The on-board telemetry system of an aerospace vehicle sends the vehicle performance parameters to the ground receiving station at all instances of its trajectory. During the course of its trajectory, the communication channel of a long range vehicle, experiences various phenomena such as plume attenuation, stage separation, manoeuvring of a vehicle and RF blackout, causing loss of valuable telemetry data. The loss of communication link is inevitable due to these harsh conditions even when using the space diversity of ground receiving systems. Conventional telemetry systems do not provide redundant data for long range aerospace vehicles. This research work proposes an innovative delay data transmission, frame switchover and multiple frames data transmission schemes to improve the availability of telemetry data at ground receiving stations. The proposed innovative schemes are modelled using VHDL and extensive simulations have been performed to validate the results. The functionally simulated net list has been synthesised with 130 nm ACTEL flash based FPGA and verified on telemetry hardware.
In: Hinrichs , S , Jahagirdar , D , Miani , C , Guerin , B & Nolte , E 2014 , Learning for the NHS on procurement and supply chain management: a rapid evidence assessment . vol. 2 , 55 edn , NIHR Journals Library . DOI:10.3310/hsdr02550
Background Procurement of clinical and non-clinical goods has been identified as one area for efficiency savings for the NHS. There is a need for robust evidence to help the NHS make informed decisions about how to make such savings and there is potential for lessons to be learned from activities and initiatives implemented elsewhere to enable the adoption of good practice. The work presented in this report seeks to contribute to this process by advancing our understanding of the evidence on procurement and supply chain management (SCM) in sectors within and outside health care that can inform practice in the NHS. Objectives Principally drawing on a rapid evidence assessment (REA), we sought to (1) describe approaches to procurement and SCM in selected areas (including, but not limited to, manufacturing and automotive sectors, defence, information and communication technology, and pharmaceutical industries) and (2) identify best practices that may inform procurement and SCM in the NHS. Data sources Searches were conducted across MEDLINE, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Academic Search Complete, Social Sciences Abstracts, Military and Government Collection, EconLit and Business Source Complete from January 2006 to November 2013, and Google Scholar, Web of Science and Business Source Complete for articles on specific sectors. Methods We conducted a REA of the published and grey literature in a range of non-health-care and health-care sectors from 2006 onwards. The review was complemented by interviews with a small set of purchasing stakeholders working within and with the NHS to help place the findings of the evidence review in the current NHS context, and a review of select experiences of procurement and SCM in New Zealand and France (chosen because of the likely application of their experiences in the NHS). Results We identified a total of 72 studies for review. Findings highlighted that there is awareness in scholarly research and industry that SCM and procurement are areas for creating efficiencies and cost savings. We found that collective approaches to purchasing, improving relationships with suppliers, building capabilities and skills for purchasing decisions and the use of technology for data and materials management may lead to more efficient procurement and potentially save costs. Existing empirical evidence was scarce and, where available, tended to be weak in design and execution. Limitations Given the nature and variety of subject areas covered, an iterative process was conducted to narrow the searches and apply a fairly restricted combination of search terms and cut-off date. Although this still yielded a large number of studies (13,191), it is possible that this approach missed studies that would have been of relevance for this review. Studies that reported empirical findings only were included for final review, but this definition was broadened to include single case studies in order to capture the limited cases of interventions in practice and find examples of what can be learned from practice rather than theory. Conclusions Many of the studies identified are only described as before-and-after studies and do not include evaluations of their effects. We identified four recommendations for further research. First, there is a need for further research using rigorous methodology to assess the effectiveness of different types of interventions in different settings for improving purchasing and SCM. Second, empirical research on current practices in health-care purchasing and SCM, or evaluation of new practices in health-care settings, should be implemented. Third, an evaluation of the Department of Health's 2013 Procurement Development Programme and its recommendations provides an opportunity to focus future evaluation efforts. Finally, there is a need for increased interdisciplinary work across health-care management and SCM.
