As Health care reform is for the most part governmental policy that affects health care delivery in a given place. Health care reform typically attempts to: Broaden the population that receives health care coverage through either public sector insurance programs or private sector insurance companies. Canada has a decentralized, universal, publicly funded health system called Canadian Medicare. Health care is funded and administered primarily by the country’s13 provinces and territories. Each has its own insurance plan, and each receives cash assistance from the federal government on a per-capita basis. Benefits and delivery approaches vary. All citizens and permanent residents, however, receive medically necessary hospital and physician services free at the point of use. To pay for excluded services, including outpatient prescription drugs and dental care, provinces and territories provide some coverage for targeted groups. In addition, about two-thirds of Canadians have private insurance.

After congenital heart surgery (CHS), Cardiopulmonary bypass (CPB), Delayed sternal closure and Low cardiac output due to ventricular dysfunction in immediate post operatively period can cause systemic inflammatory response syndrome (SIRS) which is difficult to differentiate from proven post operative infection. C – Reactive Protein (CRP) and Procalcitonin (PCT) are potential early biomarkers not only diagnose sepsis but also guide the need for empirical antibiotic therapy and duration of antibiotics.

In most Africa occurred wars that related with colonial independence wars and after that there were conflict wars, so the nursing development in Africa has involved through tree cardinal periods, namely precolonial, colonial and the post-colonial periods in most African Countries except in Ethiopia. The nursing care took from the experimental practice and experience since that the nursing in Africa develop and reached in area where there is no available in medical services the experience gained from sick and wounded, especially in African countries where inter and intra tribal wars frequently occurs. However, like in Europe and rest of the world, the Africa, not much is known about nursing. Since that the training of nurses and midwives in Africa was established and regulated by the Nursing and Midwives in Some Africa organizations, some of three African countries took cognizance of the National Policy on Education in developing sound educational principles essential to the preparation of nurses to function to improve the Nursing and midwives in Africa to cover health services in Africa. So, after developed and ensure that policies, programs and activities were developed and implement to achieve with the goal of promoting a maintaining excellence in nursing education and practices as provided in conformity with local and international standards. Some African countries like Ethiopia Nursing education is controlled by the Health Professional Council of which Ethiopia Nursing association is the member under the ministry of health. So, the ministries of health get important Nursing and midwives, they prepared to be part of educational system in the higher education such as Universities, the University education is the key to the growth profession and nursing education programs in many parts of the world and some parts of the African Countries. So, the professional Nursing and midwives offered at universities and colleges affiliated to universities. The universities and colleges offered by the teaching / learning in the profession in combination of theoretical, clinical and internship issues premised. To cover health status in Africa. In Conclusion in Africa there is suffering and terroirs and tribal conflicts and wars, in contrast to that the health services in Africa were poor and there is enough medical Nursing and Midwives in Africa.

Hepatitis is a serious public health issue of present era. According to World Health Organization Hepatitis virus is responsible for disease of liver. As per WHO more than 2 billion populations are suffering with Hepatitis infection, 620000 deaths related to HBV annually. WHO shows, 36 million healthcare professionals globally, 3 million get injury from sharps, resulting 2 million subjects being infected with HBV and 1 million with HCV annually. A systematic study of 2015 showed HCV seroprevalence in adult population of Pakistan was 6.8% whereas individuals infected with HCV were 6%.