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Zach of them lead,, to a drastic reduction of faults, andraises the quality of the manu'actured products.
This kind of defect de-tection is particularly impoTLant for the manufacture of steam turbines,aviation and reactive motors, where even an insignificant crack or defecton the surface can cause a serious break-down when shops, special luminesc:ence defect detectors do the job.in operation. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
In work-Otherl'pes of Luminnescence Analysis of DetectionThe luminescence analysis has found various apnlications in try.
The luminescence analysis of detection is being widely used in manufacturing of optical-mechanical apparatus where it various types of processed glass.is for markingthe indum-theThe radiance of glass is being excited by short-Wave ultra-violet rays(-300 - 250 mup) generated by electric spark. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
The objective of observa-tion is phosphorescence (.r -o10-of the investigated specimens is ards.
the momentary radiance of the glass (r-' lO- 5 sec.
), as well as iis2 sec.)
separated by a phosphoroscope. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
The radiarceTn this way, one can fast distinguish over 40 types of the optlcal glass.then compared with that of a set ol zanid-With certain modifications, the above method can be applied to analysison the compesition of emery where the conter.ts of corundum is being det'tr-mined by counting under a microrcope its bright ]uzinescing grains easilydiscernible from those of the other components.The luminescence analysi's of detection i. being "sed also in thesubsequent 'rul).-:izAticn. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
The production of rubber obhects consists of prepara&L(cid:127)or.rubber industry.
cf u rubber mixture, and its rubber mixt-Ir'consists of caoutchouc Lad different chemicnre whIch imnart to the rubberproduct the porosity, elasticity, resistance, etc.
During theo vulcanization, we r.Elter mixtur- .a LeC7heated together with the vulcanising substancos (for instance. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
the 'iI, One can add to the mixture also the vulcartation accelerants, and olwsome substance which will protect the rubber from an early deterioration.All the components should enter the mixture in a rigidly maintained propor-tion if pected.the required propertles of the finished product are to be as ex-flexibilitv, wuter-reaistance, 4cid-'TIh. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
-.-95- 0 Most of the rubber components can produ:e luminescence, and thi'feature is being used for control of the entire process and its individualetages, and also the check-up on the finished products. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
For exampla, bythe rubber mixtures can be sorts 1,the color of their respective radiance, the existence or lack of a saufficient amount of the vulcanization accolpr-ants determined, a natural or artificial deterioration of rubbor-cortrolel:,etc.In the textile industry, the.luminescence analysis is being used forcontrolling the quality of colored designs printed on fabrics. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
Brightlyluminescert dyes (fluorescein and betanaphthol) are being introduced intothe coloring mixtures, and the fabrics are being looked over in Wlra-violet ously control the quality of the obtained design.
and considerably reducethe number of rejects.
By usinr detect greasy spots on fabrics, etc.rays directly while being printed. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
In this way, o*.L, can continu-the luminescence, one can control the dyes,The luminescence analysis of detection is also used in the rulp andthe technical cellulose, allows distingulshiun paper industry.
The intensity and color of the radiance indicaton '-he '-the blca-hc4tent of decay in pulp from the unbleached one, young timber from the old one, etc. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
Moreo/er,one can determine the moisture - and oil-resistance of the paper by watc-Ing under an ultra-violet'light how it absorbs the luminescing, water-diluted solutions, mineral oils or fats colored with luminescent piguentq.from coopressors during the air-liquefying process; likewise, The luminescence analysis of detection is being used also in o:hirthe chemical industry it controlsin branches of industry. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
For example, the quality of liquid oxygen and detects lubricating oils which got intothe lu_-it nescence analysis of detection controls the allowable contents of nil vro-u -• ducts in water in steam boilers.
a iactor (cid:127)icn affects their corrt r-ubbr,tion. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
By observing the rediance on the edges of the insulating hoer 'va -from the speed and penetration depth of the oil or crude oii, or.ne c(cid:127)n ate its very helpful in excited with X-rays, allows an easy separation of diamonds from other min-orals and rocks.The luminescence analysis of detection A3 al-othe diamond mining industry where a characteristic r3ýiiarceresistance to both.
i17. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
i17.
Tho Luminescence Analysis of Detection as Applied in Agriculture andFoodstuff IndustrThe Luminescence Analysis of Food Products.
Te luminescence analvyisof detec'on in being used for sortinp food produ:ts, seeds, vego'tabire,etc.By the color of their luminesce.nce o, th.. fooJ ducts start rotting long before it becomes ;'e-ible under L.i, crdIr-.
"Such preliminary sorting allows a Protractei stor-ge of rroduzts, a:.also useful in the manufacture of canned food.
are simple and easy. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
are simple and easy.
