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Association between infrastructure and observed quality of care in 4 healthcare services: A cross-sectional study of 4,300 facilities in 8 countries
Authors: Hannah H Leslie, Zeye Sun, and Margaret E Kruk
Source: PLOS Medicine, 14(12):e1002464; DOI: 10.1371/journal.pmed.1002464
Topic(s): Adult health
Child health
Health care utilization
Country: Africa
  Multiple African Countries
  Kenya
  Malawi
  Namibia
  Tanzania
  Uganda
  Rwanda
  Senegal
Latin American/Caribbean
  Haiti
More than one region
  Multiple Regions
Published: DEC 2017
Abstract: It is increasingly apparent that access to healthcare without adequate quality of care is insufficient to improve population health outcomes. We assess whether the most commonly measured attribute of health facilities in low- and middle-income countries (LMICs)-the structural inputs to care-predicts the clinical quality of care provided to patients.Service Provision Assessments are nationally representative health facility surveys conducted by the Demographic and Health Survey Program with support from the US Agency for International Development. These surveys assess health system capacity in LMICs. We drew data from assessments conducted in 8 countries between 2007 and 2015: Haiti, Kenya, Malawi, Namibia, Rwanda, Senegal, Tanzania, and Uganda. The surveys included an audit of facility infrastructure and direct observation of family planning, antenatal care (ANC), sick-child care, and (in 2 countries) labor and delivery. To measure structural inputs, we constructed indices that measured World Health Organization-recommended amenities, equipment, and medications in each service. For clinical quality, we used data from direct observations of care to calculate providers' adherence to evidence-based care guidelines. We assessed the correlation between these metrics and used spline models to test for the presence of a minimum input threshold associated with good clinical quality. Inclusion criteria were met by 32,531 observations of care in 4,354 facilities. Facilities demonstrated moderate levels of infrastructure, ranging from 0.63 of 1 in sick-child care to 0.75 of 1 for family planning on average. Adherence to evidence-based guidelines was low, with an average of 37% adherence in sick-child care, 46% in family planning, 60% in labor and delivery, and 61% in ANC. Correlation between infrastructure and evidence-based care was low (median 0.20, range from -0.03 for family planning in Senegal to 0.40 for ANC in Tanzania). Facilities with similar infrastructure scores delivered care of widely varying quality in each service. We did not detect a minimum level of infrastructure that was reliably associated with higher quality of care delivered in any service. These findings rely on cross-sectional data, preventing assessment of relationships between structural inputs and clinical quality over time; measurement error may attenuate the estimated associations.Inputs to care are poorly correlated with provision of evidence-based care in these 4 clinical services. Healthcare workers in well-equipped facilities often provided poor care and vice versa. While it is important to have strong infrastructure, it should not be used as a measure of quality. Insight into health system quality requires measurement of processes and outcomes of care.
Web: http://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC5726617&blobtype=pdf


Debugging Information
ColdFusion Server Developer 2018,0,19,330149
Template /Publications/journal-details.cfm
Time Stamp 03-Jul-24 07:23 AM
Locale English (US)
User Agent Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)
Remote IP 10.0.0.149
Host Name 10.0.0.149


