Query: overview of the  financial system

title: Overview of the Financial System
abstract: This chapter describes the overall financial system, and does a detailed taxonomy of the types of financial assets and markets. It also discusses the role of penalties in enforcing contracts.

title: An overview of the financial system

title: Overview of the Financial System
abstract: Malaysia has a modern and comprehensive financial system that continues to evolve in response to the changing domestic and international conditions. Financial reforms, including the structural changes that proceeded after the Asian financial crisis, have evolved a more diversified, broader and deeper financial system, supporting Malaysia's economic growth through a more efficient intermediation process and strengthening Malaysia's interlinkages with the global economy and international financial system.

title: An Overview of Financial System in Indian Context

title: Financial arrangements for health systems in low income countries: an overview of systematic reviews
abstract: One target of the Sustainable Development Goals is to achieve "universal health coverage, including financial risk protection, access to quality essential health care services and access to safe, effective, quality and affordable essential medicines and vaccines for all" A fundamental concern of governments in striving for this goal is how to finance such a health system. This concern is very relevant for low income countries.  To provide an overview of the evidence from up to date systematic reviews about the effects of financial arrangements for health systems in low income countries. Secondary objectives include identifying needs and priorities for future evaluations and systematic reviews on financial arrangements, and informing refinements in the framework for financial arrangements presented in the overview.  We searched Health Systems Evidence in November 2010 and PDQ Evidence up to 17 December 2016 for systematic reviews. We did not apply any date, language, or publication status limitations in the searches. We included well conducted systematic reviews of studies that assessed the effects of financial arrangements on patient outcomes (health and health behaviours) the quality or utilisation of healthcare services, resource use, healthcare provider outcomes (such as sick leave) or social outcomes (such as poverty, employment, or financial burden of patients, e.g. out of pocket payment, catastrophic disease expenditure) and that were published after April 2005. We excluded reviews with limitations important enough to compromise the reliability of the findings. Two overview authors independently screened reviews, extracted data, and assessed the certainty of evidence using GRADE. We prepared SUPPORT Summaries for eligible reviews, including key messages, 'Summary of findings' tables (using GRADE to assess the certainty of the evidence) and assessments of the relevance of findings to low income countries.  We identified 7272 reviews and included 15 in this overview, on: collection of funds (2 reviews) insurance schemes (1 review) purchasing of services (1 review) recipient incentives (6 reviews) and provider incentives (5 reviews) The reviews were published between 2008 and 2015; focused on 13 subcategories; and reported results from 276 studies: 115 (42% randomised trials, 11 (4% non randomised trials, 23 (8% controlled before after studies, 51 (19% interrupted time series, 9 (3% repeated measures, and 67 (24% other non randomised studies. Forty three per cent (119/276) of the studies included in the reviews took place in low and middle income countries. Collection of funds: the effects of changes in user fees on utilisation and equity are uncertain (very low certainty evidence) It is also uncertain whether aid delivered under the Paris Principles (ownership, alignment, harmonisation, managing for results, and mutual accountability) improves health outcomes compared to aid delivered without conforming to those principles (very low certainty evidence) Insurance schemes: community based health insurance may increase service utilisation (low certainty evidence) but the effects on health outcomes are uncertain (very low certainty evidence) It is uncertain whether social health insurance improves utilisation of health services or health outcomes (very low certainty evidence) Purchasing of services: it is uncertain whether increasing salaries of public sector healthcare workers improves the quantity or quality of their work (very low certainty evidence) Recipient incentives: recipient incentives may improve adherence to long term treatments (low certainty evidence) but it is uncertain whether they improve patient outcomes. One time recipient incentives probably improve patient return for start or continuation of treatment (moderate certainty evidence) and may improve return for tuberculosis test readings (low certainty evidence) However, incentives may not improve completion of tuberculosis prophylaxis, and it is uncertain whether they improve completion of treatment for active tuberculosis. Conditional cash transfer programmes probably lead to an increase in service utilisation (moderate certainty evidence) but their effects on health outcomes are uncertain. Vouchers may improve health service utilisation (low certainty evidence) but the effects on health outcomes are uncertain (very low certainty evidence) Introducing a restrictive cap may decrease use of medicines for symptomatic conditions and overall use of medicines, may decrease insurers' expenditures on medicines (low certainty evidence) and has uncertain effects on emergency department use, hospitalisations, and use of outpatient care (very low certainty evidence) Reference pricing, maximum pricing, and index pricing for drugs have mixed effects on drug expenditures by patients and insurers as well as the use of brand and generic drugs.  Research based on sound systematic review methods has evaluated numerous financial arrangements relevant to low income countries, targeting different levels of the health systems and assessing diverse outcomes. However, included reviews rarely reported social outcomes, resource use, equity impacts, or undesirable effects. We also identified gaps in primary research because of uncertainty about applicability of the evidence to low income countries. Financial arrangements for which the effects are uncertain include external funding (aid) caps and co payments, pay for performance, and provider incentives. Further studies evaluating the effects of these arrangements are needed in low income countries. Systematic reviews should include all outcomes that are relevant to decision makers and to people affected by changes in financial arrangements.

