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1.
I
NT
RO
D
UCT
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O
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Hea
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ca
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v
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tili
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g
o
f
p
o
p
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latio
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s
[
1
]
,
[
2
]
.
Desp
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its
im
p
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tan
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esear
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[
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I
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m
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l h
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er
v
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[
7
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–
[
1
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.
T
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ap
[
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1
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1
2
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.
Am
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[
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T
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[
1
4
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.
T
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[
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.
I
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Af
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W
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an
af
f
o
r
d
ab
le
p
r
ic
e
th
at
th
e
p
o
ten
tial
cu
s
to
m
er
s
(
u
s
u
ally
p
ass
en
g
er
s
at
b
u
s
ter
m
in
als)
ca
n
af
f
o
r
d
[
2
2
]
,
[
2
6
]
.
Am
in
et
a
l
.
[
2
7
]
h
av
e
ar
g
u
ed
t
h
at,
m
ed
icin
e
h
awk
er
s
ar
e
m
o
r
e
af
f
o
r
d
ab
le
th
a
n
p
r
iv
ate
s
ec
to
r
p
r
o
v
id
er
s
an
d
ar
e
s
o
m
etim
es
ev
en
m
o
r
e
af
f
o
r
d
ab
le
th
an
p
u
b
licly
ad
m
in
is
ter
ed
f
r
e
e
clin
ics
wh
en
tr
an
s
p
o
r
t
an
d
i
n
f
o
r
m
al
p
ay
m
e
n
ts
ar
e
co
n
s
id
er
ed
.
Oth
er
s
tu
d
ies
h
av
e
also
s
h
o
wn
th
at
th
e
s
er
v
ices
o
f
m
ed
icin
e
h
awk
er
s
ar
e
p
atr
o
n
ized
lar
g
e
ly
b
y
th
e
p
o
o
r
i
n
s
o
ciety
[
2
8
]
.
Ma
cr
o
h
ea
lth
s
y
s
tem
f
ac
to
r
s
s
u
ch
as
d
is
tan
ce
t
o
h
ea
lth
f
ac
ilit
ies
an
d
d
is
r
esp
e
ctf
u
l
f
o
r
m
al
h
ea
lt
h
ca
r
e
wo
r
k
er
s
h
av
e
also
b
ee
n
ad
ju
d
g
ed
as
co
n
tr
ib
u
tin
g
to
p
eo
p
le’
s
p
atr
o
n
a
g
e
o
f
m
ed
icin
e
h
awk
er
s
[
2
4
]
,
[
2
9
]
.
Su
d
h
in
ar
a
s
et
et
a
l
.
[
3
0
]
also
co
n
ten
d
th
a
t
th
er
e
ar
e
th
r
ee
p
r
in
ci
p
al
r
ea
s
o
n
s
f
o
r
u
s
in
g
t
h
ese
in
f
o
r
m
al
m
e
d
icin
e
v
e
n
d
o
r
s
–
c
o
n
v
en
ien
ce
,
af
f
o
r
d
ab
ilit
y
,
a
n
d
s
o
cial
an
d
cu
ltu
r
al
ef
f
ec
ts
.
Fig
h
ts
ag
ain
s
t
th
ese
m
ed
icin
e
h
awk
er
s
h
av
e
c
o
n
s
is
ten
tly
f
ailed
as
th
e
p
u
b
lic
s
till
u
s
e
th
eir
s
er
v
ices
[
3
1
]
.
I
n
Gh
an
a
,
ef
f
o
r
t
s
b
y
Gh
an
a
Ph
ar
m
ac
y
C
o
u
n
ci
l
an
d
th
e
T
r
ad
itio
n
al
Me
d
icin
es
Pra
ctice
C
o
u
n
cil
to
clam
p
d
o
wn
o
n
th
e
ac
tiv
ities
o
f
m
ed
icin
e
h
awk
er
s
h
av
e
p
r
o
v
en
f
u
tile
s
in
ce
th
ese
m
ed
ic
in
e
h
awk
er
s
alwa
y
s
f
in
d
th
eir
way
b
ac
k
to
th
e
ter
m
in
als
to
d
o
th
eir
b
u
s
in
ess
[
1
9
]
.
