Fund (QNRF) and the Hamad Hospital Internal Research Grant (IRGC), on the following topics : “Continuous EEG Monitoring in the ICU “ and on “Alpha-lactoalbumin , proof of concept in the treatment of epilepsy” .Dr Mesraoua is a reviewer for the journal \"seizures\" (Europeen Epilepsy Journal ) as well as dove journals ; Dr Mesraoua is the author and co-author of many peer reviewed publications and four book chapters in the field of Epilepsy and Clinical Neurology",institutionString:"Weill Cornell Medical College in Qatar",institution:{name:"Weill Cornell Medical College in Qatar",country:{name:"Qatar"}}},{id:"282429",title:"Prof.",name:"Covanis",middleName:null,surname:"Athanasios",slug:"covanis-athanasios",fullName:"Covanis Athanasios",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/282429/images/system/282429.jpg",biography:null,institutionString:"Neurology-Neurophysiology Department of the Children Hospital Agia Sophia",institution:null},{id:"190980",title:"Prof.",name:"Marwa",middleName:null,surname:"Mahmoud Saleh",slug:"marwa-mahmoud-saleh",fullName:"Marwa Mahmoud Saleh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/190980/images/system/190980.jpg",biography:"Professor Marwa Mahmoud Saleh is a doctor of medicine and currently works in the unit of Phoniatrics, Department of Otolaryngology, Ain Shams University in Cairo, Egypt. She got her doctoral degree in 1991 and her doctoral thesis was accomplished in the University of Iowa, United States. Her publications covered a multitude of topics as videokymography, cochlear implants, stuttering, and dysphagia. She has lectured Egyptian phonology for many years. Her recent research interest is joint attention in autism.",institutionString:"Ain Shams University",institution:{name:"Ain Shams University",country:{name:"Egypt"}}},{id:"259190",title:"Dr.",name:"Syed Ali Raza",middleName:null,surname:"Naqvi",slug:"syed-ali-raza-naqvi",fullName:"Syed Ali Raza Naqvi",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259190/images/system/259190.png",biography:"Dr. Naqvi is a radioanalytical chemist and is working as an associate professor of analytical chemistry in the Department of Chemistry, Government College University, Faisalabad, Pakistan. Advance separation techniques, nuclear analytical techniques and radiopharmaceutical analysis are the main courses that he is teaching to graduate and post-graduate students. In the research area, he is focusing on the development of organic- and biomolecule-based radiopharmaceuticals for diagnosis and therapy of infectious and cancerous diseases. Under the supervision of Dr. Naqvi, three students have completed their Ph.D. degrees and 41 students have completed their MS degrees. He has completed three research projects and is currently working on 2 projects entitled “Radiolabeling of fluoroquinolone derivatives for the diagnosis of deep-seated bacterial infections” and “Radiolabeled minigastrin peptides for diagnosis and therapy of NETs”. He has published about 100 research articles in international reputed journals and 7 book chapters. 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