Execution Time

Total Time Avg Time Count Template
765 ms 32 ms 24 C:/inetpub/wwwroot/commonspot/utilities/ct-render-element.cfm
734 ms 31 ms 24 C:/inetpub/wwwroot/commonspot/utilities/ct-render-element-core.cfm
516 ms 516 ms 1 C:/inetpub/wwwroot/commonspot/master.cfm
516 ms 516 ms 1 C:/inetpub/wwwroot/dhs/Publications/journal-details.cfm
437 ms 437 ms 1 C:/inetpub/wwwroot/commonspot/master-render.cfm
437 ms 437 ms 1 C:/inetpub/wwwroot/commonspot/render-page-meat.cfm
437 ms 437 ms 1 C:/inetpub/wwwroot/commonspot/render-page.cfm
437 ms 437 ms 1 C:/inetpub/wwwroot/commonspot/uncached-master.cfm
437 ms 437 ms 1 C:/inetpub/wwwroot/commonspot/utilities/cached-page-render.cfm
406 ms 41 ms 10 C:/inetpub/wwwroot/commonspot/utilities/ct-render-named-element.cfm
406 ms 406 ms 1 C:/inetpub/wwwroot/dhs/templates/template-basepage.cfm
328 ms 328 ms 1 C:/commonspot-data/customers/commonspot-users/sites/commonspot-site-dhs/mapped/cache/2/p9706-c1378-l70-t51-dAny.read
312 ms 312 ms 1 C:/inetpub/wwwroot/commonspot/utilities/run-element.cfm
63 ms 63 ms 1 C:/inetpub/wwwroot/commonspot/set-page-vars.cfm
62 ms 62 ms 1 C:/inetpub/wwwroot/commonspot/controls/customcf/cpe-customcf.cfm
31 ms 31 ms 1 C:/inetpub/wwwroot/commonspot/site-application.cfm
31 ms 31 ms 1 C:/inetpub/wwwroot/commonspot/startup/site-application-meat.cfm
31 ms 31 ms 1 C:/inetpub/wwwroot/dhs/Publications/Application.cfm
30 ms 15 ms 2 CFC[ C:/inetpub/wwwroot/commonspot/public_api/cache.cfc | getElementCacheSettings(9706, 4304) ] from C:/inetpub/wwwroot/commonspot/public_api/cache.cfc
17 ms 17 ms 1 C:/inetpub/wwwroot/dhs/customcf/legacy/journal/detail_article_summary.cfm
16 ms 16 ms 1 C:/commonspot-data/customers/commonspot-users/sites/commonspot-site-dhs/mapped/cache/2/p9706-c19152-l70-t51-dAny.read
16 ms 16 ms 1 C:/commonspot-data/customers/commonspot-users/sites/commonspot-site-dhs/mapped/cache/2/p9706-c19169-l70-t51-dAny.read
16 ms 16 ms 1 C:/inetpub/wwwroot/commonspot/controls/control-setup.cfm
16 ms 16 ms 1 C:/inetpub/wwwroot/commonspot/render-head.cfm
16 ms 16 ms 1 C:/inetpub/wwwroot/commonspot/startup/core-application-meat.cfm
16 ms 16 ms 1 C:/inetpub/wwwroot/commonspot/startup/init-server-scope.cfm
16 ms 16 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/public_api/element.cfc | getInfo(elementTypeID = 26) ] from C:/inetpub/wwwroot/commonspot/public_api/element.cfc
15 ms 15 ms 1 C:/commonspot-data/customers/commonspot-users/sites/commonspot-site-dhs/mapped/cache/2/p9706-c19155-l70-t51-dAny.read
0 ms 0 ms 1 C:/commonspot-data/customers/commonspot-users/sites/commonspot-site-dhs/mapped/cache/2/p9706-c1432-l70-t51-dAny.read
0 ms 0 ms 1 C:/commonspot-data/customers/commonspot-users/sites/commonspot-site-dhs/mapped/cache/2/p9706-c19153-l70-t51-dAny.read
0 ms 0 ms 1 C:/commonspot-data/customers/commonspot-users/sites/commonspot-site-dhs/mapped/cache/2/p9706-c19154-l70-t51-dAny.read
0 ms 0 ms 1 C:/commonspot-data/customers/commonspot-users/sites/commonspot-site-dhs/mapped/cache/2/p9706-c19172-l70-t51-dAny.read
0 ms 0 ms 1 C:/commonspot-data/customers/commonspot-users/sites/commonspot-site-dhs/mapped/cache/2/p9706-c19174-l70-t51-dAny.read
0 ms 0 ms 1 C:/commonspot-data/customers/commonspot-users/sites/commonspot-site-dhs/mapped/cache/2/p9706-c19177-l70-t51-dAny.read
0 ms 0 ms 1 C:/inetpub/wwwroot/ADF/core/load_site_adf.cfm
0 ms 0 ms 2 C:/inetpub/wwwroot/commonspot/controls/ct-include-once.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/controls/dhtmlmenu/menu-output-display.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/controls/handle-styles.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/controls/upfront-generic.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/lview-contribute-mode-redirect-check.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/non-dashboard-include.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/pagemode/pagemodeui.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/render-body-tag.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/render-foot.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/render-metatags.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/render-tracking-code.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/security/security-page.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/startup/build-request-params.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/startup/handle-head-request.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/startup/handle-request-timeout.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/startup/init-customer-scope.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/utilities/add-resource-request.cfm
0 ms 0 ms 6 C:/inetpub/wwwroot/commonspot/utilities/add-unregistered-resource-request.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/utilities/append-to-resource-group.cfm
0 ms 0 ms 3 C:/inetpub/wwwroot/commonspot/utilities/cp-cfheader.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/utilities/cp-cfmail-request-queue.cfm
0 ms 0 ms 2 C:/inetpub/wwwroot/commonspot/utilities/define-upfront-vars.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/utilities/flush-cache-db-queue.cfm
0 ms 0 ms 4 C:/inetpub/wwwroot/commonspot/utilities/handle-in-list.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/utilities/load-template-properties.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/utilities/newwindow-js-meat.cfm
0 ms 0 ms 2 C:/inetpub/wwwroot/commonspot/utilities/newwindow-js.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/utilities/nocache-headers.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/utilities/update-page-cache-status.cfm
0 ms 0 ms 3 C:/inetpub/wwwroot/commonspot/utilities/validate-date-string.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/utilities/verify-stub-data.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/dhs/custom-application.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/dhs/custom-search/inc-custom-application-search-vars.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/dhs/templates/template-basepage.head
0 ms 0 ms 2 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/cache-settings-cache.cfc | getPageSettings(1) ] from C:/inetpub/wwwroot/commonspot/components/cache/cache-settings-cache.cfc
0 ms 0 ms 2 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/cache-settings-cache.cfc | getPageSettings(1652) ] from C:/inetpub/wwwroot/commonspot/components/cache/cache-settings-cache.cfc
0 ms 0 ms 2 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/cache-settings-cache.cfc | getPageSettings(2) ] from C:/inetpub/wwwroot/commonspot/components/cache/cache-settings-cache.cfc