R
esear
ch
o
n
h
aw
k
in
g
i
n
Gh
an
a
h
as
g
e
n
er
ally
co
n
ce
n
tr
ated
o
n
s
tr
ee
t
f
o
o
d
v
en
d
o
r
s
an
d
th
eir
clien
ts
as
well
a
s
th
eir
illeg
al
u
s
e
o
f
p
u
b
lic
s
p
ac
e
[
3
2
]
–
[
3
4
]
.
T
h
o
u
g
h
r
esea
r
ch
[
2
2
]
,
[
3
5
]
h
av
e
ex
a
m
in
ed
t
h
e
Gh
an
aian
co
n
s
u
m
e
r
s
’
p
er
c
ep
tio
n
o
f
m
ed
icin
e
h
awk
in
g
an
d
m
ed
ici
n
e
h
awk
e
r
s
at
b
u
s
ter
m
in
als
in
Gh
an
a,
th
er
e
is
d
ea
r
th
o
f
liter
atu
r
e
o
n
th
e
d
em
o
g
r
a
p
h
ic
d
eter
m
in
an
ts
o
f
th
e
p
atr
o
n
ag
e
o
f
m
ed
ici
n
es
b
y
th
e
p
u
b
lic
f
r
o
m
th
ese
h
awk
er
s
.
T
h
er
e
f
o
r
e,
t
h
is
s
tu
d
y
s
o
u
g
h
t
to
co
n
tr
ib
u
te
to
th
e
ex
is
tin
g
d
is
co
u
r
s
e
b
y
ex
a
m
in
in
g
co
m
m
er
cial
v
eh
icle
p
ass
en
g
er
s
’
d
e
m
o
g
r
ap
h
ic
ch
ar
ac
ter
is
tics
an
d
p
atr
o
n
ag
e
o
f
th
e
s
er
v
ices o
f
m
ed
icin
e
h
a
wk
er
s
in
Ku
m
asi,
Gh
an
a
.
2.
M
E
T
H
O
D
T
h
is
s
tu
d
y
u
s
ed
a
cr
o
s
s
-
s
ec
tio
n
al
s
tu
d
y
d
esig
n
,
an
d
d
ata
was
o
b
tain
ed
f
r
o
m
a
c
o
n
v
e
n
ien
c
e
s
u
r
v
ey
o
f
4
0
0
co
m
m
er
cial
v
eh
icle
p
ass
e
n
g
er
s
.
T
h
is
p
ap
er
f
o
r
m
s
p
ar
t
o
f
a
lar
g
er
s
tu
d
y
w
h
ich
to
o
k
p
l
ac
e
f
r
o
m
J
u
n
e
2
0
2
1
to
No
v
em
b
er
2
0
2
2
.
T
h
e
s
tu
d
y
ex
am
in
ed
m
ed
icin
e
h
aw
k
er
s
an
d
th
eir
p
atr
o
n
s
in
Ku
m
asi,
Gh
an
a.
Ku
m
asi
is
th
e
s
ec
o
n
d
la
r
g
est
city
in
G
h
a
n
a
with
m
ajo
r
b
u
s
ter
m
in
als
a
n
d
lo
ca
ted
in
th
e
r
eg
io
n
h
a
v
in
g
m
o
r
e
th
an
h
alf
o
f
th
e
ac
tiv
e
la
b
o
u
r
f
o
r
ce
o
f
th
e
in
f
o
r
m
al
s
ec
to
r
in
Gh
an
a
[
3
6
]
.
T
h
e
q
u
esti
o
n
n
air
e
f
o
r
t
h
is
p
ap
e
r
co
n
s
is
ted
o
f
clo
s
e
-
en
d
ed
q
u
esti
o
n
s
r
elatin
g
to
s
o
m
e
d
em
o
g
r
a
p
h
ic
c
h
ar
ac
ter
is
tics
o
f
th
e
p
ass
en
g
er
s
an
d
was
ad
m
in
is
ter
ed
f
r
o
m
Feb
r
u
ar
y
2
0
2
2
to
Ma
r
c
h
2
0
2
2
.