The product to be analyzed is simply illumina,1 w.-,The methods applii .-nn detect w.,_- ,--,-96- In southern parts of t' ..either ultra-violet or short-wave visible rays.
country, the sun rays are used for exciting the radiance. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
the products should be placed in this way, nne can detect the ,arly stage of ro.ting in cucumbers, beans,cabbage, potatoes, oranges, mandarins, and other vegetables and fruits.Moreover, healthy vegetables can be distinguished from those affected byfungus, sold, eurygaster or frost.
For instance, fresh mandarins produce adark orange luminescence; those affected by sold invisible to the human 'yewill luminesce in the affected spots with a blue light.the sun luminoscopes (see 105). | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
in that ca:-,":,Also the quality of other food products can be controlled by meane oftheir luminescence.
For example, color of its radiance.
radiance which will turn fr(cid:127)m detected in the flour by its yellow-orange luminescence.
violet rays, one can also control milk, eggs, egg powder, fish, etc.light blue into dark blue.
Ergot can be eas.ilyBy using the ultra-The *ore bran it contains, the sore intensive itsthe flour grade can be established by th.eDetermining the Germinating Power of Seeds. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
Using the luminescpnc"analysis, one can by elimination, establish toe seed germinating power ofvarious agricultural crops as well as species of tree.
turned out thatthe radiance color of seeds of oats, wheat, barley, corr, flax, fir, pine,to a great extent on their germinating power.
For acedar, etc., depends, better contrast, the cross-*sctions of the germs can be colored by variousfluorochromes.
soda solution of the rhodamine 6ZhDI dye. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
soda solution of the rhodamine 6ZhDI dye.
produce a bright yellow radiance, case, the seeds incapable of geroinating produce a dull-brown luminescence.the barley germ is being colored with a 1%The germinating seeds of barleythe germs of wheat-yellow.
For example, In eitherIt Another technique is based on the use of fluorochromes - indicatorsthe gerse of barley and wheat should be colored with a water-alcohol(C z 1.10-3 gram/milliliter). | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
After thewhich change their radiance when changing the magnitude of their pH; thischange occurs always in the germs of different germinating power.
For in-stance, solution of dimethylnaphthorhodine above treatment, under an ultra-violet light, the germinating seeds will pro-duce a bright, light-yellow radiance, pink-orange luminescence. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
Similar methods permit determining the giruira-tion of seeds of the corn, flax and oats.the non-germinating ones - a dull,Particularly important is the luminescence analysis in the controlc; the tubere of potato which, after they have been stored for certainS-iodm, are bing used for planting.
Here, one can determine variou!. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
Here, one can determine variou!.
ci:xi0esof tne potato, as well as detect the frozen tubers; the frost-bitte' mot-produce a whitish-blue radiince easily discernible on the barkgrow.d of 'nyellow or gray-brown luminescence of a healthy tuber.118.
Detection of the Ridden CurrentsInvestigating the Water Current.
An extremely high sensitivity --fthe luminescence methods facilitates the detection of a subterraneaz= linkbetween rivers and water reservoirs. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
For this purpose, sowe tens of litersof concentrated solution of any brightly luminescing dye (for instance, th-fluorescein) abotld be dropped into one of the water reservoirs; at certain-9/7- intervals; fro.
another reservoir, samples of water are being taken forthe samples wiijanalysis.
Providedi the two reservoirs are interconnected, The above method ýias been uriedreveal the presence of the luminescent dye. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
to prove a link -atween the two biggest European water systems: '%,hat of therivers Rhine and Danube.
The coloring of the water with luminescent dyes,ia also us~ed in t-& research on water currents in the existing models ofhydrotechnical installations.Inv~estlgtin& the Air Currents.
The luminescent substsances are beingused for investigating the characteristics of air currents existing alongthe wind tunnels. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
For exanple, when studying the distribution of pressuresin a wind tunnel, at preasures -~ 50-20t& of mercury column, observation isbein~g carried out on the after-radianco of pases (air, argon or helium) whichhaye be~n preliminaril~y excited with a high-frequency discharge.
gas travels.
from the disobarg into the wind tunnel, the distribution of itsdensity became. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
clearly discernible in the wipersonic shock waye.When theInvostiaetinit the ?ranfer of 5iitstances in Dioloalcal Objects and inIn the former case, solutions of harm-In the ultra-violet light, right through the skin, one canSimilar methods are being used ra the biological research and iaPlants.
Mhe stud.7 on physio~logy of plants.
less dyes (floores.,ein) A".
introduced into the blood stream of an animalor h~an being, and then one can watch how a substance is traveling - inthe orpmaism. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
see t~le spread of the fluorescein.
After the, fluc-roscein has been injectedintravenously, and after a certain time necessary for blood circulation,,individual orgams color.