Background: Achieving universal health coverage (UHC) involves all people receiving the health services they need, of high quality, without experiencing financial hardship. Making progress towards UHC is a policy priority for both countries and global institutions, as highlighted by the agenda of the UN Sustainable Development Goals (SDGs) and WHO's Thirteenth General Programme of Work (GPW13). Measuring effective coverage at the health-system level is important for understanding whether health services are aligned with countries' health profiles and are of sufficient quality to produce health gains for populations of all ages. Methods: Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we assessed UHC effective coverage for 204 countries and territories from 1990 to 2019. Drawing from a measurement framework developed through WHO's GPW13 consultation, we mapped 23 effective coverage indicators to a matrix representing health service types (eg, promotion, prevention, and treatment) and five population-age groups spanning from reproductive and newborn to older adults (>= 65 years). Effective coverage indicators were based on intervention coverage or outcome-based measures such as mortality-to-incidence ratios to approximate access to quality care; outcome-based measures were transformed to values on a scale of 0-100 based on the 2.5th and 97.5th percentile of location-year values. We constructed the UHC effective coverage index by weighting each effective coverage indicator relative to its associated potential health gains, as measured by disability-adjusted life-years for each location-year and population-age group. For three tests of validity (content, known-groups, and convergent), UHC effective coverage index performance was generally better than that of other UHC service coverage indices from WHO (ie, the current metric for SDG indicator 3.8.1 on UHC service coverage), the World Bank, and GBD 2017. We quantified frontiers of UHC effective coverage performance on the basis of pooled health spending per capita, representing UHC effective coverage index levels achieved in 2019 relative to country-level government health spending, prepaid private expenditures, and development assistance for health. To assess current trajectories towards the GPW13 UHC billion target-1 billion more people benefiting from UHC by 2023-we estimated additional population equivalents with UHC effective coverage from 2018 to 2023. Findings: Globally, performance on the UHC effective coverage index improved from 45.8 (95% uncertainty interval 44.2-47.5) in 1990 to 60.3 (58.7-61.9) in 2019, yet country-level UHC effective coverage in 2019 still spanned from 95 or higher in Japan and Iceland to lower than 25 in Somalia and the Central African Republic. Since 2010, sub-Saharan Africa showed accelerated gains on the UHC effective coverage index (at an average increase of 2.6% [1.9-3.3] per year up to 2019); by contrast, most other GBD super-regions had slowed rates of progress in 2010-2019 relative to 1990-2010. Many countries showed lagging performance on effective coverage indicators for non-communicable diseases relative to those for communicable diseases and maternal and child health, despite non-communicable diseases accounting for a greater proportion of potential health gains in 2019, suggesting that many health systems are not keeping pace with the rising non-communicable disease burden and associated population health needs. In 2019, the UHC effective coverage index was associated with pooled health spending per capita (r=0.79), although countries across the development spectrum had much lower UHC effective coverage than is potentially achievable relative to their health spending. Under maximum efficiency of translating health spending into UHC effective coverage performance, countries would need to reach $1398 pooled health spending per capita (US$ adjusted for purchasing power parity) in order to achieve 80 on the UHC effective coverage index. From 2018 to 2023, an estimated 388.9 million (358.6-421.3) more population equivalents would have UHC effective coverage, falling well short of the GPW13 target of 1 billion more people benefiting from UHC during this time. Current projections point to an estimated 3.1 billion (3.0-3.2) population equivalents still lacking UHC effective coverage in 2023, with nearly a third (968.1 million [903.5-1040.3]) residing in south Asia. Interpretation: The present study demonstrates the utility of measuring effective coverage and its role in supporting improved health outcomes for all people-the ultimate goal of UHC and its achievement. Global ambitions to accelerate progress on UHC service coverage are increasingly unlikely unless concerted action on non-communicable diseases occurs and countries can better translate health spending into improved performance. Focusing on effective coverage and accounting for the world's evolving health needs lays the groundwork for better understanding how close-or how far-all populations are in benefiting from UHC.