E
th
ical
clea
r
an
ce
f
o
r
th
e
s
tu
d
y
was
o
b
tain
ed
f
r
o
m
th
e
Hu
m
an
ities
an
d
So
cial
Scien
ce
s
R
esear
ch
E
t
h
ics
C
o
m
m
ittee,
Kwa
m
e
Nk
r
u
m
ah
Un
iv
e
r
s
ity
o
f
Scien
ce
an
d
T
ec
h
n
o
l
o
g
y
,
Ku
m
asi,
Gh
an
a
(
H
u
SS
R
E
C
/
AP/
1
/VOL
.
1
)
,
an
d
th
e
I
n
s
titu
te
o
f
Hea
lth
R
esear
ch
,
Un
iv
e
r
s
ity
o
f
Hea
lth
an
d
Allied
Scien
ce
s
,
Ho
,
Gh
an
a
(
UHAS
-
R
E
C
A.
2
[
6
]
2
1
-
2
2
)
.
T
h
e
in
d
e
p
en
d
e
n
t
v
a
r
iab
les
in
t
h
is
s
tu
d
y
wer
e
th
e
d
e
m
o
g
r
ap
h
ic
ch
ar
ac
ter
is
tics
o
f
th
e
r
esp
o
n
d
en
ts
an
d
co
n
s
is
ted
o
f
s
ex
(
m
ale
an
d
f
e
m
al
e)
,
ag
e
g
r
o
u
p
(
1
8
t
o
2
8
y
e
ar
s
,
2
9
to
3
9
y
ea
r
s
,
4
0
to
5
0
y
ea
r
s
an
d
m
o
r
e
t
h
an
5
0
y
ea
r
s
)
,
m
a
r
ital
s
tatu
s
(
m
ar
r
ied
,
s
in
g
le,
d
iv
o
r
ce
d
,
wid
o
we
d
an
d
s
ep
ar
ated
)
,
r
elig
io
n
(
C
h
r
is
tian
ity
,
I
s
lam
an
d
Af
r
ican
T
r
ad
itio
n
al
R
elig
io
n
)
,
ed
u
ca
tio
n
al
lev
el
(
n
o
f
o
r
m
al
ed
u
ca
tio
n
,
b
asic
ed
u
ca
tio
n
,
s
ec
o
n
d
ar
y
ed
u
ca
tio
n
an
d
ter
tiar
y
ed
u
ca
tio
n
)
,
o
cc
u
p
atio
n
al
s
ec
to
r
(
civ
il
s
er
v
an
t,
f
o
r
m
al
p
r
iv
ate
s
ec
to
r
,
in
f
o
r
m
al
p
r
iv
ate
s
ec
to
r
,
s
elf
-
em
p
lo
y
ed
a
n
d
u
n
em
p
lo
y
e
d
)
,
h
ea
lth
in
s
u
r
an
ce
s
u
b
s
cr
ip
tio
n
(
y
es
an
d
n
o
)
,
ty
p
e
o
f
in
s
u
r
a
n
ce
(
Gh
an
a
Natio
n
a
l
Hea
lth
I
n
s
u
r
an
ce
Sch
em
e
an
d
p
r
iv
ate
in
s
u
r
an
ce
)
an
d
wh
e
r
e
m
ed
icin
e
h
awk
er
was
f
ir
s
t
en
co
u
n
ter
ed
(
b
u
s
ter
m
in
al,
with
in
th
e
c
o
m
m
u
n
ity
an
d
in
s
id
e
a
b
u
s
)
.
T
h
e
d
ep
en
d
en
t
v
ar
ia
b
le
was
“e
v
e
r
p
u
r
ch
ased
f
r
o
m
a
m
ed
icin
e
h
awk
er
?”
with
a
d
ic
h
o
to
m
o
u
s
o
u
tco
m
e
o
f
y
es a
n
d
n
o
.
Data
wer
e
co
d
ed
an
d
a
n
aly
s
ed
u
s
in
g
s
tatis
tical
p
ac
k
ag
e
f
o
r
s
o
cial
s
cien
ce
s
(
SP
SS
v
er
s
io
n
2
0
)
.
Descr
ip
tiv
e
an
d
i
n
f
er
e
n
tial
s
tatis
tics
wer
e
u
s
ed
in
th
e
d
ata
a
n
aly
s
is
.