Thus, ase can determine the blood zirc~atltion t~ze of healt~hy peopleand those with h..Art condition,, oulsj systuil, so radiance appsa~r culat'.ca.
Thb.s featlur* is being used in diagnauiitcs eovcerning rz.
upmotblood circla~tion. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
upmotblood circla~tion.
(.yalida,, lips, tonigma) eill, Waopt * greenish-yellowIn diseasis affe-ting the peripheric vam-in thea places wit-A' to weakened blood cir-ALialar technique* &re being applied for Lnvesttgeting th1o transferTht dye used for celoring should producoof saibetances in living VlAntm.
a lumseacence dractically different than that of the plant tissues.
Usua-ally, they take either fluorescein or esculin which produce an intensivepveen or blue radiance,, respectively. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
the plant in form of a wator or gelat~ini.
sclution.
light, one *an see the my*"d and the direction of the spreading solution.The dyes are being introiuced intoIn an ultra-,4 oletThe Method of J'azled SaiM..
The national economy is suffering afrom silesental relocations of huge masses of sand both, on thegreat &"r land and under we'~ttr.
This disaster can drift over various land installa-tions, washes away and knocks down the coast, on navigational rqute.,, etc. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
also when building #As hMrbors, hydropower stations, etc., it to anticipate the relocation of sand masses for a long period ahead.formsa shoals and eaandoankaIn order to fight the above disaster, andis no-:e'NW.ryThese forecasts can be composed by using the method of marted sauds,worked 2ut by Y~tveev.
The grains of naatura'l sand should he coated ve th a-98- .he sand ass.
After a certain time has passed, at variousthin layer of transparent material containing & brightly luminescent sub-stance. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
Frow severtl kilograms up to soveral tons of the marked sand areintroduced into distances from the place the marked sand bas been dumped, samples of soilshould be taken and exposed to an ultra-violet light.
eand grains can be detected in the soil, even if as, for instance, .- 1l:lO .grains, we can determine the rolrtivo amount of the marked sand in sample. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
of the maximum intensity, speed and distance covered by the reloaeatednatural sand.By counting the number of the luminescingtheThus, oe can determine the direction, width of the front, the zoneIn this way, *orkedthey are strongly dilutedIf the "aple contains a high percentage of the marked sand, it willthe analysis should beThe sand should be colored with fluore-- hydraziphenyl beasozazole or other lminescent substance whichbecome hard to count the lminesoing grainA.
Here, carried out in a different way. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
Here, carried out in a different way.
scein, 2.2' through non-vater soluble, will form brightly luminescent liquids in alkaline water solutions.
Eaoh smple of soil should be washed with waterto that all soluble ingredients are removed, and then treated with 1%solution of easutic soda. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
The moil will then be filtered and spin Muhedin watorl next, the radiance intensity of the filtrate should be comparedwith that of the standard solutions containixg a knon concentration ofthe Mae Ilxineut tect the mated mad when diluted in By uing the above smthod, one a. deo77.the sample inlproportiou of-1: substances.
theuMinescence Analysis of Detection as Applied to Paleontology, Arche-119. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
ology and CrimizetIM-The luinneoce anaa1vis of detection is very helpful in the paleonto-oIgizal, areheologioal aed ocriinological research.
Being highly sensitive,siaplo, and ftt, importAnt feature is ject in not subjected to any destruction or modification, and remains inIte original form after the analysis has been terminated.it beeam irreplaceable in such investigations.
Anotherthat in the process of analysis, the investigated cb-2he LXnineoenece A(cid:127)(cid:127)s of Detection in Paleontolo *. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
Here, thelumineemence analysis is used for investigation on imprints of ancientanimals and plants in seet prints start nIýnoeciug, and thus one can see the structural details ofthe prehistoric aimala and plants.to be wa"be out.
When illuminated with ultra-violet light, the im-In daylight, these imprintsthe sedimentary rock.
in Archeology. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
in Archeology.
The LTaaInesonce Analysis of Detecti(cid:127)n In archeologi-eas, the luinoescence allows the deteruination of worn-out,eal investigF faded or eroded spots in ancient manuscri-ta and doouments.
Usually, is sufficient to illminate the affected areas with ultra-violet rays.Newever, (methylese violet, ðylene blue), satisfictory result. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
shoual be exoited by the viai' 1e rays of a powerful incandescent laup, auda picture of the 4eassmat takea.ink containizg sniline dyesthe above method does not produce athe lafra-red luminescevne of the documentthe letters have becn vritten in Them, if it 'of14'1~ 3.M' * ~0 4J,-0'.444d-%.406000 0.94M'40 1~4J-100- w In this %%y, one can restor* the text which became Invisible in ordin-ary conditions d~ze to fading of the dye contained in the ink. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
The abovemethod will also rtveal the faded areas of a 1ypewritten text.
