Tracking development assistance for health and for COVID-19: a review of development assistance, government, out-of-pocket, and other private spending on health for 204 countries and territories, 1990-2050

Background The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed, especially during public health emergencies. Development assistance is an important source of health financing in many low-income countries, yet little is known about how much of this funding was disbursed for COVID-19. We aimed to put development assistance for health for COVID-19 in the context of broader trends in global health financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020. Methods We estimated domestic health spending and development assistance for health to generate total health-sector spending estimates for 204 countries and territories. We leveraged data from the WHO Global Health Expenditure Database to produce estimates of domestic health spending. To generate estimates for development assistance for health, we relied on project-level disbursement data from the major international development agencies' online databases and annual financial statements and reports for information on income sources. To adjust our estimates for 2020 to include disbursements related to COVID-19, we extracted project data on commitments and disbursements from a broader set of databases (because not all of the data sources used to estimate the historical series extend to 2020), including the UN Office of Humanitarian Assistance Financial Tracking Service and the International Aid Transparency Initiative. We reported all the historic and future spending estimates in inflation-adjusted 2020 US$, 2020 US$ per capita, purchasing-power parity-adjusted US$ per capita, and as a proportion of gross domestic product. We used various models to generate future health spending to 2050. Findings In 2019, health spending globally reached $8. 8 trillion (95% uncertainty interval [UI] 8.7-8.8) or $1132 (1119-1143) per person. Spending on health varied within and across income groups and geographical regions. Of this total, $40.4 billion (0.5%, 95% UI 0.5-0.5) was development assistance for health provided to low-income and middle-income countries, which made up 24.6% (UI 24.0-25.1) of total spending in low-income countries. We estimate that $54.8 billion in development assistance for health was disbursed in 2020. Of this, $13.7 billion was targeted toward the COVID-19 health response. $12.3 billion was newly committed and $1.4 billion was repurposed from existing health projects. $3.1 billion (22.4%) of the funds focused on country-level coordination and $2.4 billion (17.9%) was for supply chain and logistics. Only $714.4 million (7.7%) of COVID-19 development assistance for health went to Latin America, despite this region reporting 34.3% of total recorded COVID-19 deaths in low-income or middle-income countries in 2020. Spending on health is expected to rise to $1519 (1448-1591) per person in 2050, although spending across countries is expected to remain varied. Interpretation Global health spending is expected to continue to grow, but remain unequally distributed between countries. We estimate that development organisations substantially increased the amount of development assistance for health provided in 2020. Continued efforts are needed to raise sufficient resources to mitigate the pandemic for the most vulnerable, and to help curtail the pandemic for all. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.

Авторы

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⁴⁶³ , Zastrozhin M.S. ^464, ⁴²⁴ , Zastrozhina A. ⁴⁶⁵ , Zhang Z.J. ⁴⁶⁰ , Ziapour A. ²⁷⁵ , Zuniga Y.MH. ^466, ⁴⁶⁷ , Hay S.I. ^1, ² , Murray C.JL. ^1, ² , Dieleman J.L. ^2, ¹