Fre
q
u
en
cies
an
d
p
er
ce
n
tag
es
wer
e
u
s
ed
to
d
ep
ict
th
e
d
em
o
g
r
ap
h
ic
ch
ar
a
cter
is
tics
,
an
d
C
hi
-
s
q
u
ar
e
test
o
f
in
d
ep
en
d
en
ce
was
also
u
s
ed
to
e
x
am
in
e
th
e
ass
o
ciatio
n
b
etwe
en
h
a
v
in
g
e
v
er
p
u
r
ch
ased
f
r
o
m
m
e
d
icin
e
h
awk
er
s
a
n
d
p
u
r
c
h
asin
g
f
r
o
m
th
em
ag
ain
in
th
e
f
u
tu
r
e.
E
f
f
ec
t
s
ize
o
f
th
e
C
h
i
-
s
q
u
ar
e
test
was
al
s
o
co
m
p
u
ted
with
C
r
am
er
’
s
V
to
esti
m
at
e
th
e
s
tr
en
g
th
an
d
m
ag
n
itu
d
e
o
f
th
e
o
b
s
er
v
ed
e
f
f
ec
t
.
T
h
e
b
in
ar
y
lo
g
is
tic
r
eg
r
ess
io
n
was
m
o
d
elled
to
p
r
ed
ict
p
atr
o
n
ag
e
o
f
m
ed
icin
e
h
awk
er
s
,
with
th
e
d
em
o
g
r
ap
h
ic
ch
ar
ac
ter
is
tics
as
p
r
ed
icto
r
v
ar
iab
les.
A
p
-
v
alu
e
o
f
less
th
an
0
.
0
5
was c
o
n
s
id
er
ed
s
tatis
tically
s
i
g
n
i
f
ican
t.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
1
4
,
No
.
2
,
J
u
n
e
20
2
5
:
9
1
2
-
9
1
8
914
3.
RE
SU
L
T
S AN
D
D
I
SCU
SS
I
O
N
3
.
1
.
Resul
t
s
Fro
m
T
ab
le
1
,
a
to
tal
o
f
4
0
0
p
ass
en
g
er
s
r
esp
o
n
d
ed
t
o
th
e
s
u
r
v
ey
.
Of
th
e
4
0
0
r
esp
o
n
d
en
ts
,
5
2
%
wer
e
m
ales.
R
eg
ar
d
in
g
ag
e
g
r
o
u
p
,
1
9
0
wer
e
f
r
o
m
1
8
to
2
8
y
ea
r
s
o
ld
.
On
ly
9
.
5
%
wer
e
m
o
r
e
th
an
5
0
y
ea
r
s
o
f
ag
e
.
Mo
s
t
(
4
7
.
3
%)
wer
e
s
in
g
le,
f
o
llo
wed
b
y
th
e
m
a
r
r
ied
r
e
p
r
esen
tin
g
4
0
.
5
%.
C
h
r
is
tian
s
wer
e
in
th
e
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8
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o
s
h
o
w
l
o
y
a
l
t
y
a
n
d
m
a
i
n
t
a
i
n
k
i
n
s
h
i
p
,
r
a
t
h
e
r
t
h
a
n
t
o
b
u
y
f
r
o
m
o
u
t
s
i
d
e
r
s
.
T
h
is
is
d
o
n
e
t
o
s
h
o
w
s
u
p
p
o
r
t
f
o
r
t
h
e
k
i
n
o
r
a
s
s
o
c
ia
t
e.
T
h
o
u
g
h
s
tu
d
ies
h
av
e
s
h
o
wn
t
h
at
s
er
v
ices
o
f
h
awk
er
s
ar
e
m
ain
ly
p
atr
o
n
is
ed
b
y
th
e
less
ed
u
ca
ted
i
n
th
e
s
o
ciety
[
9
]
,
[
2
2
]
,
[
2
8
]
,
r
esu
lts
f
r
o
m
th
e
b
in
ar
y
lo
g
is
tic
r
eg
r
ess
io
n
in
th
is
s
tu
d
y
s
h
o
we
d
o
th
e
r
wis
e.
I
n
th
is
s
tu
d
y
,
th
o
s
e
wh
o
h
a
d
ter
tiar
y
ed
u
ca
tio
n
wer
e
th
r
ee
tim
es
m
o
r
e
lik
ely
t
o
p
atr
o
n
is
e
th
e
s
er
v
ices
o
f
th
e
m
e
d
icin
e
h
awk
er
s
.