0 ms 0 ms 2 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/cache-settings-cache.cfc | getPageSettings(9706) ] from C:/inetpub/wwwroot/commonspot/components/cache/cache-settings-cache.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/cache-status.cfc | DBQueue_Count() ] from C:/inetpub/wwwroot/commonspot/components/cache/cache-status.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/cache-status.cfc | GetPageCacheStatus(1652, 2, 2, 0) ] from C:/inetpub/wwwroot/commonspot/components/cache/cache-status.cfc
0 ms 0 ms 2 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/cache-status.cfc | GetPageCacheStatus(9706, 2, 1652, 0) ] from C:/inetpub/wwwroot/commonspot/components/cache/cache-status.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/cache-status.cfc | UpdateStatus(argumentCollection = [complex value]) ] from C:/inetpub/wwwroot/commonspot/components/cache/cache-status.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/custom-module-cache.cfc | getCustomAppPath(2) ] from C:/inetpub/wwwroot/commonspot/components/cache/custom-module-cache.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/custom-module-cache.cfc | getCustomModulePath(post-page-render, 2) ] from C:/inetpub/wwwroot/commonspot/components/cache/custom-module-cache.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/item-security-cache.cfc | GetEntry(9706) ] from C:/inetpub/wwwroot/commonspot/components/cache/item-security-cache.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/rewrite-rules-cache.cfc | getRewriteSettings(2) ] from C:/inetpub/wwwroot/commonspot/components/cache/rewrite-rules-cache.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/subsite-cache-manager.cfc | getLatest() ] from C:/inetpub/wwwroot/commonspot/components/cache/subsite-cache-manager.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/subsite-cache-manager.cfc | getSecurityPageIDMap([complex value]) ] from C:/inetpub/wwwroot/commonspot/components/cache/subsite-cache-manager.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/template-cache.cfc | LoadTemplateProperties(publication-template.cfm, 1652, 2) ] from C:/inetpub/wwwroot/commonspot/components/cache/template-cache.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/custom-application-framework/handle-applications.cfc | executeFunction(handleRequestStart) ] from C:/inetpub/wwwroot/commonspot/components/custom-application-framework/handle-applications.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/engine/ACF/utilities.cfc | checkFileExists(C:/inetpub/wwwroot/dhs/templates/template-basepage.cfm, 0, false) ] from C:/inetpub/wwwroot/commonspot/components/engine/ACF/utilities.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/engine/ACF/utilities.cfc | queryRowToStruct(ArgumentCollection = [complex value]) ] from C:/inetpub/wwwroot/commonspot/components/engine/ACF/utilities.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/commonspot-context.cfc | getDSN(site) ] from C:/inetpub/wwwroot/commonspot/components/util/commonspot-context.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent('head' request check) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(CGI variable processing) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(Request object updates) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(Request.Params initialized) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(RequestTimeout check) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(Server-level remote requests checked) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(Subsite context updated (ID=2)) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(authoring suspended check) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(basic setup) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(check for server property changes) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(core cleanup) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(core initialization) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(core variables) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(custom-application.cfm) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(customerScope object initialized) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(handleRequestStart) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(init-server-scope loaded) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(lock checks/updates) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(site environment initialization) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(site session check) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(subsite context refreshed) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(wait for lock: CommonSpot_Server_Scope (read)) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(wait for lock: CommonSpot_Site1_Core (exclusive)) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | init() ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 2 CFC[ C:/inetpub/wwwroot/commonspot/components/util/object-factory.cfc | getObject(Cache) ] from C:/inetpub/wwwroot/commonspot/components/util/object-factory.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/object-factory.cfc | getObject(Element) ] from C:/inetpub/wwwroot/commonspot/components/util/object-factory.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/object-factory.cfc | getObject(Keywords) ] from C:/inetpub/wwwroot/commonspot/components/util/object-factory.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/object-factory.cfc | getObject(LiveBookmarks) ] from C:/inetpub/wwwroot/commonspot/components/util/object-factory.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/visitor-context-rule-actions.cfc | onPageVisit(9706, 2) ] from C:/inetpub/wwwroot/commonspot/components/util/visitor-context-rule-actions.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/public_api/keywords.cfc | appendEnforced(subsiteIDOrURL = , keywordList = Journal Details) ] from C:/inetpub/wwwroot/commonspot/public_api/keywords.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/public_api/livebookmarks.cfc | getTags(9706) ] from C:/inetpub/wwwroot/commonspot/public_api/livebookmarks.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/udf/database.cfc | getUDF(commonspot-site-dhs) ] from C:/inetpub/wwwroot/commonspot/udf/database.cfc
0 ms  STARTUP, PARSING, COMPILING, LOADING, & SHUTDOWN
547 ms  TOTAL EXECUTION TIME
red = over 250 ms average execution time