Background Achieving universal health coverage (UHC) involves all people receiving the health services they need, of high quality, without experiencing financial hardship. Making progress towards UHC is a policy priority for both countries and global institutions, as highlighted by the agenda of the UN Sustainable Development Goals (SDGs) and WHO's Thirteenth General Programme of Work (GPW13). Measuring effective coverage at the health-system level is important for understanding whether health services are aligned with countries' health profiles and are of sufficient quality to produce health gains for populations of all ages. Methods Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we assessed UHC effective coverage for 204 countries and territories from 1990 to 2019. Drawing from a measurement framework developed through WHO's GPW13 consultation, we mapped 23 effective coverage indicators to a matrix representing health service types (eg, promotion, prevention, and treatment) and five population-age groups spanning from reproductive and newborn to older adults (≥65 years). Effective coverage indicators were based on intervention coverage or outcome-based measures such as mortality-to-incidence ratios to approximate access to quality care; outcome-based measures were transformed to values on a scale of 0–100 based on the 2·5th and 97·5th percentile of location-year values. We constructed the UHC effective coverage index by weighting each effective coverage indicator relative to its associated potential health gains, as measured by disability-adjusted life-years for each location-year and population-age group. For three tests of validity (content, known-groups, and convergent), UHC effective coverage index performance was generally better than that of other UHC service coverage indices from WHO (ie, the current metric for SDG indicator 3.8.1 on UHC service coverage), the World Bank, and GBD 2017. We quantified frontiers of UHC effective coverage performance on the basis of pooled health spending per capita, representing UHC effective coverage index levels achieved in 2019 relative to country-level government health spending, prepaid private expenditures, and development assistance for health. To assess current trajectories towards the GPW13 UHC billion target—1 billion more people benefiting from UHC by 2023—we estimated additional population equivalents with UHC effective coverage from 2018 to 2023. Findings Globally, performance on the UHC effective coverage index improved from 45·8 (95% uncertainty interval 44·2–47·5) in 1990 to 60·3 (58·7–61·9) in 2019, yet country-level UHC effective coverage in 2019 still spanned from 95 or higher in Japan and Iceland to lower than 25 in Somalia and the Central African Republic. Since 2010, sub-Saharan Africa showed accelerated gains on the UHC effective coverage index (at an average increase of 2·6% [1·9–3·3] per year up to 2019); by contrast, most other GBD super-regions had slowed rates of progress in 2010–2019 relative to 1990–2010. Many countries showed lagging performance on effective coverage indicators for non-communicable diseases relative to those for communicable diseases and maternal and child health, despite non-communicable diseases accounting for a greater proportion of potential health gains in 2019, suggesting that many health systems are not keeping pace with the rising non-communicable disease burden and associated population health needs. In 2019, the UHC effective coverage index was associated with pooled health spending per capita (r=0·79), although countries across the development spectrum had much lower UHC effective coverage than is potentially achievable relative to their health spending. Under maximum efficiency of translating health spending into UHC effective coverage performance, countries would need to reach $1398 pooled health spending per capita (US$ adjusted for purchasing power parity) in order to achieve 80 on the UHC effective coverage index. From 2018 to 2023, an estimated 388·9 million (358·6–421·3) more population equivalents would have UHC effective coverage, falling well short of the GPW13 target of 1 billion more people benefiting from UHC during this time. Current projections point to an estimated 3·1 billion (3·0–3·2) population equivalents still lacking UHC effective coverage in 2023, with nearly a third (968·1 million [903·5–1040·3]) residing in south Asia. Interpretation The present study demonstrates the utility of measuring effective coverage and its role in supporting improved health outcomes for all people—the ultimate goal of UHC and its achievement. Global ambitions to accelerate progress on UHC service coverage are increasingly unlikely unless concerted action on non-communicable diseases occurs and countries can better translate health spending into improved performance. Focusing on effective coverage and accounting for the world's evolving health needs lays the groundwork for better understanding how close—or how far—all populations are in benefiting from UHC. Funding Bill & Melinda Gates Foundation.