On
e
ca
n
o
p
in
e
t
h
at
it
is
o
u
t
o
f
co
n
v
en
ie
n
ce
o
r
t
h
e
m
ar
k
etin
g
s
k
ills
o
f
th
e
s
eller
s
wh
ich
en
ticed
clien
ts
to
b
u
y
f
r
o
m
th
e
m
.
N
y
ar
k
o
et
a
l
.
[
1
9
]
a
v
er
s
th
at
m
ed
icin
e
h
awk
er
s
wh
o
o
p
er
a
te
with
in
u
r
b
an
b
u
s
ter
m
in
als
em
p
lo
y
d
ir
ec
t
cu
s
to
m
er
en
g
ag
em
e
n
t
as
a
m
ea
n
s
t
o
m
ar
k
et
th
eir
m
ed
icin
es
an
d
co
n
v
in
ce
clien
ts
to
p
atr
o
n
is
e
th
eir
m
ed
icin
es.
I
t
h
as
b
ee
n
f
o
u
n
d
in
Nig
er
ia
th
at
th
e
s
in
g
le
an
d
h
i
g
h
ly
ed
u
ca
ted
p
atr
o
n
is
e
th
e
s
er
v
ices
o
f
h
awk
er
s
b
ec
au
s
e
t
h
ey
p
e
r
ce
iv
e
th
ese
v
e
n
d
o
r
s
as
p
o
o
r
/d
is
ad
v
an
tag
ed
,
b
u
t
th
at
h
awk
in
g
h
elp
s
th
em
to
escap
e
p
o
v
e
r
ty
[
4
5
]
.
Als
o
,
th
e
af
f
o
r
d
ab
ilit
y
o
f
th
ese
h
a
wk
er
s
'
s
er
v
ices
an
d
p
r
o
d
u
cts
is
a
f
ac
to
r
th
at
th
eir
clien
ts
,
in
g
en
er
al
,
ca
n
n
o
t ig
n
o
r
e
[
4
3
]
.
4.
CO
NCLU
SI
O
N
T
h
e
cu
r
r
en
t
s
tu
d
y
r
ev
ea
led
th
at
Gh
an
aian
s
d
o
p
atr
o
n
is
e
t
h
e
s
er
v
ices
o
f
m
ed
icin
e
h
awk
er
s
d
esp
ite
m
ed
ia
ad
v
is
e
ag
ai
n
s
t
th
eir
p
at
r
o
n
ag
e
an
d
o
p
er
atin
g
o
u
ts
id
e
g
o
v
er
n
m
en
t
p
o
licies
an
d
r
e
g
u
latio
n
s
.
T
h
e
s
tu
d
y
co
n
clu
d
es
th
at
ag
e,
r
elig
io
n
an
d
lev
el
o
f
ed
u
ca
tio
n
d
eter
m
in
es
th
e
p
u
b
lic’
s
p
atr
o
n
ag
e
o
f
th
e
s
er
v
ices
o
f
m
ed
icin
e
h
aw
k
er
s
in
u
r
b
an
Gh
an
a.
Als
o
,
a
p
e
r
s
o
n
’
s
p
r
e
v
io
u
s
p
atr
o
n
ag
e
o
f
m
e
d
icin
e
s
f
r
o
m
th
e
h
awk
er
s
s
ig
n
if
ican
tly
p
r
ed
icts
p
atr
o
n
is
in
g
f
r
o
m
th
e
h
awk
er
s
ag
ai
n
.
B
ased
o
n
th
ese
f
in
d
in
g
s
,
it
is
r
ec
o
m
m
e
n
d
ed
th
at
g
o
v
er
n
m
en
t
in
ten
s
if
ies
p
u
b
lic
ed
u
ca
tio
n
o
n
th
e
im
p
licatio
n
s
o
f
b
u
y
i
n
g
m
e
d
icin
es
f
r
o
m
m
ed
icin
e
h
awk
er
s
wh
o
o
p
e
r
ate
o
u
ts
id
e
s
tate
r
eg
u
latio
n
s
.
RE
F
E
R
E
NC
E
S
[
1
]
L.
A
.
Za
m
p
e
t
a
k
i
s
a
n
d
C
.