Journal

Lancet

Издательство

Elsevier Limited

Номер выпуска

10308

Язык

English

Страницы

1317-1343

Статус

Published

DOI

10.1016/S0140-6736(21)01258-7

Том

398

Год

2021

Организации

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³ Univ Tokyo, Dept Global Hlth Policy, Tokyo, Japan
⁴ Keio Univ, Dept Hlth Policy & Management, Tokyo, Japan
⁵ Univ Oxford, Nuffield Dept Med, Oxford, England
⁶ Univ Oxford, Ctr Trop Med & Global Hlth, Oxford, England
⁷ Univ Oxford, George Inst Global Hlth, Oxford, England
⁸ Univ Roma La Sapienza, Dept Jurid & Econ Studies, Rome, Italy
⁹ Marshall Univ, Dept Surg, Huntington, WV USA
¹⁰ Univ Southern Calif, Dept Orthopaed Surg, Los Angeles, CA 90007 USA
¹¹ Univ Southern Calif, Radiol, Los Angeles, CA 90007 USA
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¹⁵ Sree Narayana Guru Coll Chelannur, Dept Bot, Kozhikode, India
¹⁶ Karolinska Univ Hosp, Dept Lab Med, Huddinge, Sweden
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³² Univ Technol Sydney, Australian Ctr Publ & Populat Hlth Res, Sydney, NSW, Australia
³³ Shahid Beheshti Univ Med Sci, Sch Adv Technol Med, Tehran, Iran
³⁴ Shahid Beheshti Univ Med Sci, Natl Nutr & Food Technol Res Inst, Tehran, Iran
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³⁷ COMSATS Inst Informat Technol, Dept Biosci, Islamabad, Pakistan
³⁸ Jimma Univ, Dept Epidemiol, Jimma, Ethiopia
³⁹ Univ South Australia, Australian Ctr Precis Hlth, Adelaide, SA, Australia
⁴⁰ Univ Kurdistan Hewler, Dept Comp Sci & Engn, Erbil, Iraq
⁴¹ Natl Inst Nutr, Dept Food & Nutr Policy & Planning Res, Tehran, Iran
⁴² Jenderal Soedirman Univ, Fac Med & Publ Hlth, Purwokerto, Indonesia
⁴³ Univ Gondar, Dept Med Physiol, Gondar, Ethiopia
⁴⁴ Univ Gondar, Dept Clin Pharm, Gondar, Ethiopia
⁴⁵ Univ Gondar, Dept Midwifery, Gondar, Ethiopia
⁴⁶ Intercountry Ctr Oral Hlth Afr, Dept Publ Hlth, Jos, Nigeria
⁴⁷ Fed Minist Hlth, Dept Publ Hlth, Garki, Nigeria
⁴⁸ Hamad Med Corp, Geriatr & Long Term Care Dept, Doha, Qatar
⁴⁹ Hamad Med Corp, Rumailah Hosp, Doha, Qatar
⁵⁰ Murdoch Univ, Murdoch Business Sch, Perth, WA, Australia
⁵¹ Imam Abdulrahman Bin Faisal Univ, Hlth Informat Management & Technol Dept, Dammam, Saudi Arabia
⁵² Imam Abdulrahman Bin Faisal Univ, Dept Environm Hlth, Dammam, Saudi Arabia
⁵³ Imam Abdulrahman Bin Faisal Univ, Forens Med Div, Dammam, Saudi Arabia
⁵⁴ Imam Abdulrahman Bin Faisal Univ, Dept Pharm Practice, Dammam, Saudi Arabia
⁵⁵ Imam Abdulrahman Bin Faisal Univ, Dammam, Saudi Arabia
⁵⁶ Arba Minch Univ, Dept Midwifery, Arba Minch, Ethiopia
⁵⁷ Univ Hlth & Allied Sci, Inst Hlth Res, Ho, Ghana
⁵⁸ Univ Hlth & Allied Sci, Dept Populat & Behav Sci, Ho, Ghana
⁵⁹ Univ Hlth & Allied Sci, Dept Hlth Policy Planning & Management, Ho, Ghana
⁶⁰ Urmia Univ Med Sci, Dept Hlth Care Management & Econ, Orumiyeh, Iran
⁶¹ Kuwait Univ, Dept Hlth Policy & Management, Safat, Kuwait
⁶² Natl Univ Malaysia, Int Ctr Casemix & Clin Coding, Bandar Tun Razak, Malaysia
⁶³ Alfaisal Univ, Coll Med, Riyadh, Saudi Arabia
⁶⁴ Minist Hlth, Riyadh, Saudi Arabia
⁶⁵ Univ Costa, Res Grp Hosp Management & Hlth Policies, Barranquilla, Colombia
⁶⁶ Univ Costa, Dept Econ Sci, Barranquilla, Colombia
⁶⁷ Univ Cartagena, Hlth Econ Res Grp, Cartagena, Colombia
⁶⁸ Natl Inst Hlth, Natl Hlth Observ, Bogota, Colombia
⁶⁹ Natl Inst Hlth, Colombian Natl Hlth Observ, Bogota, Colombia
⁷⁰ Arak Univ Med Sci, Dept Hlth Serv Management, Arak, Iran
⁷¹ Arak Univ Med Sci, Dept Pediat, Arak, Iran
⁷² Isfahan Univ Med Sci, Hlth Management & Econ Reasearch Ctr, Esfahan, Iran
⁷³ Carol Davila Univ Med & Pharm, Dept Pharm, Bucharest, Romania
⁷⁴ Carol Davila Univ Med & Pharm, Dept Cardiol, Bucharest, Romania
⁷⁵ Carol Davila Univ Med & Pharm, Dept Gen Surg, Bucharest, Romania
⁷⁶ Carol Davila Univ Med & Pharm, Dept Legal Med & Bioeth, Bucharest, Romania
⁷⁷ Bucharest Univ Econ Studies, Dept Stat & Econometr, Bucharest, Romania
⁷⁸ Bucharest Univ Econ Studies, Dept Management, Bucharest, Romania
⁷⁹ UCL, Inst Global Hlth, London, England
⁸⁰ George Inst Global Hlth, Hlth Syst Sci Program, Newtown, NSW, Australia
⁸¹ Univ Philippines Manila, Dept Hlth Policy & Adm, Manila, Philippines