By using* the luminescence, one can also detect the early stages of the paper beingaffected with fungue.
Luminescence is being applied in laboratories for pro-tecting or restorin t various documents..the Lumin~sceneti Anal sie of Detection in CriminoloCL.
Particularlyimportant as the l'i4,teacenc* analysis for criminology, forensic chemistryand forenaic medicine. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
It is being widely used in the court practice whoreit ummistakenly detects various forgeries, erasures and other traces offoul play.
These mnethods at;-* based on illumination of the objects withultra-violet rays, and watching their radiance.
As a rule, each substanceproduces its cwn characteristic luz~ineecence.
For example, it is almostImpossible to find two types of paper which would produce a similar radi-ance. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
In this way, one can establish the authenticity of valxtablle docu-ment., notes, shares, etc.
The *inuttat tampering becomes visible to anaked eye.
Particularly distinct, are t?., marks~ on a wator-lined paper.~Figure 214 serves an an illustration.
Th* forgery of the date is clearlyvisible in the picture.In a similar way, one can detect also other typeo of forgery. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
As weknow, the surfaice of marble, bone, glass and other matvinal., after it hasbeen exposed to air for a long time, starts producing it characteristicluminescence which only slightly resembles the radianc#, of recently manu-factured objects.
In this way, one separates the~ authentic art objectsfrom forgeries of a more recent origin.
Similarly, oue can detect thetraces of taspering with old paintings, invisibl* in a daylight but easilyrecopaizable in the ultra-violet rays. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
Thus, one can verify the originalsignature of the paiater, a&d also study the history of the painting; byobserving the ra4iance of paints applied after the work has been finished.The luminescence analysis can reveal the text of a letter written withthe ink Inviuible under ordinary conditions.
Figure 214 b, shows a pictureof such a letter whose text is clearly visible under the ultra-violet light(white letters on a &.rk background).
One can also restore mnanuscriptsover which ink has been spilled. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
Here, the text should be covered wi~th aspecial luminescent compound, and then illuminated with an ultra-violetlight-dr-k letters of tbe overspillod ares will appear on a brightly1 aminescent background.By using luminescence, one can detect various spots on fabric, cloth-Ing and other objects.
In this way one can detect spots of blood, saliva,perspiration, urine, grease, etc.
The grease on fingers produce vory clearliusinescent fingerprints. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
The luminesce analysis can detect traces of thegun oil around the bullet bole, compare different fabric thredad, and per-fore many other investigations associated with criminology.-101- | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799757321.pdf | https://apps.dtic.mil/sti/pdfs/AD0632799.pdf | Central African Republic |
ddeezziirroohhttuuAAeerruussooccssDDcclliiiillbbuuPPddeezziirroohhttuuAAeerruussooccssDDcclliiiillbbuuPPddeezziirroohhttuuAAeerruussooccssDDcclliiPolicy, Planning, and ResarchWORKING PAPERSPopulation, Health, and NutritionPopulation and Human Resou cesDepartmentThe World BankJuly 198WPS 23Cost-EffectiveIntegration of Immunizationand Basic Health Servicesin Developing Countries:The Problem of Joint CostsiillbbuuPPMead OverddeezziirroohhttuuAAeerruussooccssDDcclliiiillbbuuPPThe debate between those who favor delivering comprehensiveprimary health care from fixed health centers and those whofavor delivering selective primary care from mobile healthteams can be decided, in principle, on empirical grounds. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
Keyrequirements for choosing the more cost-effective approach in agiven developing country are (1) an effectiveness measurecommon to both types of health care programs and (2) anapproach to modeling joint costs.The Pdicy.
Plning, nd Research Canplex distibutes PPR Woddng Papers to disseminte the findings of work in progress and toanoreg the exchange of ideas amng Bank staff and all othens interested in development issues. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
These papesca ry the nafmes ofthe author, reflect only teir views, and should be used and cited accordingly.
The fndings, interpretations, and conclusions are theuthors own.They should not be awtibuted totheWorld Bank.
its Board of Directors, itsmanagement.
or any of its membercountries. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
or any of its membercountries.
Polcy aPtning, and R rech |Population, Health, and NutritionWith limited budgets for rural primary health care, developing countries are under pressure to intcgrate the basic medical services that govem- ment health centers provide with the vaccination programs that mobile immunization tearns handle.
For health planners, the question is whether to organize the integrated servicesaround the fixed health centers or around the mobile health teams. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
Implicit in this decision is a choice between more comprehensive health care from the fixed center versus more selective care from the mobile teams.
Application of cost-effectiveness analysis is complicated by two inherent difficulties.