title: An overview of advances in global maternal health: From broad to specific improvements
abstract: After the declaration of the Millennium Development Goals in 2000 by the United Nations, many stakeholders allocated financial resources to "global maternal health." Research to expand care and improve delivery of maternal health services has exponentially increased. The present article highlights an overview, namely 10 of the health system, clinical, and technology based advancements that have occurred in the past three decades in the field of global maternal health. The list of topics has been selected through the cumulative clinical and public health expertise of the authors and is certainly not exhaustive. Rather, the list is intended to provide a mapping of key topics arranged from broad to specific that span from the global policy level to the level of individual care. The list of health system, clinical, and technology based advancements include: (10) Millennium Development Goals and Sustainable Development Goals; (9) Development of clinical training programs, including the potential for subspecialty development; (8) Prenatal care expansion and potential; (7) Decentralized health systems, including the use of skilled birth attendants; (6) Antiretroviral therapy for HIV; (5) Essential medicines; (4) Vaccines; (3) mHealth/eHealth; (2) Ultrasonography; and (1) Obstetric hemorrhage management. With the Sustainable Development Goals now underway, the field must build upon past successes to sustain maternal and neonatal well being in the future global health agenda.

title: Adhesion prevention agents for gynaecological surgery: an overview of Cochrane reviews.
abstract: Intraperitoneal adhesions are associated with considerable co morbidity and have large financial and public health repercussions. They have secondary effects that include chronic pelvic pain, dyspareunia, subfertility and bowel obstruction. In women with adhesions, subsequent surgery is more difficult, often takes longer, and is associated with a higher complication rate (Broek 2013) The significant burden of adhesions has led to the development of several anti adhesion agents, although there is disagreement as to their relative effectiveness.  To summarise evidence derived from Cochrane systematic reviews on the clinical safety and effectiveness of solid agents, gel agents, liquid agents and pharmacological agents, used as adjuvants to prevent formation of adhesions after gynaecological pelvic surgery.  The Cochrane Database of Systematic Reviews was searched using the keyword 'adhesion' up to August 2014. The Cochrane information management system was also searched for any titles or protocols of reviews in progress. Two review authors independently extracted information from the reviews, with disagreements being resolved by a third review author. The quality of the included reviews was described in a narrative manner, and the AMSTAR tool was used to formally assess each review included in this overview. The quality of evidence provided in the original reviews was described using GRADE methods.  We included two reviews, one with 18 studies comparing solid agents (oxidised regenerated cellulose expanded polytetrafluoroethylene, sodium hyaluronate and carboxymethylcellulose, and fibrin sheets) with control or with each other. The other review included 29 studies which compared liquid agents (4% icodextrin, 32% dextran, crystalloids) gel agents (carboxymethylcellulose and polyethylene oxide, polyethylene glycol gels, hyaluronic acid based gel, 0.5% ferric hyaluronate gel, sodium hyaluronate spray) and pharmacological agents (gonadotrophin releasing hormone agonist, reteplase plasminogen activator, N,O carboxymethyl chitosan, steroid agents, intraperitoneal noxytioline, intraperitoneal heparin, systemic promethazine) with control or each other. Both reviews met all of the criteria of the AMSTAR assessment.The reviews included as outcomes both the primary outcomes of this overview (pelvic pain, pregnancy, live birth rate and quality of life (QoL) and our secondary outcomes (adverse effects, presence or absence of adhesions at second look laparoscopy (SLL) and adhesion score) However, neither of the reviews identified any primary studies of solid, gel or pharmacological agents that reported any of our primary outcomes. The only studies in either review that reported any of our primary outcomes were studies comparing liquid agents versus control (saline or Hartmann's solution) which reported pelvic pain (two studies) live birth (two studies) and pregnancy (three studies).An external source of funding was stated for 25 of the 47 studies across both reviews; in 24 of these studies the funding was commercial. Solid agents (18 studies)None of our primary outcomes were reported. Adverse events were reported as an outcome by only 9 of the 18 studies. These reported no adverse events. Liquid agents (nine studies)There was no evidence of a difference between liquid agents and control (saline or Hartmann's solution) with respect to pelvic pain (odds ratio (OR) 0.65, 95% confidence interval (CI) 0.37 to 1.14, 1 study, n 286, moderate quality evidence) pregnancy rate (OR 0.64, 95% CI 0.36 to 1.14, 3 studies, n 310, moderate quality evidence) or live birth rate (OR 0.67, 95% CI 0.29 to 1.58, 2 studies, n 208, moderate quality evidence) No studies of liquid agents reported QoL. Adverse events were not reported as an outcome by any of the nine studies. Gel agents (seven studies)None of our primary outcomes were reported. Adverse events were not reported as an outcome by any of the seven studies. Pharmacological agents (seven studies)None of our primary outcomes were reported. Adverse events were reported as an outcome by only one of the seven primary studies. This study reported no evidence of difference in ectopic pregnancy rates between intraperitoneal noxytioline and no treatment (OR 4.91, 95% CI 0.45 to 53.27, 1 study, n 33, low quality evidence) AUTHORS' CONCLUSIONS There is insufficient evidence to allow us to draw any conclusions about the effectiveness and safety of anti adhesion agents in gynaecological surgery, due to the lack of data on pelvic pain, fertility outcomes, quality of life or safety. A substantial proportion of research in this field has been funded by private companies that manufacture these agents, and further high powered, independent trials will be needed before definitive conclusions can be made.