⁸² Hong Kong Polytech Univ, Dept Appl Social Sci, Hong Kong, Peoples R China
⁸³ Fdn Univ Islamabad, Dept Psychol, Rawalpandi, Pakistan
⁸⁴ Iran Univ Med Sci, Hlth Management & Econ Res Ctr, Tehran, Iran
⁸⁵ Iran Univ Med Sci, Student Res Comm, Tehran, Iran
⁸⁶ Iran Univ Med Sci, Prevent Med & Publ Hlth Res Ctr, Tehran, Iran
⁸⁷ Iran Univ Med Sci, Dept Physiol, Tehran, Iran
⁸⁸ Iran Univ Med Sci, Physiol Res Ctr, Tehran, Iran
⁸⁹ Iran Univ Med Sci, Tehran, Iran
⁹⁰ Birjand Univ Med Sci, Social Determinants Hlth Res Ctr, Birjand, Iran
⁹¹ Tashkent Inst Postgrad Med Educ, Publ Hlth & Healthcare Management, Tashkent, Uzbekistan
⁹² Boston Childrens Hosp, Boston, MA USA
⁹³ Univ Vita Salute San Raffaele, Sci Inst San Raffaele Hosp, Milan, Italy
⁹⁴ Univ Lahore, Univ Inst Radiol Sci & Med Imaging Technol, Lahore, Pakistan
⁹⁵ Univ Lahore, Fac Allied Hlth Sci, Lahore, Pakistan
⁹⁶ Univ Lahore, Univ Inst Publ Hlth, Lahore, Pakistan
⁹⁷ Bahir Dar Univ, Dept Hlth Syst & Hlth Econ, Bahir Dar, Ethiopia
⁹⁸ Univ Leicester, Sch Business, Leicester, Leics, England
⁹⁹ Natl Inst Publ Hlth, Ctr Hlth Syst Res, Cuernavaca, Morelos, Mexico
¹⁰⁰ Natl Inst Publ Hlth, Ctr Nutr & Hlth Res, Cuernavaca, Morelos, Mexico
¹⁰¹ Capella Univ, Sch Nursing & Hlth Sci, Minneapolis, MN USA
¹⁰² Univ Nevada, Continuing Educ Writing Acad, Las Vegas, NV 89154 USA
¹⁰³ Curtin Univ, Sch Publ Hlth, Perth, WA, Australia
¹⁰⁴ RAND Corp, Badan Pusat Stat Cent Bur Stat, Santa Monica, CA USA
¹⁰⁵ Univ KwaZulu Natal, Discipline Publ Hlth Med, Durban, South Africa
¹⁰⁶ Univ Lagos, Dept Community Hlth & Primary Care, Lagos, Nigeria
¹⁰⁷ Univ Lagos, Dept Psychiat, Lagos, Nigeria
¹⁰⁸ Shiraz Univ Med Sci, Dept Healthcare Management & Educ, Shiraz, Iran
¹⁰⁹ Shiraz Univ Med Sci, Hlth Human Resources Res Ctr, Shiraz, Iran
¹¹⁰ Shiraz Univ Med Sci, Noncommunicable Dis Res Ctr, Shiraz, Iran
¹¹¹ Shiraz Univ Med Sci, Ctr Hlth Policy Res, Shiraz, Iran
¹¹² Univ Sultan Zainal Abidin Sultan Zainal Abidin Un, Biochem Unit, Kuala Terengganu, Malaysia
¹¹³ Univ Sultan Zainal Abidin Sultan Zainal Abidin Un, Fac Business & Management, Kuala Terengganu, Malaysia
¹¹⁴ Med Univ Lodz, Dept Hypertens, Lodz, Poland
¹¹⁵ Polish Mothers Mem Hosp Res Inst, Lodz, Poland
¹¹⁶ Hamedan Univ Med Sci, Deputy Res & Technol, Hamadan, Hamadan, Iran
¹¹⁷ Heidelberg Univ, Heidelberg Inst Global Hlth, Heidelberg, Germany
¹¹⁸ Heidelberg Univ, Dept Ophthalmol, Heidelberg, Germany
¹¹⁹ Harvard Univ, TH Chan Sch Publ Hlth, Boston, MA 02115 USA
¹²⁰ Harvard Univ, Ctr Primary Care, Boston, MA 02115 USA
¹²¹ Harvard Univ, Div Gen Internal Med, Boston, MA 02115 USA
¹²² Univ Gambia, Dept Publ & Environm Hlth, Brikama, Gambia
¹²³ Minist Hlth, Epidemiol & Dis Control Unit, Kotu, Gambia
¹²⁴ Imperial Coll London, Sch Publ Hlth, London, England
¹²⁵ Imperial Coll London, Imperial Coll Business Sch, London, England
¹²⁶ Imperial Coll London, Dept Primary Care & Publ Hlth, London, England
¹²⁷ Imperial Coll London, WHO Collaborating Ctr Publ Hlth Educ & Training, London, England
¹²⁸ Univ Munster, Dept Psychiat, Munster, Germany
¹²⁹ Melbourne Med Sch, Dept Psychiat, Melbourne, Vic, Australia
¹³⁰ NYU, Dept Epidemiol & Hlth Promot, New York, NY USA
¹³¹ NYU, Sch Global Publ Hlth, New York, NY USA
¹³² Augusta Univ, Med Coll Georgia, Dept Med, Augusta, GA USA
¹³³ Charles Univ Prague, Dept Social & Clin Pharm, Hradec Kralova, Czech Republic
¹³⁴ United Arab Emirates Univ, Inst Publ Hlth, Al Ain, U Arab Emirates
¹³⁵ Govt Med Coll Pali, Dept Anat, Pali, India
¹³⁶ All India Inst Med Sci, Dept Community Med & Family Med, Jodhpur, Rajasthan, India
¹³⁷ All India Inst Med Sci, Sch Publ Hlth, Jodhpur, Rajasthan, India
¹³⁸ All India Inst Med Sci, Dept Pharmacol, Jodhpur, Rajasthan, India
¹³⁹ All India Inst Med Sci, Dept Forens Med & Toxicol, Jodhpur, Rajasthan, India
¹⁴⁰ NSW Brain Clot Bank, Neurovasc Imaging Lab, Sydney, NSW, Australia
¹⁴¹ South West Sydney Local Heath Dist & Liverpool Ho, Dept Neurol & Neurophysiol, Sydney, NSW, Australia
¹⁴² Univ Agr Faisalabad, Inst Soil & Environm Sci, Faisalabad, Pakistan
¹⁴³ Babol Univ Med Sci, Social Determinants Hlth Res Ctr, Babol, Iran
¹⁴⁴ Amer Univ Sharjah, Sch Business Adm, Sharjah, U Arab Emirates
¹⁴⁵ Univ Genoa, Genoa, Italy