First, because the two types of health care programs improve the health of different target groups,some common measure of the effectiveness of the two programs must be agreed upon. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
Here the healthy-life-years saved by the two altema- tive programs is proposed and implemented as a useful common measure of effectiveness.
The second difficulty is that of modeling the joint costs of simultaneously producing morethan one health care service. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
In some situationsthe degree of "jointness" of the cost structureand the associated production technology havean important impact on thc relative cost-effec-tiveness of the two altemative approaches.Using the Liethod described here, econo-mists can address this problem in a way thatdoes justice to both the superior efficiency of themobile teams and the superior comprehensive-ness of the fixed centers. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
Special purposemodels such as this one can guide policy deci-sions since they are less complex than moregeneral models and can be easily understood bydecisionmakers.This paper is a product of the Population,Health, and Nutrition Division, Population andHuman Resources DepartmenL Copies areavailable free from the World Bank, 1818 HStreet NW, Washington, DC 20433. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
Pleasecontact Noni Jose, room S6-105, extension33688.The PPR Working Paper Series disseminates the fuidings of work under way in the Bank's Policy, Planningn and ResearchComplex.
An objective of the series is to get these findings out quickly, even if presentations are less than fuilly polished. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
'Me findings, interpretations, and conclusions in these papers do not necessarily represent offilcial policy of the Bank.Copyright i) 1988 by the Intemational Bank for Reconstruction and Development/Tc World Bank Cost-Effective Integration of Immunization and Basic Health Services inDeveloping Countries:The Problem of Joint CostsbyMead OverTable of ContentsIntroduction .................................................Page1The Planner's Decision Problem .........................22..................
I. II. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
I. II.
m. A Rule for Choosing the Cost-Effective Integration Strategy.. IV.
Application and Interpretations of the Decision Rule .1.
Estlmates of Healthy Life-Days-Saved Per Vaccination ... 2.
Estimates of Life-Days-Saved Per Encounter ................... 3.
Estimates of Parameters of the Cost Functions ............... 4.
Applications of the Decision Rule .................................... .V. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
Concluding Remarks ................................................ 4121215192223Notes .27Refereices .30 L Introductionpage'countries (LDCs) has been a goal of almost all of The delivery of life-saving primary health care (PHC) to the rural poor ofless developed thesecountries' governments since the Alma Ata Conference of 1978, if not before(World Health ergam.zation, 1978). | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
To achieve this goal, each LDC must choosehow much of its limited recurrent to rural primary heaLthcare, what mix of health care services n deliver with this limited budget andhow to organize and manage their deliver,.
As the scarcity of LDC recurrentbudgetary urged to programs efficiency difficult choice between disease-specific, multi-purpose, Warford, 1981, p. 1124).resources grows more acute, minL-ries of health focus on consolidating than on rather "will raise implementing new ones. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
However, trade-offs about organised health services (MORs) are beingof currentthe forsearch the(such as] theand andservices] approach" questions vertically and enhancing (basic health (Evans, Ral to allocate horizontal efaciency budget the high priority diseases. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
An alternative The choice between vertical immunizatio-n programs using mobile vaccinationteams and horizontal basic health services programs using polyvalent villagehealth workers (VHWs) is particularly painful because the two types of programsattack different tointegrate both VaWs and vaccination than either would be alone.
some of the most successful primary health care experiments and Wray, 1980; Berggren, Ewbank and Berggren, 1981). | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
For the integratedto be cost-effective, program inputs,transport and management skill, must be conserved by the chosen integrationstrategy. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
There are at least two different thiscriterion and again a choice must be made.Indeed this kind of integration has been Achieved in(Gwatkin, Wilcoxinto a program that is more cost-effectivestrategies which fulfill scarce and expensive two critically this choice integration the to is target On the one hand, immunization activities system and referral The MOH that budget can ba added to the functions ofthe horizontally organized government health centers which also function as thesupport for the VH Ws who deliver basic healthservices. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
its limitedthis strategy transportation totrips by fixed center personnel to verticallyorganized mobile vaccination pre-speciEied days at frxed-center-based several villages is referred strategy onthe center, but most vaccination would be done by thethe VH Ws in theirintegrationto the support and supervision of fixed centers and teams.
Villagers could obtain vaccinations VH W supervisor when he or she visits to supervise VH Ws, rather to as "Strategy F."this paper to allocate rest of a year. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
chooses follovs rn the tides than this On the other hand, VHW support and supervision could be added to the tasksteam.