SQL Queries

SelectedCustomRenderElements (Datasource=commonspot-site-dhs, Time=63ms, Records=2117) in C:\inetpub\wwwroot\commonspot\set-page-vars.cfm @ 07:23:50.050
		SELECT dcr.*
		  FROM Data_Custom_Render dcr, CustomElementModules cem
		 WHERE (dcr.PageID IN (?,?,?,?)) 
			AND dcr.VersionState=?
			AND (dcr.ModuleID = cem.ID OR dcr.ModuleID <= 0)
	 ORDER BY dcr.ControlID, dcr.PageID DESC, dcr.VersionID DESC
	
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 1
Parameter #2(CF_SQL_INTEGER) = 2
Parameter #3(CF_SQL_INTEGER) = 1652
Parameter #4(CF_SQL_INTEGER) = 9706
Parameter #5(CF_SQL_INTEGER) = 2

Request.PageData.PageParams (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\render-page-meat.cfm @ 07:23:50.050
			SELECT *
			  FROM Param_Page
			 WHERE (PageID=9706 OR (PageID IN (1652,2,1) AND (VersionState = 2)))
			   AND VersionState=2
			 ORDER BY PageID DESC
		
qry (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\udf\validation\core.cfm @ 07:23:50.050
					SELECT SubsiteID
					  FROM SitePages
					 WHERE ID = ? 
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 9706

testQuery (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\udf\validation\generated-validators.cfm @ 07:23:50.050
		SELECT ID
		  FROM SitePages
		 WHERE ID = ?
			AND (PageType IN (0,1) AND Uploaded=0)
	
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 9706

qry (Datasource=commonspot-site-dhs, Time=0ms, Records=0) in C:\inetpub\wwwroot\commonspot\commands\livebookmarks.cfc @ 07:23:50.050
		SELECT Data_SeeAlso.ID, SubSites.SubSiteURL, SitePages.filename as pagename,
				 XMLPublications.name as feedname, XMLPublicationFormat.name as feedformat,
				 XMLPublications.description,
				 CASE
					 	WHEN XMLPublicationFormat.IsSyndication = 0 THEN 0
						ELSE 1
				 END AS IsSyndicationFeed
		  FROM Data_SeeAlso, XMLPublications, XMLPublicationFormat, SitePages, SubSites
		 WHERE Data_SeeAlso.PageID = ?
		 	AND Data_SeeAlso.Action = ?
		 	AND Data_SeeAlso.ItemID = XMLPublicationFormat.XMLPublicationFormatID
		 	AND Data_SeeAlso.TargetPageID = XMLPublications.XMLPublicationID
		 	AND XMLPublications.XMLPublicationFormatID = XMLPublicationFormat.XMLPublicationFormatID
		 	AND XMLPublications.PageID = SitePages.ID
		 	AND SitePages.SubSiteID = SubSites.ID
	
