The purpose of the present study was to explore the experience of the patients and hospital behaviour after the implementation of the no-class wards policy and its possible impact on the poor and non-poor patients provision and quality of care. This case study was conducted at Wates Hospital and purposeful sampling was used to yield participants. This study employed in-depth interviews with health care users district health care stakeholders, and focus group discussions with hospital healthcare professionals. The no-class wards policy had clearly demonstrated on improving the right to access to quality health care for the poor. The policy had been effectively reducing the experiences of patients on discriminatory treatment and improving quality of services. The policy also had an impact on increasing hospital utilization significantly among public insurance beneficiaries for both the poor and non-poor patients which supports the success of the implementation of the universal health coverage. Moreover, the policy had improved the assurance of quality of services. Future research needs to expand on our work to compare the implementation of no-class wards policy in other hospitals in different regions in Indonesia considering different local context such as local political issues, public expectations and other technical issues.

The risk factors for preeclampsia, extremes of maternal age, changing paternity, concomi-tant maternal autoimmunity, and/or birth intervals greater than 5 years, suggest an underlying immunopathology. We used peripheral blood and lymphocytes from the UteroPlacental Interface (UPI) of 3 rd trimester healthy pregnant women in multicolor flow cytometry-and in vitro suppression assays. The major end-point was the characterization of activation markers , and potential effector functions of different CD4-and CD8 subsets as well as T regulatory cells (Treg). We observed a significant shift of peripheral CD4-and CD8-T cells from naïve to memory phenotype in preeclamptic women compared to healthy pregnant women consistent with long-standing immune activation. While the proportions of the highly sup-pressive Cytokine and Activated Treg were increased in preeclampsia, Treg tolerance toward fetal antigens was dysfunctional. Thus, our observations indicate a long-standing inflammatory derangement driving immune activation in preeclampsia; in how far the Treg dysfunction is caused by/causes this immune activation in preeclampsia will be the object of future studies.

No abstract

No abstract

There has been a dearth of evidence in exploring the role of stakeholders in making the transition process from donor to local responsibility successful in relation to maternal and child health programs to date. This study aimed to generate practical experiences concerning stakeholder involvement in sustaining maternal and child health programs when donor support ends, so as to lead systematic strategies for supporting the success of the post-transition process and capture critical challenges of the programme's sustainability. This study employed Focus Group Discussion (FGD) with district healthcare stakeholders such as hospital managers, district health officers, community health centres, community associations and local authorities. In-depth interviews one to one with the local authority, health staff, informal leaders, and traditional birth attendants were conducted.From the final research project sample of participants, we extracted the interviews to analyse their narratives. Content analysis revealed 5 main themes from the FGDs and interviews: (1) Stakeholders' collaborative culture and organisational capacity; (2) Stakeholders' commitment; (3) Challenges in partnership and coordination; (4) Barriers to sustainable local financial support (5) Policy for maintaining institutionalisation. Two areas of concern were the priorities for follow-up to sustain the maternal and neonatal care programme and factors responsible for the continuation when donor funding ends, specifically longevity of stakeholder engagement and commitment and internal resource