With this option, "Strategyof the vertically organized mobile vaccination M," the fixed centers would have no respousibility supervision, but might remain involved with basic health services as the trainirgsites and referral for either vaccination or VRWfor the VHWs. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
[l]targets The planner who attempts strategies of the Strategy F, the approach VHWs, while immunization experts will probably prefer Strategy H, because to choose between integrationfor a given country or region of a country wiMl not lack for advocacesto preferto the support of theitPrimary health that allocates care experts transport two alternatives. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
likely these two the are to the economist to the mobile vaccination for guidance that "there allocates transport turns program, he may be told allocating applying cost-effectiveness capricious, plausible, (allocation] rules are adopted" (arman, ... are arbitrary and subject analysis teams. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
However, when the piannerintegratedin choosing a cost-effective is no general solution" to the problem ofthe results of... notto change when other, perhaps equallysuch a program, "although joint costs among several outputs of a program and that 1982, p. 595).to page 2are to teams integration this paper to contribute The goals of at producing vaccinations joint costs, while capturing both alone and between VHW support and vaccinations the methodology analysis in the presence of joint outputs and to address ofthein developing countries.the planner's choice problem in a way that avoids theofdegree ofThecost-effectiveness substantive problem of primary health care The paper characterizes need to allocate mobile complementarity model is set out in general terms in Section HI and then with sufficient structurethat a decision rule can be derived in Section II Section IV derives preliminaryinformation onestimates of the parameters of the decision rule from available the epidemiology and costs of rural primary health care in developing countriesand uses these estimates of thethe model developed in this paper toproposed decision rule. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
Section V contrasts two other onthe proposed decision rule and suggests directions large programming models, remarks on the impact of u ertainty the superior efficiency in fixed centers.
and interpretation the application the greater to illustrate for fruitful res.IL The Planner's Decision ProblemA con-etuent index of a health strategy's success in reducing both morbiditythat the s.rategy saves (Ghanaand mortality is the number of "healthy-life-days" Health Assessment Team, 1981). | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
By counting a day of reduced health as only athis index is able to summarize in cne numberfraction of a day of ful health, the effects of a policy on both mortality and morbidity.
As applied here, thehealthy-life-days the same as that of a workingadult, but it would be straightforward for a country which applies this decisionprocess to develop its own weights for life-days saved in each rural demographicgroup. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
(21index weights a child's life-day In the context of the present decision problem, there are two health sectorof ruralisactivities contribute ciizens: VHW services and immunization services.
Each of these aggregates itself a mix of different elementary activities.that could potentially the healthy-life-days to VH W services can, curative consultatons, dispensary.
Typically have different opinions regarding services. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
The mix actually achieved factors non-pecuniar; from other care providers, Let the term "encounter" the and a VH W. Then represented by el, e2 and e3. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
(31rewards attached turn, be further in drug dispensing and referrals disaggregated the VHW, the villager-patients to the the "best" mix of these local clinic orand the health ministry willofin the field will depend upon a variety ofthe pecuniary andthree categories among preventiveto each kind of service, the distance of the VHiWthe price and quality of those alternatives, refer three and so on.contact between a villagercan beto any health-related of encounters categories different including the quantity and quality of VHW supervision, page 3that diseases and then among the Immunizatdon services can also be disaggregated among vaccinations first and subsequent vaccinations different diseases (EPI) recommended by the World Health Organizaticn against sLx diseases are vaccination let vl, v, relevant forforrequire more than one. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
The "expanded program of immunization"to protecttwo of whicharet eight distinctsuch a progzam as the norm,that areservices the administratio", of four vaccines, services delivered by an EPL the 2ight distinct vaccination v tk a "cLve LDC.to be administered times each is designed represent through 'aking Thus three there .With healthy-life-days represented by h, the health planner's objectivefunction is given by:H - h(e, v, x),respectively e and v represent and vaccination in all of the elements of e, v and x. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
The variables in x representencounterThe function H is assumed convex andwhere variables increasing cther health socio-economic independent of rest of this paper these variables are held constant at activities sector of determinants the chosen primary health care and the health, which environmental, are all integration .the vectors of subscripted andto beIn theasumed strategy.
behavioral variables. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
behavioral variables.
In attempting to maximize h subject to a given annual operating budget, therecurrent c-*t constraints dependinghealth planner faces one of two different is followed.
(41 Let A be a vector of theon whether the fixed or mobile strategy theprices of inputs such as prices of gasoline for transport, essential drugs andvaccines, or office supplies.
Then denote the "fixed" and "mobile" primary healthstrategies by the subscripts f and m, respectively. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
The recurrentcare integraron cost functio.. the wages of the various manpower categories, for the two strategies can be written:kerosene for refrigerators, C f .cf(,v, V ,Cm acm(e,v,2)where the cf and cm functions are increasing concave in e and v, and homogeneous of degree one in p .51in (the elements of) e, v and a.If these functions are known, then the planner must solve two constrainedIf theis representedinput prices by j, then the two problems are:optimization maxiw.um annual recurrent budget for the health planning region by C and the vector of expected then compare problems and two optimal solutions. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
the For Strategy F:subject to:For Strategy t:subject to:max h(e, v, it)cf(e,v,) O< C*max h(e, v, if)cm(e,V,i) < C .