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 9706
Parameter #2(CF_SQL_INTEGER) = 11

ControlInstanceData (Datasource=commonspot-site-dhs, Time=0ms, Records=76) in C:\inetpub\wwwroot\commonspot\controls\control-setup.cfm @ 07:23:50.050
		SELECT ControlID, ControlName, ControlType, ParentControlID, ParentControlType, pageID
		  FROM ControlInstance
		 WHERE (PageID IN (?,?,?,?)) 
	 ORDER BY ControlID, PageID DESC
	
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 1
Parameter #2(CF_SQL_INTEGER) = 2
Parameter #3(CF_SQL_INTEGER) = 1652
Parameter #4(CF_SQL_INTEGER) = 9706

qInfo (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\commands\element.cfc @ 07:23:50.050
		SELECT ac.ShortDesc AS Name, CustomRenderSupport AS SupportsCustomLayouts,
				 CASE
					WHEN ac.ID <?
					 THEN 'Standard'
					WHEN (ac.Name is NULL or ac.Name = '')
					 THEN 'Saved'
					WHEN fcm.ClassID = 1
					 THEN 'Global'
					ELSE 'Local'
				 END AS ElementType,
				 CASE WHEN ac.Name = 'custom' THEN 'custom/ce' ELSE ac.ControlPrefix END AS ElementURLPrefix,
				 CASE WHEN (ac.ID IN (?,?,?,?,?,?,?,?,?,?,?,?))  THEN 0 ELSE 1 END AS HasFontColorProperties,
				 CASE WHEN (ac.ID IN (?,?,?,?,?,?,?))  THEN 0 ELSE 1 END AS HasLayoutProperties,
				 1 AS HasStyleProperties
		  FROM AvailableControls ac
		  LEFT OUTER JOIN FormControlMap fcm ON fcm.FormID = ac.ID
		 WHERE ac.ID = ? 
Query Parameter Value(s) -
Parameter #1(cf_sql_integer) = 400
Parameter #2(CF_SQL_INTEGER) = 22
Parameter #3(CF_SQL_INTEGER) = 44
Parameter #4(CF_SQL_INTEGER) = 55
Parameter #5(CF_SQL_INTEGER) = 1
Parameter #6(CF_SQL_INTEGER) = 56
Parameter #7(CF_SQL_INTEGER) = 47
Parameter #8(CF_SQL_INTEGER) = 26
Parameter #9(CF_SQL_INTEGER) = 48
Parameter #10(CF_SQL_INTEGER) = 27
Parameter #11(CF_SQL_INTEGER) = 28
Parameter #12(CF_SQL_INTEGER) = 51
Parameter #13(CF_SQL_INTEGER) = 31
Parameter #14(CF_SQL_INTEGER) = 33
Parameter #15(CF_SQL_INTEGER) = 26
Parameter #16(CF_SQL_INTEGER) = 48
Parameter #17(CF_SQL_INTEGER) = 37
Parameter #18(CF_SQL_INTEGER) = 27
Parameter #19(CF_SQL_INTEGER) = 38
Parameter #20(CF_SQL_INTEGER) = 28
Parameter #21(cf_sql_integer) = 26

Request.customCFUpfront (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\controls\upfront-generic.cfm @ 07:23:50.050
	SELECT *
	  FROM Data_CustomCF
	 WHERE (PageID=9706 OR (PageID IN (1652,2,1) AND (VersionState = 2)))
		AND (VersionState = 2) 
 ORDER BY ControlID, PageID DESC, VersionID DESC 
testQuery (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\udf\validation\generated-validators.cfm @ 07:23:50.050
		SELECT ID
		  FROM SitePages
		 WHERE ID = ?
			AND (PageType IN (0,1,2) AND Uploaded=0)
	
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 9706

qry (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\commands\cache.cfc @ 07:23:50.050
		SELECT SubsiteID, InheritedTemplateList
		  FROM SitePages
		 WHERE ID=? 
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 9706

testQuery (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\udf\validation\generated-validators.cfm @ 07:23:50.050
		SELECT ID
		  FROM SitePages
		 WHERE ID = ?
			AND (PageType IN (0,1,2) AND Uploaded=0)
	