title: Restructuring institutional block trading: an overview of the OptiMark system
abstract: Financial markets perform many functions, but principal among them is to bring buyers and sellers together and provide a mechanism for price discovery. Information technology has had a number of significant impacts on financial markets, enabling enormous increases in volumes and more sophisticated trading techniques such as program trading and index arbitrage. Despite improvements, some large institutional investors identify shortcomings in today's markets that make the process of buying or selling large, block orders time consuming and costly. To address these concerns, a new trading system, OptiMark, has been built around several innovations including: a graphical user front end for depicting trading preferences; and a back end built on high performance computers that process expressions of trading interest according to a price setting algorithm intended to achieve superior outcomes for traders. OptiMark provides a means for more cost effective block trading, and expects to contribute to regulatory objectives. This paper details the operations of OptiMark, examines its adoption potential, and assesses the impact it may have on block trading, broker dealer intermediaries, and the equities markets.

title: Smoke free air interventions in Seven Latin American Countries: Health and Financial Impact to Inform Evidence Based Policy Implementation.
abstract: Disease burden due to tobacco smoking in Latin America remains very high. The objective of this study was to evaluate potential impact of implementing smoke free air interventions on health and cost outcomes in Argentina, Bolivia, Brazil, Chile, Colombia, Mexico, and Peru, using a mathematical model.  We built a probabilistic Montecarlo microsimulation model, considering natural history, direct health system costs and quality of life impairment associated with main tobacco related diseases. We followed individuals in hypothetical cohorts and calculated health outcomes on an annual basis to obtain aggregated 10 year population health outcomes (deaths, events) and costs. To populate the model, we completed an overview and systematic review of literature. Also, we calibrated the model comparing the predicted disease specific mortality rates with those coming from local national statistics.  With current policies, over 10 years, of 137,121 deaths and 917,210 events could be averted, adding 3.84 million years of healthy life and saving USD 9.2 billion in these seven countries. If countries fully implemented smoke free air strategies, it would be possible avert nearly 180,000 premature deaths and 1,2 million events, adding 5 million healthy years of life and saving USD 13.1 billion in direct healthcare.  Implementing the smoke free air strategy would substantially reduce deaths, diseases, and health care costs attributed to smoking. Latin American countries should not delay the full implementation of this strategy.  Tobacco smoking is the single most preventable and premature mortality cause in the world. The Framework Convention on Tobacco Control, supported by the World Health Organization, introduced a package of evidence based measures for tobacco control. This study adds quality evidence on the potential health effects and savings of implementing smoke free air policies in countries representing almost 80% of the LAC population.

title: Overview of CSIR's activities towards smart sustainable energy for rural communities
abstract: CSIR has a long history in energy and energy related matters. Initially, this work was primarily focused on the industrial sector, with a specific emphasis on coal that was and still is the primary energy source in South Africa. Additionally, activities have included thermal efficiency of building design, solar water heating and the evaluation of photovoltaic installations. CSIR has developed and established electronic databases that provide information on South Africa's eco system and that can be linked to investigations in the field of renewable energy. CSIR has increasingly focused on the area of technology for sustainable development, thereby moving away from the bias of the formal sector, towards a more balanced approach that includes all strata of South African society. CSIR as an organization has significant activities within developing communities, as well as strong links with business, the financial sector and all levels of government. As a result of the work done in technology for development, an interest in renewable and alternative energy towards a low carbon economy was developed. Such work is of strategic importance to those communities that are unlikely to be connected to the electricity grid within the foreseeable future. This paper provides a review of the various tools that have been developed, projects undertaken and models developed that provides the basis for smart sustainable energy for rural communities.