¹⁴⁶ Univ Florida, Dept Epidemiol, Gainesville, FL USA
¹⁴⁷ Univ Florida, Hlth Canc Ctr, Canc Populat Sci Program, Gainesville, FL USA
¹⁴⁸ Ohio State Univ, Psychiat & Behav Hlth Dept, Columbus, OH 43210 USA
¹⁴⁹ Ohio State Univ, Dept Psychol, Columbus, OH 43210 USA
¹⁵⁰ Ohio State Univ, Div Cardiovasc Med, Columbus, OH USA
¹⁵¹ RUDN Univ, Inst Med, Moscow, Russia
¹⁵² IM Sechenov First Moscow State Med Univ, Dept Epidemiol & Evidence Based Med, Moscow, Russia
¹⁵³ Tech Univ Berlin, Dept Hlth Care Management, Berlin, Germany
¹⁵⁴ Peruvian Univ Cayetano Heredia, Sch Publ Hlth & Adm, Lima, Peru
¹⁵⁵ Monash Univ, Sch Publ Hlth & Prevent Med, Melbourne, Vic, Australia
¹⁵⁶ Hosp Italiano Buenos Aires, Dept Internal Med, Buenos Aires, DF, Argentina
¹⁵⁷ Argentine Soc Med, Buenos Aires, DF, Argentina
¹⁵⁸ Univ Nacl Colombia, Epidemiol & Publ Hlth Evaluat Grp, Bogota, Colombia
¹⁵⁹ Inst Hlth Carlos III, Natl Sch Publ Hlth, Madrid, Spain
¹⁶⁰ Ottawa Hosp Res Inst, Clin Epidemiol Program, Ottawa, ON, Canada
¹⁶¹ Medanta Medicity, Dept Microbiol & Infect Control, Gurugram, India
¹⁶² Texila Amer Univ, Dept Publ Hlth, Georgetown, Guyana
¹⁶³ Univ Toronto, Dept Med, Toronto, ON, Canada
¹⁶⁴ Global Inst Publ Hlth, Thiruvananthapuram, Kerala, India
¹⁶⁵ Univ Bologna, Dept Med & Surg Sci, Bologna, Italy
¹⁶⁶ Univ Bologna, Dept Biomed & Neuromotor Sci, Bologna, Italy
¹⁶⁷ Kyoto Univ, Dept Hlth Informat, Kyoto, Japan
¹⁶⁸ Kyoto Univ, Grad Sch Med, Kyoto, Japan
¹⁶⁹ Mid Sweden Univ, Div Publ Hlth Sci, Sundsvall, Sweden
¹⁷⁰ Al Farabi Kazakh Natl Univ, Higher Sch Publ Hlth, Alma Ata, Kazakhstan
¹⁷¹ Publ Hlth Fdn India, Gurugram, India
¹⁷² Indian Council Med Res, New Delhi, India
¹⁷³ Clin Emergency Hosp Sf Pantelimon, Dept Surg, Bucharest, Romania
¹⁷⁴ Univ Fed Santa Catarina, Dept Clin Med, Florianopolis, SC, Brazil
¹⁷⁵ Dr Baba Sahib Ambedkar Med Coll & Hosp, Dept Community Med, Delhi, India
¹⁷⁶ Univ Peradeniya, Dept Community Med, Peradeniya, Sri Lanka
¹⁷⁷ Tabriz Univ Med Sci, Dept Hlth Policy & Management, Tabriz, Iran
¹⁷⁸ Tabriz Univ Med Sci, Dept Med Surg Nursing, Tabriz, Iran
¹⁷⁹ Tabriz Univ Med Sci, Social Determinants Hlth Res Ctr, Tabriz, Iran
¹⁸⁰ Univ Windsor, Off Inst Anal, Windsor, ON, Canada
¹⁸¹ Cairo Univ, Reference Lab Egyptian, Minist Higher Educ & Sci Res, Cairo, Egypt
¹⁸² Alexandria Univ, Pediat Dent & Dent Publ Hlth Dept, Alexandria, Egypt
¹⁸³ Hawassa Univ, Sch Nursing, Hawassa, Ethiopia
¹⁸⁴ Hawassa Univ, Sch Midwifery, Hawassa, Ethiopia
¹⁸⁵ Ravensburg Weingarten Univ Appl Sci, Inst Gerontol Hlth Serv & Nursing Res, Weingarten, Germany
¹⁸⁶ Natl Acad Med Sci Ukraine, Inst Gerontol, Kiev, Ukraine
¹⁸⁷ Univ Porto, Dept Community Med Informat & Hlth Decis Sci, Porto, Portugal
¹⁸⁸ Univ Porto, Associated Lab Green Chem, Porto, Portugal
¹⁸⁹ Univ Porto, Ctr Hlth Technol & Serv Res, Porto, Portugal
¹⁹⁰ Ctr Hlth Technol & Serv Res, Porto, Portugal
¹⁹¹ Kobe Univ, Dept Dermatol, Kobe, Hyogo, Japan
¹⁹² Semmelweis Univ, Hlth Serv Management Training Ctr, Budapest, Hungary
¹⁹³ Semmelweis Univ, Fac Hlth & Publ Adm, Budapest, Hungary
¹⁹⁴ Sapientia Hungarian Univ Transylvania, Dept Appl Social Sci, Targu Mures, Romania
¹⁹⁵ Cleveland Clin, Dept Cardiovasc Med, Cleveland, OH 44106 USA
¹⁹⁶ Cleveland Clin, Dept Hypertens & Nephrol, Cleveland, OH 44106 USA
¹⁹⁷ Cleveland Clin, Inst Heart & Vasc, Cleveland, OH 44106 USA
¹⁹⁸ Univ N Carolina, Gillings Sch Global Publ Hlth, Chapel Hill, NC 27515 USA
¹⁹⁹ Univ Autonoma Chile, Fac Business & Management, Talca, Chile
²⁰⁰ King Edward Mem Hosp, Dept Radiol, Mumbai, Maharashtra, India
²⁰¹ Islamic Azad Univ, Young Researchers & Elite Club, Rasht, Iran
²⁰² Islamic Azad Univ, Dept Biol, Tehran, Iran
²⁰³ Univ Muhammadiyah Kalimantan Timur, Dept Publ Hlth, Samarinda, Indonesia
²⁰⁴ Afro Asian Inst, Lahore, Pakistan
²⁰⁵ Indian Inst Publ Hlth, Hlth Syst & Policy Res, Gandhinagar, India
²⁰⁶ Indian Inst Publ Hlth, Dept Epidemiol, Gandhinagar, India
²⁰⁷ Univ Western Australia, Australia India Inst New Generat Network, Perth, WA, Australia
²⁰⁸ Univ Western Australia, UWA Publ Policy Inst, Perth, WA, Australia
²⁰⁹ Case Western Reserve Univ, Harrington Heart & Vasc Inst, Cleveland, OH 44106 USA