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 1652

testQuery (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\udf\validation\generated-validators.cfm @ 07:23:50.050
		SELECT ID
		  FROM SitePages
		 WHERE ID = ?
			AND (PageType IN (0,1,2) AND Uploaded=0)
	
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 2

testQuery (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\udf\validation\generated-validators.cfm @ 07:23:50.050
		SELECT ID
		  FROM SitePages
		 WHERE ID = ?
			AND (PageType IN (0,1,2) AND Uploaded=0)
	
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 1

getArticlesDetails (Datasource=dhs_legacy_live, Time=0ms, Records=1) in C:\inetpub\wwwroot\dhs\customcf\legacy\journal\detail_article_summary.cfm @ 07:23:50.050
SELECT distinct(a.article_id),p.pub_id,tp.article_type_id,title,authors,article_date,article_year,
vol,link,active,source,pub_name,article_type_name,
abstract as abstractText
FROM dhs_articles a
INNER JOIN  Dhs_article_pub p ON a.pub_id = p.pub_id
INNER JOIN   Dhs_article_type Tp ON a.article_type_id = Tp.Article_type_Id

WHERE active=1	and tp.article_type_id=1

AND a.article_id =? 
Order By title
Query Parameter Value(s) -
Parameter #1(cf_sql_integer) = 3059

getart_topic (Datasource=dhs_legacy_live, Time=0ms, Records=3) in C:\inetpub\wwwroot\dhs\customcf\legacy\journal\detail_article_summary.cfm @ 07:23:50.050
				select * from dhs_article_topics_lnk l, dhs_article_topics t 
				where article_id=?
				and l.topic_id=t.topic_id
				order by topic_name
			 
Query Parameter Value(s) -
Parameter #1(cf_sql_integer) = 3059

getart_Ctry (Datasource=dhs_legacy_live, Time=0ms, Records=10) in C:\inetpub\wwwroot\dhs\customcf\legacy\journal\detail_article_summary.cfm @ 07:23:50.050
				select * from dhs_article_ctry_lnk l, dhs_article_ctry c ,dhs_article_rgn r
				where article_id=? and l.country_id=c.country_id
				and R.Rgn_id = c.country_rgn_id	
			 
Query Parameter Value(s) -
Parameter #1(cf_sql_integer) = 3059

testQuery (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\udf\validation\generated-validators.cfm @ 07:23:50.050
		SELECT ID
		  FROM SitePages
		 WHERE ID = ?
			AND (PageType IN (0,1,2) AND Uploaded=0)
	
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 9706

qry (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\commands\cache.cfc @ 07:23:50.050
		SELECT SubsiteID, InheritedTemplateList
		  FROM SitePages
		 WHERE ID=? 
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 9706

testQuery (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\udf\validation\generated-validators.cfm @ 07:23:50.050
		SELECT ID
		  FROM SitePages
		 WHERE ID = ?
			AND (PageType IN (0,1,2) AND Uploaded=0)
	
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 1652

testQuery (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\udf\validation\generated-validators.cfm @ 07:23:50.050
		SELECT ID
		  FROM SitePages
		 WHERE ID = ?
			AND (PageType IN (0,1,2) AND Uploaded=0)
	
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 2

testQuery (Datasource=commonspot-site-dhs, Time=15ms, Records=1) in C:\inetpub\wwwroot\commonspot\udf\validation\generated-validators.cfm @ 07:23:50.050
		SELECT ID
		  FROM SitePages
		 WHERE ID = ?
			AND (PageType IN (0,1,2) AND Uploaded=0)
	