M
e
l
a
s,
“
Th
e
h
e
a
l
t
h
b
e
l
i
e
f
m
o
d
e
l
p
r
e
d
i
c
t
s
v
a
c
c
i
n
a
t
i
o
n
i
n
t
e
n
t
i
o
n
s a
g
a
i
n
s
t
C
O
V
I
D
-
1
9
:
A
s
u
r
v
e
y
e
x
p
e
r
i
me
n
t
a
p
p
r
o
a
c
h
,
”
A
p
p
l
i
e
d
Psy
c
h
o
l
o
g
y
:
H
e
a
l
t
h
a
n
d
W
e
l
l
-
Be
i
n
g
,
v
o
l
.
1
3
,
n
o
.
2
,
p
p
.
4
6
9
–
4
8
4
,
M
a
y
2
0
2
1
,
d
o
i
:
1
0
.
1
1
1
1
/
a
p
h
w
.
1
2
2
6
2
.
[
2
]
L.
A
.
C
h
a
v
e
s,
D
.
M
.
D
e
S
o
u
z
a
S
e
r
i
o
D
o
s
S
a
n
t
o
s,
M
.
R
o
d
r
i
g
u
e
s
C
a
mp
o
s,
a
n
d
V
.
L
.
Lu
i
z
a
,
“
U
se
o
f
h
e
a
l
t
h
o
u
t
c
o
m
e
a
n
d
h
e
a
l
t
h
serv
i
c
e
u
t
i
l
i
z
a
t
i
o
n
i
n
d
i
c
a
t
o
r
s a
s
a
n
o
u
t
c
o
m
e
o
f
a
c
c
e
ss
t
o
me
d
i
c
i
n
e
s
i
n
B
r
a
z
i
l
:
P
e
r
s
p
e
c
t
i
v
e
s
f
r
o
m
a
l
i
t
e
r
a
t
u
r
e
r
e
v
i
e
w
,
”
P
u
b
l
i
c
H
e
a
l
t
h
Re
v
i
e
w
s
,
v
o
l
.
4
0
,
n
o
.
1
,
p
.
5
,
D
e
c
.
2
0
1
9
,
d
o
i
:
1
0
.
1
1
8
6
/
s4
0
9
8
5
-
0
1
9
-
0
1
1
5
-
1.
[
3
]
F
.
L
o
t
f
i
,
S
.
N
o
u
r
a
e
i
M
o
t
l
a
g
h
,
G
.
M
a
h
d
a
v
i
,
K
.
K
e
s
h
a
v
a
r
z
,
M
.
H
a
d
i
a
n
,
a
n
d
H
.
A
b
o
l
g
h
a
s
e
m
G
o
r
j
i
,
“
F
a
c
t
o
r
s
a
f
f
e
c
t
i
n
g
t
h
e
u
t
i
l
i
z
a
t
i
o
n
o
f
o
u
t
p
a
t
i
e
n
t
h
e
a
l
t
h
s
e
r
v
i
c
e
s
a
n
d
i
mp
o
r
t
a
n
c
e
o
f
h
e
a
l
t
h
i
n
s
u
r
a
n
c
e
,
”
S
h
i
r
a
z
E
M
e
d
i
c
a
l
J
o
u
r
n
a
l
,
v
o
l
.
1
8
,
n
o
.
8
,
p
p
.
1
–
8
,
J
u
l
.
2
0
1
7
,
d
o
i
:
1
0
.
5
8
1
2
/
s
e
mj
.
5
7
5
7
0
.
[
4
]
M
.
Z.
H
a
s
a
n
e
t
a
l
.
,
“
F
a
c
t
o
r
s
a
f
f
e
c
t
i
n
g
t
h
e
h
e
a
l
t
h
c
a
r
e
u
t
i
l
i
z
a
t
i
o
n
f
r
o
m
S
h
a
s
t
h
y
o
S
u
r
o
k
s
h
a
K
a
r
mas
u
c
h
i
sc
h
e
m
e
a
mo
n
g
t
h
e
b
e
l
o
w
-
p
o
v
e
r
t
y
-
l
i
n
e
p
o
p
u
l
a
t
i
o
n
i
n
o
n
e
s
u
b
d
i
s
t
r
i
c
t
i
n
B
a
n
g
l
a
d
e
sh
:
a
c
r
o
ss
se
c
t
i
o
n
a
l
st
u
d
y
,
”
B
MC
H
e
a
l
t
h
S
e
rv
i
c
e
s
Re
s
e
a
r
c
h
,
v
o
l
.