²¹⁰ Case Western Reserve Univ, Dept Nutr & Prevent Med, Cleveland, OH 44106 USA
²¹¹ Case Western Reserve Univ, Div Pediat Gastroenterol, Cleveland, OH 44106 USA
²¹² Deakin Univ, Sch Med, Geelong, Vic, Australia
²¹³ Macquarie Univ, Dept Clin Med, Sydney, NSW, Australia
²¹⁴ TH Chan Sch Publ Hlth, Dept Global Hlth & Populat, Boston, MA USA
²¹⁵ Ohio Univ, Dept Social & Publ Hlth, Athens, OH 45701 USA
²¹⁶ Univ Bergen, Dept Global Publ Hlth & Primary Care, Bergen, Norway
²¹⁷ Univ Bergen, Ctr Int Hlth, Bergen, Norway
²¹⁸ Univ Bergen, Bergen Ctr Ethics & Prior Setting, Bergen, Norway
²¹⁹ Hamdan Bin Mohammed Smart Univ, Sch Hlth & Environm Studies, Dubai, U Arab Emirates
²²⁰ Univ Syiah Kuala Syiah Kuala Univ, Med Res Unit, Banda Aceh, Indonesia
²²¹ Inst Publ Hlth Sci, Sekolah Tinggi Ilmu Kesehatan Indonesia Maju, Indonesian Adv Coll Hlth Sci, Jakarta, Indonesia
²²² Al Azhar Univ, Dept Zool & Entomol, Cairo, Egypt
²²³ Univ Vet & Anim Sci, Inst Pharmaceut Sci, Lahore, Pakistan
²²⁴ Xi An Jiao Tong Univ, Dept Pharm Adm & Clin Pharm, Xian, Shaanxi, Peoples R China
²²⁵ Cairo Univ, Dept Neurol, Cairo, Egypt
²²⁶ London South Bank Univ, Sch Business, London, England
²²⁷ Taiz Univ, Dept Appl Microbiol, Taizi, Yemen
²²⁸ Nankai Univ, Dept Microbiol, Tianjin, Peoples R China
²²⁹ Kasturba Med Coll & Hosp, Mangalore, India
²³⁰ Manipal Coll Pharmaceut Sci, Manipal, India
²³¹ Manipal Coll Dent Sci, Manipal, India
²³² Manipal Acad Higher Educ, Dept Community Med, Manipal, India
²³³ Manipal Acad Higher Educ, Dept Hlth Informat Management, Manipal, India
²³⁴ Int Ctr Diarrhoeal Dis Res, Maternal & Child Hlth Div, Dhaka, Bangladesh
²³⁵ Natl Inst Legal Med Mina Minovici, Clin Legal Med Dept, Bucharest, Romania
²³⁶ Univ Sydney, Sch Publ Hlth, Sydney, NSW, Australia
²³⁷ Univ Sydney, Sydney Med Sch, Sydney, NSW, Australia
²³⁸ Univ Sydney, Save Sight Inst, Sydney, NSW, Australia
²³⁹ China Med Univ, Dept Occupat Safety & Hlth, Taichung, Taiwan
²⁴⁰ Univ Naples Federico II, Dept Publ Hlth, Naples, Italy
²⁴¹ Bashkir State Med Univ, Dept Infect Dis, Ufa, Russia
²⁴² Moscow Inst Phys & Technol, Lab Publ Hlth Indicators Anal & Hlth Digitalizat, Moscow, Russia
²⁴³ Univ Ibadan, Dept Community Med, Ibadan, Nigeria
²⁴⁴ Univ Ibadan, Dept Med, Ibadan, Nigeria
²⁴⁵ Univ Coll Hosp, Dept Community Med, Ibadan, Nigeria
²⁴⁶ Univ Coll Hosp, Dept Med, Ibadan, Nigeria
²⁴⁷ Deakin Univ, Inst Phys Activ & Nutr, Burwood, Vic, Australia
²⁴⁸ Deakin Univ, Dept Econ, Burwood, Vic, Australia
²⁴⁹ MAHSA Univ, Dept Clin Pharm, Bandar Saujana Putra, Malaysia
²⁵⁰ Univ Catania, Dept Gen Surg & Surg Med Specialties, Catania, Italy
²⁵¹ Hosei Univ, Inst Comparat Econ Studies, Tokyo, Japan
²⁵² Univ Kragujevac, Dept Global Hlth Econ & Policy, Kragujevac, Serbia
²⁵³ Boston Univ, Hlth Informat Lab, Boston, MA 02215 USA
²⁵⁴ Boston Univ, Dept Comp Sci, Boston, MA 02215 USA
²⁵⁵ Minist Hlth, Ctr Studies & Res, Muscat, Oman
²⁵⁶ Univ Colombo, Dept Physiol, Colombo, Sri Lanka
²⁵⁷ Univ Colombo, Dept Pharmacol, Colombo, Sri Lanka
²⁵⁸ Queensland Univ Technol, Sch Exercise & Nutr Sci, Brisbane, Qld, Australia
²⁵⁹ Univ Florida, Dept Urol, Jacksonville, FL USA
²⁶⁰ Dr Baba Saheb Ambedkar Med Coll & Hosp, Dept Community Med, Delhi, India
²⁶¹ Banaras Hindu Univ, Dept Community Med, Varanasi, Uttar Pradesh, India
²⁶² Beijing Tongren Hosp, Beijing Inst Ophthalmol, Beijing, Peoples R China
²⁶³ Guilan Univ Med Sci, Gastrointestinal & Liver Dis Res Ctr, Rasht, Iran
²⁶⁴ Guilan Univ Med Sci, Caspian Digest Dis Res Ctr, Rasht, Iran
²⁶⁵ Univ Tartu, Inst Family Med & Publ Hlth, Tartu, Estonia
²⁶⁶ Flinders Univ S Australia, Hlth Econ Unit, Adelaide, SA, Australia
²⁶⁷ Flinders Univ S Australia, Coll Med & Publ Hlth, Adelaide, SA, Australia
²⁶⁸ Flinders Univ S Australia, Hlth & Social Care Econ Grp, Adelaide, SA, Australia
²⁶⁹ Qazvin Univ Med Sci, Inst Prevent Noncommunicable Dis, Qazvin, Iran
²⁷⁰ Qazvin Univ Med Sci, Hlth Serv Management Dept, Qazvin, Iran
²⁷¹ South Eastern Sydney Local Hlth Dist, Sydney Eye Hosp, Sydney, NSW, Australia
²⁷² Kermanshah Univ Med Sci, Res Ctr Environm Determinants Hlth, Kermanshah, Iran
²⁷³ Kermanshah Univ Med Sci, Dept Publ Hlth, Kermanshah, Iran
²⁷⁴ Kermanshah Univ Med Sci, Social Dev & Hlth Promot Res Ctr, Kermanshah, Iran