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 1


Scope Variables

Application Variables:
activesubsites=1,2,5,6,8,17,18,19,20,21,22,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58
adf=Struct (89)
adfscheduler=Struct (0)
applicationname=site1
assocpubdocs=Struct (4)
blogcache=Struct (4)
cachedimages=Struct (32)
cacheinfocache=Struct (53)
confidentiality=Array (5)
controlinstance_toplevel_cache=Struct (126)
covid_articlecount=10
covid_newsarticlecount=49
covid_pressreleasecount=4
covid_pubcount=3
cs_elementcache=Struct (10)
cs_resourcesmissing=Struct (0)
cs_rewriterulescache=Struct (21)
cs_subsitecachemanager=Struct (28)
customerinfo=Complex type
customerscope=Struct (21)
custommodulecache=Struct (21)
defaultconfidentiality=2
dhspagesyncdata=Struct (1)
itemsecuritycache=Struct (31)
languagenames=Struct (51)
languages=Struct (51)
lastknownchange=Struct (18)
lastupdate=Struct (14)
metadatacache=Struct (4)
pendingstubrequests=Struct (0)
rsscache=Struct (2)
search_archive_next_clean=2024-07-03 12:12:03
serverstatus=Struct (1)
site=Struct (74)
sitescope=Struct (9)
styleids=Struct (248)
stylenames=Struct (248)
subsitecache=Struct (46)
subsitecachebysecuritypageid=Struct (46)
templatecache=Struct (28)
templatedefaultsecuritycache=Struct (60)
templateenforcedsecuritycache=Struct (60)
treecache=Struct (25)
twittercache=Struct (2)
typefactory=Complex type
youtubecache=Struct (3)
CGI Variables:
AUTH_PASSWORD=
AUTH_TYPE=
AUTH_USER=
CERT_COOKIE=
CERT_FLAGS=
CERT_ISSUER=
CERT_KEYSIZE=
CERT_SECRETKEYSIZE=
CERT_SERIALNUMBER=
CERT_SERVER_ISSUER=
CERT_SERVER_SUBJECT=
CERT_SUBJECT=
CF_TEMPLATE_PATH=C:\inetpub\wwwroot\dhs\Publications\journal-details.cfm
CONTENT_LENGTH=0
CONTENT_TYPE=
CONTEXT_PATH=
GATEWAY_INTERFACE=CGI/1.1
HTTPS=off
HTTPS_KEYSIZE=
HTTPS_SECRETKEYSIZE=
HTTPS_SERVER_ISSUER=
HTTPS_SERVER_SUBJECT=
HTTP_ACCEPT=*/*
HTTP_ACCEPT_ENCODING=gzip, br, zstd, deflate
HTTP_ACCEPT_LANGUAGE=
HTTP_CONNECTION=
HTTP_COOKIE=JSESSIONID=5E116930ADF32CE2C1F12A9835607861.cfusion; CSRFTOKEN=5B82FDF0073684A6FA58F61AFC152F2F0C48368E
HTTP_HOST=preview.dhsprogram.com
HTTP_REFERER=
HTTP_URL=/Publications/journal-details.cfm?C_id=40&P_ID=0&T_ID=0&article_id=3059&r_id=0
HTTP_USER_AGENT=Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)
LOCAL_ADDR=10.0.0.111
PATH_INFO=
PATH_TRANSLATED=C:\inetpub\wwwroot\dhs\Publications\journal-details.cfm
QUERY_STRING=C_id=40&P_ID=0&T_ID=0&article_id=3059&r_id=0
REMOTE_ADDR=10.0.0.149
REMOTE_HOST=10.0.0.149
REMOTE_USER=
REQUEST_METHOD=GET
SCRIPT_NAME=/Publications/journal-details.cfm
SERVER_NAME=preview.dhsprogram.com
SERVER_PORT=80
SERVER_PORT_SECURE=0
SERVER_PROTOCOL=HTTP/1.1
SERVER_SOFTWARE=Microsoft-IIS/10.0
WEB_SERVER_API=
Cookie Variables:
CSRFTOKEN=5B82FDF0073684A6FA58F61AFC152F2F0C48368E
JSESSIONID=5E116930ADF32CE2C1F12A9835607861.cfusion
Request Parameters:
anonnoreadelements=
applockname=CS_App_Site1_1
archiveemail=archive@dhsprogram.com
assetsdir=/assets/
author_approve_whereclause=(VersionState = 2)
authormode=0
authorok=1
blupfront=
browser=Struct (13)
browserallincluded=1
cachefilesused=22
cachestatus=Complex type
cfflushcount=0
cgivars=Struct (49)
cloudfrontkeypairid=K3LSHNFSZFMIUC
cloudfronturl=d1vyaiefsqy4pf
constants=Complex type
cors.isCorsRequest=NO
cp=Struct (123)
cs_includedobjects=nwjs
cs_init_timings=Struct (23)
cs_isdashboardcmd=0
cs_request_start_memory=899019256
cs_runningdashboardcmdcode=0