2
2
,
n
o
.
1
,
p
.
8
8
5
,
D
e
c
.
2
0
2
2
,
d
o
i
:
1
0
.
1
1
8
6
/
s
1
2
9
1
3
-
0
2
2
-
0
8
2
5
4
-
1.
[
5
]
W
.
A
g
y
e
m
a
n
g
-
D
u
a
h
,
C
.
P
e
p
r
a
h
,
a
n
d
P
.
P
e
p
r
a
h
,
“
F
a
c
t
o
r
s
i
n
f
l
u
e
n
c
i
n
g
t
h
e
u
s
e
o
f
p
u
b
l
i
c
a
n
d
p
r
i
v
a
t
e
h
e
a
l
t
h
c
a
r
e
f
a
c
i
l
i
t
i
e
s
a
m
o
n
g
p
o
o
r
o
l
d
e
r
p
e
o
p
l
e
i
n
r
u
r
a
l
G
h
a
n
a
,
”
J
o
u
r
n
a
l
o
f
P
u
b
l
i
c
H
e
a
l
t
h
(
G
e
r
m
a
n
y
)
,
v
o
l
.
2
8
,
n
o
.
1
,
p
p
.
5
3
–
6
3
,
F
e
b
.
2
0
2
0
,
d
o
i
:
1
0
.
1
0
0
7
/
s
1
0
3
8
9
-
0
1
8
-
0
1
0
1
0
-
y.
[
6
]
P
.
B
a
st
a
n
i
,
M
.
M
o
h
a
mm
a
d
p
o
u
r
,
M
.
S
a
ma
d
b
e
i
k
,
M
.
B
a
s
t
a
n
i
,
G
.
R
o
ss
i
-
F
e
d
e
l
e
,
a
n
d
M
.
B
a
l
a
su
b
r
a
m
a
n
i
a
n
,
“
F
a
c
t
o
r
s
i
n
f
l
u
e
n
c
i
n
g
a
c
c
e
ss
a
n
d
u
t
i
l
i
z
a
t
i
o
n
o
f
h
e
a
l
t
h
s
e
r
v
i
c
e
s
a
mo
n
g
o
l
d
e
r
p
e
o
p
l
e
d
u
r
i
n
g
t
h
e
C
O
V
I
D
−
1
9
p
a
n
d
e
mi
c
:
a
s
c
o
p
i
n
g
r
e
v
i
e
w
,
”
Ar
c
h
i
v
e
s
o
f
Pu
b
l
i
c
H
e
a
l
t
h
,
v
o
l
.
7
9
,
n
o
.
1
,
p
p
.
1
–
1
1
,
2
0
2
1
,
d
o
i
:
1
0
.
1
1
8
6
/
s
1
3
6
9
0
-
0
2
1
-
0
0
7
1
9
-
9.
[
7
]
C
.
G
o
o
d
m
a
n
,
W
.
B
r
i
e
g
e
r
,
A
.
U
n
w
i
n
,
A
.
M
i
l
l
s
,
S
.
M
e
e
k
,
a
n
d
G
.
G
r
e
e
r
,
“
M
e
d
i
c
i
n
e
se
l
l
e
r
s
a
n
d
ma
l
a
r
i
a
t
r
e
a
t
me
n
t
i
n
s
u
b
-
S
a
h
a
r
a
n
A
f
r
i
c
a
:
W
h
a
t
d
o
t
h
e
y
d
o
a
n
d
h
o
w
c
a
n
t
h
e
i
r
p
r
a
c
t
i
c
e
b
e
i
m
p
r
o
v
e
d
?
,
”
Am
e
r
i
c
a
n
J
o
u
rn
a
l
o
f
T
r
o
p
i
c
a
l
M
e
d
i
c
i
n
e
a
n
d
H
y
g
i
e
n
e
,
v
o
l
.
7
7
,
n
o
.
S
U
P
P
L.
6
,
p
p
.
2
0
3
–
2
1
8
,
2
0
0
7
,
d
o
i
:
1
0
.
4
2
6
9
/
a
j
t
m
h
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Evaluation Warning : The document was created with Spire.PDF for Python.