²⁷⁵ Kermanshah Univ Med Sci, Dept Hlth Educ & Hlth Promot, Kermanshah, Iran
²⁷⁶ Inst Human Virol Nigeria, Int Res Ctr Excellence, Abuja, Nigeria
²⁷⁷ Univ Utrecht, Julius Ctr Hlth Sci & Primary Care, Utrecht, Netherlands
²⁷⁸ Alborz Univ Med Sci, Sch Hlth, Karaj, Iran
²⁷⁹ Jordan Univ Sci & Technol, Dept Publ Hlth, Irbid, Jordan
²⁸⁰ Amity Univ, Amity Inst Forens Sci, Noida, India
²⁸¹ Baku State Univ, Dept Biophys & Biochem, Baku, Azerbaijan
²⁸² Moscow State Pedag Univ, Russian Inst Adv Study, Moscow, Russia
²⁸³ Zahedan Univ Med Sci, Hlth Promot Res Ctr, Zahedan, Iran
²⁸⁴ Int Inst Populat Sci, Dept Populat Studies, Mumbai, Maharashtra, India
²⁸⁵ Int Inst Populat Sci, Dept Dev Studies, Mumbai, Maharashtra, India
²⁸⁶ Int Inst Populat Sci, Dept Publ Hlth & Mortal Studies, Mumbai, Maharashtra, India
²⁸⁷ New Mexico State Univ, Dept Publ Hlth, Las Cruces, NM 88003 USA
²⁸⁸ Yonsei Univ, Dept Prevent Med, Seoul, South Korea
²⁸⁹ Yonsei Univ, Inst Hlth Serv Res, Seoul, South Korea
²⁹⁰ Xiamen Univ Malaysia, Sch Tradit Chinese Med, Sepang, Malaysia
²⁹¹ Kristiania Univ Coll, Sch Hlth Sci, Oslo, Norway
²⁹² Tulane Univ, Dept Global Community Hlth & Behav Sci, New Orleans, LA 70118 USA
²⁹³ Oslo Metropolitan Univ, Dept Nursing & Hlth Promot, Oslo, Norway
²⁹⁴ Eastern Virginia Med Sch, Microbiol & Mol Cell Biol Dept, Norfolk, VA 23501 USA
²⁹⁵ Kasturba Med Coll & Hosp, Udupi, India
²⁹⁶ CIBERSAM, San Juan de Dios Sanit Pk, Sant Boi De Llobregat, Spain
²⁹⁷ Catalan Inst Res & Adv Studies, Barcelona, Spain
²⁹⁸ Panjab Univ, Dept Anthropol, Chandigarh, India
²⁹⁹ Univ Indonesia, Fac Publ Hlth, Depok, Indonesia
³⁰⁰ European Univ Cyprus, Dept Hlth Sci, Nicosia, Cyprus
³⁰¹ HelpMeSee, New York, NY USA
³⁰² Mexican Inst Ophthalmol, Queretaro, Mexico
³⁰³ Uppsala Univ, Dept Med Sci, Uppsala, Sweden
³⁰⁴ Uppsala Univ Hosp, Dept Clin Chem & Pharmacol, Uppsala, Sweden
³⁰⁵ Father Muller Med Coll, Dept Otorhinolaryngol, Mangalore, India
³⁰⁶ Monash Univ, Sch Pharm, Bandar Sunway, Malaysia
³⁰⁷ Taylors Univ Lakeside Campus, Sch Pharm, Subang Jaya, Malaysia
³⁰⁸ Univ Sci Malaysia, Dept Med, Kota Baharu, Kelantan, Malaysia
³⁰⁹ Univ Sci Malaysia, Sch Med Sci, Kota Baharu, Kelantan, Malaysia
³¹⁰ Meharry Med Coll, Dept Profess & Med Educ, Nashville, TN 37208 USA
³¹¹ Mercer Univ, Dept Biomed Sci, Macon, GA 31207 USA
³¹² Egypt Minist Hlth & Populat, Dept Radiol, Mansoura, Egypt
³¹³ Minist Hlth & Populat, Dept Ophthalmol, Aswan, Egypt
³¹⁴ Saveh Univ Med Sci, Social Determinants Hlth Res Ctr, Saveh, Iran
³¹⁵ Univ Sharjah, Mass Commun Dept, Sharjah, U Arab Emirates
³¹⁶ Kurdistan Univ Med Sci, Environm Hlth Res Ctr, Sanandaj, Iran
³¹⁷ Kurdistan Univ Med Sci, Social Determinants Hlth Res Ctr, Sanandaj, Iran
³¹⁸ Emergency Univ Hosp Bucharest, Gen Surg Dept 1, Bucharest, Romania
³¹⁹ Technol Inst Coll Bolivar, Inst Tecnol Colegio Mayor de Bolivar, Cartagena, Colombia
³²⁰ Univ Nacl Autonoma Mexico, Hlth Policy & Populat Res Ctr, Mexico City, DF, Mexico
³²¹ Univ Coverage, Joint Learning Network, Arlington, VA USA
³²² Hamadan Univ Med Sci, Dept Midwifery, Hamadan, Hamadan, Iran
³²³ Mahidol Univ, Mahidol Oxford Trop Med Res Unit, Bangkok, Thailand
³²⁴ London Sch Hyg & Trop Med, Dept Hlth Serv Res & Policy, London, England
³²⁵ London Sch Hyg Trop Med, Dept Dis Control, London, England
³²⁶ Autonomous Univ Hidalgo State, Dept Dent, Pachuca, Hidalgo, Mexico
³²⁷ Helsinki Univ Hosp, Neurol Unit, Helsinki, Finland
³²⁸ Helsinki Univ Hosp, Breast Surg Unit, Helsinki, Finland
³²⁹ Univ Melbourne, Sch Hlth Sci, Melbourne, Vic, Australia
³³⁰ Univ Helsinki, Helsinki, Finland
³³¹ Menoufia Univ, Dept Orthopaed Surg, Shibin Al Kawm, Egypt
³³² Dr Zora Profoz Polyclin, Clin Microbiol & Parasitol Unit, Zagreb, Croatia
³³³ Univ North, Univ Ctr Varazdin, Varazhdin, Croatia
³³⁴ Inst Social Innovat, Skopje, North Macedonia
³³⁵ Ctr Reg Policy Res & Cooperat Studiorum, Hlth Policy & Management, Calverton, MD USA
³³⁶ Pacific Inst Res & Evaluat, Calverton, MD USA
³³⁷ Ananthapuri Hosp & Res Inst, Global Inst Publ Hlth, Trivandrum, Kerala, India
³³⁸ Womens Social & Hlth Studies Fdn, Trivandrum, Kerala, India
³³⁹ Kyrgyz State Med Acad, Internal Med Programme, Bishkek, Kyrgyzstan