By solving each of the two problema for the optimal vectors of encounterspage 4and t i compute and vaccinationr is possible each decision healthy strategy.
rule Call just life days for is then substituting the number of healthy these amounts Hf and H*. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
Then the strategy to choose saves those optimal vectors life days that into h(e, v, R) itthat would be saved bythe the health larger planner'snumber ofthe given budget.
In other words:Decision Rule:If Hm > Hf, choose Strategy M. If Hm < Hf, choose Strategy F. If Hm a Hf, choose either strategy.
(C ase 1)(Case 2)(Case 3)Thus the problem of choosing care known.
ectivities Since it the is neither is easily e necessary activities. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
by Klarman The for rural primary health are life-days-saved, among these highlighted analysis.
[6] these functions with much confidence is which regarding precise decision behavior of that the correct integration of the nature these rule can be developel rule under various circumstances.present-day functions, Therefore p. 595) strategy. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
creates (1982, that fact the the most cost-effective solved once and v are nor desirable intsgration strategyh, cf and cterms in all the functions judged to allocate such arbitrariness J1costsjoint allocationsta thespecifyaboutOn the basis of some assumptionsto uncertainty not inadequate the prevailing does is attach of and others knowledge the next for a given section region illustrates and discusses how atheII A Rule for Choosing the Cost-Effective Integration StrategyTo simplify the characterization of the objective function h and the costthe ratio and ei that therefore the cost-effective independent cf and cm, assume and of vaccination F or Strategy M is chosen. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
functions e2is constant scale of &he program, whether services the simple sum of the elements of e. Adopting a similar assumption vaccination simple to the objecive Strategy should be produced three in fixed proportions types of encounters.
h(e, v, ! | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
h(e, v, !
), can be wricten:sum of all vaccinations vaccination oerformed, function, sum of services allows the services In this mix of VHW services of such variables as to VHW services the case el,theandthree VHWbyscalarfor the eight differentand can be represented Let e represent this activity to v. Then a first-order be represented approximationby theH ho + a e + b v , (1)a represents and b vaccination. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
where encounter average in the absence baseline health the number of healthy-life-days represents the The intercept number ho is the nupiler activity of any VH W or vaccinatLon status of the population.
[7]of healthy-life-days saved by an average VH Wby anlivedthesaved of healthy-life-days and represents thus justice To do to functions must capture representing the strengths the their two respective competing integration -trategies, strengths. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
A functional costtheir form capable ofof both strategies is:c(e, v, - A(p) ((/u)1 3 + v'3](/3) W e) (2) page 5s are ui and The parameters where A(2 ) is a linear parameters one.
isocast production complementarity primary health transformation, the technology.
in care by 6 - 1/(B- 1e axis The program. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
in care by 6 - 1/(B- 1e axis The program.
1i and curve on the production homogeneous increasing function strictly positive s determine and B3 is greater respectively of the returns measures of input than intercept scale to the of an integrated prices, or equal of of degree thetothetheofruralof productthe elasticity degree a and the parameter of It us related the two outputs to 6, the shape o , isocost (2) for foar different :e is no complementarity la. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
Figure 1 depicts associated with equation there in Figure demonstrating vaccinations.
which status.
[81 to specify of the should The next paragraphs the two competing relative magnitudes strategies.larger For increasing As a approaches be produced between values complementarity infinity, fixed in bring or production frontiervalues of B. W`ien B equals one,asisocost curve possibility is linear the e and v and of B t&,e isocost curve in the proportions the production two ouCptUL. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
become if both to bear a few "stylized of the parameters of equation bows of encounters outward,andjoint productshealthin order(2) for eachim prove facts" Evidence from tie Ivory Coast supports the observation that verticallyteams can be as much as twice as cost-effective the delivery of vaccination services in cost-effectiveness alone structures, their mobility and flexibility which allow difference and compliance tight the at organized mobile vaccination fixed centers Coffi, 1982b). | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
The observed the greater organized management teams, on a given day, of employees pressure accountability to increase the speed of their itinerary and the physical per vehicle which acts employment on the as an effective teams.that are task definitions properties of verticallyof the vaccinationthem to go where the people arelimit on the numberthe politicalcheck on as(Shepard, Sanoh andis probably due toTo capture this stylized fact, set e equal to zero in equation (2) and solvefor v:v [ C/A(p) Il/s . | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
(3)The assumption the production the for that, equation Strategy budget C from the same budget by Strategy M will be 2V .that Strategy M is of vaccinations recurrent same (3) is twice as large *F values.d9l by Strategy Call * the F, V .alone budget twice can Then C*, as cost-effective be then actainable the represented value as Strategy F atby supposingfromforfromof v for Strategy M values of A(2) and s as it is vaccinations produceable number of the nu%ber of vaccinations produceableAdvocates of fixed centers argue that once such a center is operating at abudget and one of its staff is making periodic vaccinationto for villages, recurrent the surrounding given annual visits be foregone the in each village would be quite small. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
VH W supervision to vaccinations.