csrftoken=5B82FDF0073684A6FA58F61AFC152F2F0C48368E
ctrl_data=Struct (64)
customcf_data=Struct (2)
customcfupfront=Query (1)
customerinfo=Complex type
customhead=1
customrenderhandlerpairs=
customsearch=Struct (11)
dbdsn=measure_db
debugstate=Struct (1)
dhspagesyncdata=Struct (1)
dhtmlmenuitemsprefetch=
disablehideformenus=0
dsource=dhs_legacy_live
editmode=0
element=Struct (42)
elementrundetail=Struct (1)
elementsrun=1
environment=Struct (5)
finalreportids=5,26,21,10,18,30,39
finalreportna=139,315,445,488,107,138,459,518
formattedtimestamp=2024-07-03 07:23:50
getghost=
hivbold=1,3,8,9
imageupfront=
imgdir=/images/
includerootdir=/
initialsiteid=1
initticks=1719991430338
jswarnmessage=
linkdataupfront_itempos=
linkdataupfront_itemtitle=
lockid=0
mainpage=Struct (84)
master_cfm_used=1
maxperms=Complex type
modeorderbyclause=VersionID Desc
modewhereclause=(VersionState = 2)
modewhereclause_page=(VersionState = 2)
multisectionupfront=
noauthorreason=
nocacheelementtypes=
nocacheheaderincluded=1
nondashboardincludedone=1
obcountires=EG,ZM
package=Struct (0)
page=Struct (84)
pagedata=Struct (1)
pagedhtmlitems=
pagedhtmlmenus=
pageperms=Complex type
pagesync=Struct (4)
params=Struct (9)
params_formfields=
params_urlfields=T_ID,r_id,P_ID,C_id,article_id
readmodewhereclause=(VersionState = 2)
renderedelements=Struct (0)
renderelementdata=Struct (0)
renderfordiff=0
renderforprint=0
renderstate=Struct (73)
req_cam_callcount=1
req_inittimestamp=2024-07-03 07:23:50.322
req_sequenceid=65362
req_startticks=1719991430322
rootdir=/
rootpath=
rooturldatasetadmin=https://preview.dhsprogram.com/data/dataset_admin
samesite_value=
scheduleupfront=
serverdatasource=commonspot-sites
sessionlockname=Session_1_5E116930ADF32CE2C1F12A9835607861.cfusion
sessionstring=1_5E116930ADF32CE2C1F12A9835607861.cfusion
sicupfront=
sicupfrontparam=
site=Struct (74)
siteid=1
standardrenderhandlers=
styleids=Struct (248)
stylenames=Struct (248)
subsite=Struct (0)
subsitecache=Struct (46)
subsitecachebysecuritypageid=Struct (46)
subsiteid=2
taiupfrontparam=
tbupfront=
tbupfrontparam=
templatecachestatus=Struct (0)
templaterootdir=/
timestamp={ts '2024-07-03 07:23:50'}
trustcachestatus=1
typefactory=Complex type
udslockname=CS_Customer_commonspot-users
updatingschemas=0
user=Struct (30)
usersdatasource=commonspot-users
wanterrorsrethrown=0
warnmessage=
xmlbrowser=Struct (13)
Server Variables:
ADF=Struct (15)
COMMONSPOT=Struct (44)
EMAILALERTKEY=BSu0cRa8xSWdSrClnnGvpA==
coldfusion=Struct (10)
os=Struct (5)
system=Struct (2)
Session Variables:
_csrf_token=5B82FDF0073684A6FA58F61AFC152F2F0C48368E
adf=Struct (0)
authormode=0
contributemode=read
currentpageid=9706
debugmode=0
debugstate=Struct (1)
editmode=0
environment=Struct (5)
hasusertempfiles=0
language=Struct (216)
lastupdate=Struct (2)
lastuserupdate=1719991427916
lockid=0
lockobjectid=0
lockobjecttype=
locktype=
logintime=
ownedobjecttypes=
pendingapprovalpages=
pendingapprovals=
previewmode=0
requestedversioncounter=
requestedversiontimestamp=
sessionid=5E116930ADF32CE2C1F12A9835607861.cfusion
sessionstring=1_5E116930ADF32CE2C1F12A9835607861.cfusion
urltoken=CFID=2301896&CFTOKEN=5dc2c901b2769172-AAC7D4E2-B31A-1DE9-38591747DE34D18A&jsessionid=5E116930ADF32CE2C1F12A9835607861.cfusion
usagelist=
user=Struct (30)
xmlbrowser=Struct (13)
xmlenvironment=Struct (5)
URL Parameters:
C_id=40
P_ID=0
T_ID=0
article_id=3059
r_id=0
Debug Rendering Time: 31 ms