³⁴⁰ Natl Ctr Cardiol & Internal Dis, Dept Atherosclerosis & Coronary Heart Dis, Bishkek, Kyrgyzstan
³⁴¹ Univ Duhok, Coll Dent, Duhok, Iraq
³⁴² Lebanese French Univ, Dept Informat Technol, Erbil, Iraq
³⁴³ Shahrekord Univ Med Sci, Dept Epidemiol & Biostat, Shahrekord, Iran
³⁴⁴ Ahmadu Bello Univ, Hlth Syst & Policy Res Unit, Zaria, Nigeria
³⁴⁵ Kings Coll London, Fac Life Sci & Med, London, England
³⁴⁶ Pabna Univ Sci & Technol, Dept Comp Sci & Engn, Pabna, Bangladesh
³⁴⁷ Univ Warmia & Mazury, Dept Cardiol & Cardiac Surg, Olsztyn, Poland
³⁴⁸ Kerman Univ Med Sci, Management & Leadership Med Educ Res Ctr, Kerman, Iran
³⁴⁹ Kerman Univ Med Sci, Hlth Serv Management Res Ctr, Kerman, Iran
³⁵⁰ Kerman Univ Med Sci, Dept Hlth Management Policy & Econ, Kerman, Iran
³⁵¹ Univ Nairobi, Sch Econ, Nairobi, Kenya
³⁵² Univ Nairobi, Sch Publ Hlth, Nairobi, Kenya
³⁵³ Mekelle Univ, Dept Med Microbiol & Immunol, Mekelle, Ethiopia
³⁵⁴ Mekelle Univ, Sch Pharm, Mekelle, Ethiopia
³⁵⁵ Saveetha Inst Med & Tech Sci, Saveetha Dent Coll, Chennai, Tamil Nadu, India
³⁵⁶ Initiat Financing Hlth & Human Dev, Res & Analyt Dept, Chennai, Tamil Nadu, India
³⁵⁷ Bioinsilico Technol, Dept Res & Analyt, Chennai, Tamil Nadu, India
³⁵⁸ Natl Res Univ Higher Sch Econ, Grad Sch Business, Moscow, Russia
³⁵⁹ Natl Res Univ Higher Sch Econ, Dept Hlth Care Adm & Econ, Moscow, Russia
³⁶⁰ Suraj Eye Inst, Nagpur, Maharashtra, India
³⁶¹ Univ Sci Malaysia, Discipline Social & Adm, Petaling Jaya, Penang, Malaysia
³⁶² Univ Fed Minas Gerais, Dept Clin Med, Belo Horizonte, MG, Brazil
³⁶³ Univ Fed Minas Gerais, Clin Hosp, Belo Horizonte, MG, Brazil
³⁶⁴ Univ Cent Punjab, Dept Biotechnol, Lahore, Pakistan
³⁶⁵ Makerere Univ, Dept Dis Control & Environm Hlth, Kampala, Uganda
³⁶⁶ Emergency Hosp Bucharest, Dept Gen Surg, Bucharest, Romania
³⁶⁷ Bupa, Bupa Clemton Pk, Sydney, NSW, Australia
³⁶⁸ Duy Tan Univ, Inst Global Hlth Innovat, Da Nang, Vietnam
³⁶⁹ Duy Tan Univ, Fac Med, Da Nang, Vietnam
³⁷⁰ Duy Tan Univ, Inst Res & Dev, Da Nang, Vietnam
³⁷¹ Univ Ghana, Sch Publ Hlth, Accra, Ghana
³⁷² Univ Adelaide, Ctr Heart Rhythm Disorders, Adelaide, SA, Australia
³⁷³ Natl Hosp, Dept Pediat, Abuja, Nigeria
³⁷⁴ Univ Liverpool, Dept Int Publ Hlth, Liverpool, Merseyside, England
³⁷⁵ Univ Bucharest, Adm & Econ Sci Dept, Bucharest, Romania
³⁷⁶ United Nations Childrens Fund, Social Policy Program, Abuja, Nigeria
³⁷⁷ McMaster Univ, Dept Psychiat & Behav Neurosci, Hamilton, ON, Canada
³⁷⁸ Natl AIDS Control Comm, Community Prevent & Care Serv, Abuja, Nigeria
³⁷⁹ Univ Bergamo, Dept Management Econ & Quantitat Methods, Bergame, Italy
³⁸⁰ Ctr Healthy Start Initiat, Lagos, Nigeria
³⁸¹ Univ Nigeria Nsukka, Dept Pharmacol & Therapeut, Enugu, Nigeria
³⁸² Yale Univ, Dept Genet, New Haven, CT USA
³⁸³ Univ New South Wales, Sch Optometry & Vis Sci, Sydney, NSW, Australia
³⁸⁴ City Hlth & Sci Univ Hosp Turin, SSD Epidemiol Screening, Turin, Italy
³⁸⁵ Univ Groningen, Univ Med Ctr Groningen, Groningen, Netherlands
³⁸⁶ Univ Groningen, Sch Business & Econ, Groningen, Netherlands
³⁸⁷ Fdn Valle del Lili, Clin Res Ctr, Cali, Colombia
³⁸⁸ Univ ICESI, Ctr PROESA, Cali, Colombia
³⁸⁹ Amirkabir Univ Technol, Dept Biomed Engn, Tehran, Iran
³⁹⁰ Sharif Univ Technol, Dept Chem, Tehran, Iran
³⁹¹ Ahvaz Jundishapur Univ Med Sci, Thalassemia & Hemoglobinopathy Res Ctr, Ahvaz, Iran
³⁹² Ahvaz Jundishapur Univ Med Sci, Educ Dev Ctr, Ahvaz, Iran
³⁹³ Maharishi Markandeshwar Med Coll & Hosp, Dept Community Med, Solan, India
³⁹⁴ Rajshahi Univ, Dept Populat Sci & Human Resource Dev, Rajshahi, Bangladesh
³⁹⁵ Natl Yunlin Univ Sci & Technol, Future Technol Res Ctr, Touliu, Yunlin, Taiwan
³⁹⁶ Policy Res Inst, Res Dept, Kathmandu, Nepal
³⁹⁷ Global Ctr Res & Dev, Hlth & Publ Policy Dept, Kathmandu, Nepal
³⁹⁸ Univ Coll London Hosp, London, England
³⁹⁹ Publ Hlth England, Acad Publ Hlth England, London, England
⁴⁰⁰ CQ Univ, Sch Hlth Med & Appl Sci, Sydney, NSW, Australia
⁴⁰¹ Western Sydney Univ, Sch Med, Campbelltown, NSW, Australia
⁴⁰² Western Sydney Univ, Translat Hlth Res Inst, Campbelltown, NSW, Australia
⁴⁰³ Jahangirnagar Univ, Dept Publ Hlth & Informat, Dhaka, Bangladesh
⁴⁰⁴ Univ Calif San Francisco, Hlth Hub, San Francisco, CA 94143 USA