from a fixed center its The technology little of producing can thus be characterized staff member tasks at traveling the number of vaccinations to also supervise In other words, "opportunity the fixed center cost" in both VH W services by substantial complementarity.that would have toand support a VHWcould add.oregoneand vaccinacionsterms of 6e e e e(a) Figure 1.
The Effect Possibility (b) (c) (d)- Varying R3 on the ProductionYrontiereStrategy FP-mV, | | i. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
/ ICombinod Feasible Region.
0 | m | > /for Budget C| , S | E K ~Strategy 11V* 2v*Figure 2.
Superposition of the Feasible Combinationsof e and v for Budget C* and the Two Strategies page 7there Although is no accumulated experience is reason teams to supervise VHWs, there on the use of mobilevaccination to be less sanguine aboutthe effects of adding VHW supervision to their tasks. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
The very features of themobile teams which make them so efficient the tight taskdefinitions, their mobility, the speed of their schedules and the physical limit onthe number of employees per vehicle, imply that the adoition of VH W supervisionand support to team duties will substantially Inother words, for a given recurrent budget the opportunity cost of adding VHWsupport and supervision to the duties of the mobile team is likely to be high interms of foregone vaccinations.slow the progress of the team. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
for their given tasks, To capture this hypothesized difference in complementatity, technology for Strategy production complementarity tigures Strategy M demonstrates Then a is two or greater complementarity Strategy F cost function while it equals one for the Strategy M function.F demonstrates between encounters and vaccinations that for in Figure la. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
such as that as illustrated lc, while and lb a modest degree suppose that theofshown inzerofor theFinally consider the relative magnitudes of the parameter the twoFor Strategy F and budget C*, the parameter Pf is defined as theto theThus if V* is thethen pfV* is itsstrategies.
ratio of the number of encounters nuaber of vaccinations intercept of the Strategy F isocost curve with the v axis, intercept with the e axis.produceable with no vaccinations produceable with no encounters. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
for i While Strategy M is twice as cost-effective alone, it is unlikely to be more cost-effective as Strategy F at producingvaccinations than Strategy F atthis last stylized fact, define 1im forproducing encounters alone[101 To capture the given budget C*, as the ratio of the number of encounters produceable byStrategy M with no vaccinations produceable byStrategy F with no encounters will be less than butgreater than one. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
The intercept isocost curve with f.he eaxis is thus m v * as shown in Figure 2.to the number of vaccinations to V ) Thb , of the Suategy (ie.
, e These assumptions superpo&tion for the two strategies operating under the same cost constraint.
the production possibilityTheallow the of frontiers equations for the two constraints are:Strategty F: a [ (ehlf) + V a 1/a V Strategy H: 2 (e/pm) + v -*2 V (4)(5)where V is an increasing feasible region for the two strategies. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
any combination of e and v that these combinations and thereby two possiblity sets. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
function of C .ll Figur# 2 depicts the combinedit to attainis on the northeast boundary of the union oftheseFor budget C the best of is possible to choose is The problem to choose the best strategy.Following the solution technique described in Section IL the maximize equation Strategy F cost constraint and then to substitute into equation (1) to obtain the maximum number of healthy-life-days saved under budget C* with Strategy F. The result is:to e and v subject (1) with respect irst step is totheto equation the resulding values of e and vthat can be(4), Hf w where B/Cu1) a (d4-l) and B > 1.page 8(6)frontier Because thefor the possibility Strategy M maximizatioo problem reduces twointercepts of that frontier with the e and v axes. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
That is, e,xcapt in the specialcase where b/a - Pm2, the mobile team should devote to eithervaccinations Formally theand should not mix the maximization problem is:the mobile strategy li'ear, to a choice bseween one of the or encounters itself entirely two tasks. | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
is Hm f max ( aimV* , 2 b V (7)Since mobile teams could probably save many more healthy-life-days only vaccinations valu of Hm is:than doing only VH W supervision and support, the maxim: doing-Hm 2 b V* According to the decision the number of life-days saved according yields the condition:rule of Section U, Strategy M is preferable saved according to equation (8) exceeds to equation (6). | https://docs-lawep.s3.us-east-2.amazonaws.com/1709799763133.pdf | https://documents1.worldbank.org/curated/en/928621468765588258/pdf/multi0page.pdf | Central African Republic |
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