⁴⁰⁵ Ain Shams Univ, Dept Entomol, Cairo, Egypt
⁴⁰⁶ Northern Reg Hlth Adm, Publ Hlth Unit, Vila Nova De Gaia, Portugal
⁴⁰⁷ Univ Belgrade, Fac Med, Belgrade, Serbia
⁴⁰⁸ Univ Belgrade, Sch Publ Hlth & Hlth Management, Belgrade, Serbia
⁴⁰⁹ Bournemouth Univ, Fac Hlth & Social Sci, Bournemouth, Dorset, England
⁴¹⁰ GlaxoSmithKline Biol, Wavre, Belgium
⁴¹¹ Datta Meghe Inst Med Sci, Dept Community Med, Wardha, India
⁴¹² Charite Univ Med Ctr Berlin, Oral Diag Digital Hlth & Hlth Serv Res, Berlin, Germany
⁴¹³ Manian Med Ctr, Emergency Dept, Erode, India
⁴¹⁴ NHLBI, NIH, Rockville, MD USA
⁴¹⁵ Univ Edinburgh, Med Informat Ctr, Edinburgh, Midlothian, Scotland
⁴¹⁶ Manipal Acad Higher Educ, Dept Obstet & Gynaecol, Mangalore, India
⁴¹⁷ Manipal Acad Higher Educ, Dept Forens Med, Mangalore, India
⁴¹⁸ Univ Tokyo, Tokyo, Japan
⁴¹⁹ Royal Coll Surgeons Ireland, Inst Global Surg, Dublin, Ireland
⁴²⁰ Quaid I Azam Univ, Natl Inst Psychol, Islamabad, Pakistan
⁴²¹ Univ Alabama Birmingham, Sch Med, Birmingham, AL USA
⁴²² US Dept Vet Affairs VA, Med Serv, Birmingham, AL USA
⁴²³ Moscow Res & Pract Ctr Addict, Dept 16, Moscow, Russia
⁴²⁴ Moscow Res & Pract Ctr Addict, Lab Genet & Genom, Moscow, Russia
⁴²⁵ Balashiha Cent Hosp, Dept Therapeut, Balashikha, Russia
⁴²⁶ Univ Valencia, Dept Med, Valencia, Spain
⁴²⁷ Carlos III Hlth Inst, Biomed Res Networking Ctr Mental Hlth Network CIB, Madrid, Spain
⁴²⁸ Arbaminch Coll Hlth Sci, Dept Pharm, Arba Minch, Ethiopia
⁴²⁹ Univ Hosp Rainbow Babies, Dept Pediat, Cleveland, OH USA Childrens Hosp, Cleveland, OH USA;
⁴³⁰ Natl Inst Populat & Social Secur Res, Dept Social Secur Empir Res, Tokyo, Japan
⁴³¹ Jagiellonian Univ Med Coll, Inst Publ Hlth, Krakow, Poland
⁴³² Agcy Hlth Technol Assessment & Tariff Syst, Warsaw, Poland
⁴³³ Univ Sao Paulo, Dept Pathol & Legal Med, Ribeirao Preto, Brazil
⁴³⁴ Modestum, London, England
⁴³⁵ Hanoi Med Univ, Dept Hlth Econ, Hanoi, Vietnam
⁴³⁶ Nanyang Technol Univ, Lee Kong Chian Sch Med, Singapore, Singapore
⁴³⁷ Natl Univ Med Sci, Multidisciplinary Dept, Rawalpindi, Pakistan
⁴³⁸ Pontificia Univ Catolica Chile, Sch Govt, Santiago, Chile
⁴³⁹ Velez Sarsfield Hosp, Buenos Aires, DF, Argentina
⁴⁴⁰ UKK Inst, Tampere, Finland
⁴⁴¹ IRCCS Fdn Don Carlo Gnocchi, Don Carlo Gnocchi Fdn, Dept Clin Res, Milan, Italy
⁴⁴² St Orsola Malpighi Hosp, Occupat Hlth Unit, Bologna, Italy
⁴⁴³ Ho Chi Minh City Univ Technol, Fac Informat Technol, Ho Chi Minh City, Vietnam
⁴⁴⁴ Univ Gottingen, Dept Econ, Gottingen, Germany
⁴⁴⁵ Nguyen Tat Thanh Univ, Ctr Excellence Behav Med, Ho Chi Minh City, Vietnam
⁴⁴⁶ Northeastern Univ, Cultures Societies & Global Studies & Integrated, Boston, MA 02115 USA
⁴⁴⁷ Fed Inst Populat Res, Demog Change & Aging Res Area, Wiesbaden, Germany
⁴⁴⁸ Ethiopian Publ Hlth Inst, Natl Data Management Ctr Hlth, Addis Ababa, Ethiopia
⁴⁴⁹ Univ Newcastle, Res Ctr Generat Hlth & Ageing, Newcastle, NSW, Australia
⁴⁵⁰ Nanjing Univ, Sch Med, Nanjing, Jiangsu, Peoples R China
⁴⁵¹ Univ Ottawa, Sch Int Dev & Global Studies, Ottawa, ON, Canada
⁴⁵² Suleyman Demirel Univ, Dept Hlth Management, Isparta, Turkey
⁴⁵³ Univ Hong Kong, Ctr Suicide Res & Prevent, Hong Kong, Peoples R China
⁴⁵⁴ Univ Hong Kong, Dept Social Work & Social Adm, Hong Kong, Peoples R China
⁴⁵⁵ Natl Ctr Neurol & Psychiat, Dept Neuropsychopharmacol, Kodaira, Tokyo, Japan
⁴⁵⁶ Juntendo Univ, Dept Publ Hlth, Tokyo, Japan
⁴⁵⁷ Jackson State Univ, Dept Hlth Policy & Management, Jackson, MS USA
⁴⁵⁸ Tsinghua Univ, Sch Med, Beijing, Peoples R China
⁴⁵⁹ Wuhan Univ, Dept Epidemiol & Biostat, Wuhan, Hubei, Peoples R China
⁴⁶⁰ Wuhan Univ, Sch Med, Wuhan, Hubei, Peoples R China
⁴⁶¹ Univ South Carolina, Dept Clin Pharm & Outcomes Sci, Columbia, SC 29208 USA
⁴⁶² Ardabil Univ Med Sci, Social Determinants Hlth Res Ctr, Ardebil, Iran
⁴⁶³ Ardabil Univ Med Sci, Dept Community Med, Ardebil, Iran
⁴⁶⁴ Russian Med Acad Continuous Profess Educ, Addictol Dept, Moscow, Russia
⁴⁶⁵ Russian Med Acad Continuous Profess Educ, Dept Pediat, Moscow, Russia
⁴⁶⁶ Dept Hlth Philippines, Hlth Technol Assessment Unit, Manila, Philippines
⁴⁶⁷ MentalHealthPH, Quezon City, Philippines

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