More articles from Original Articles
- Systems approach to monitoring and evaluation guides scale up of the Standard Days Method of family planning in Rwanda
Scaling-up lessons included: (1) simplifying provider training and client materials; (2) ensuring core aspects of the intervention, for example, that the CycleBeads client tool was integrated into the supply chain system; (3) addressing provider-generated medical barriers; and (4) managing threats from changing political and policy environments. A focus on systems, the use of multiple M&E data sources, maintaining fidelity of the innovation, and ongoing environmental scans facilitated scale-up success.
- Evaluation of community-based interventions to improve TB case detection in a rural district of Tanzania
Enlisting traditional healers and pharmacists to improve TB detection contributed 38% to 70% of new smear-positive case notifications per quarter in a rural district of Tanzania.
- Rising cesarean deliveries among apparently low-risk mothers at university teaching hospitals in Jordan: analysis of population survey data, 2002–2012
Cesarean deliveries nationally in Jordan have increased to 30%, including substantial increases among births that are likely low risk for cesarean delivery for the most part. This level is double the threshold that WHO considers reasonable.
- Are pregnant women prioritized for bed nets? An assessment using survey data from 10 African countries
Women of reproductive age are generally more likely to sleep under an insecticide-treated net (ITN) than other household members. Universal coverage increases ITN use by all family members, including pregnant women. However, BCC efforts are needed to achieve desired levels of bed net use, which is especially important for pregnant women.
- The quality–coverage gap in antenatal care: toward better measurement of effective coverage
The proportion of pregnant women receiving 4 or more antenatal care (ANC) visits has no necessary relationship with the actual content of those visits. We propose a simple alternative to measure program performance that aggregates key services that are common across countries and measured in Demographic and Health Surveys, such as blood pressure measurement, tetanus toxoid vaccination, first ANC visit before 4 months gestation, urine testing, counseling about pregnancy danger signs, and iron–folate supplementation.
- Meningococcal vaccine introduction in Mali through mass campaigns and its impact on the health system
The meningococcal A vaccine campaign led to major disruption of routine vaccination services and reduced other services, notably antenatal care.
- Introduction of the levonorgestrel intrauterine system in Kenya through mobile outreach: review of service statistics and provider perspectives
Limited introduction of the LNG IUS through mobile outreach in Kenya, without any special promotion, resulted in good uptake. And providers viewed it positively, particularly because of its noncontraceptive benefits. Increased provision of the LNG IUS can improve options for women needing highly effective reversible contraception.
- Safety of adult medical male circumcision performed by non-physician clinicians in Kenya: a prospective cohort study
Trained, experienced nurses and clinical officers provided safe voluntary medical male circumcision (VMMC) in public health facilities in Nyanza Province, Kenya, as evidenced by the low 2% adverse event rate (most commonly, excess swelling). Task shifting for male circumcision can improve access to quality VMMC services.
- Moving malaria in pregnancy programs from neglect to priority: experience from Malawi, Senegal, and Zambia
Program areas that were generally working well in malaria in pregnancy programs (MIP) included: (1) integration of MIP interventions into antenatal care; (2) development of up-to-date policies; (3) active involvement of communities; and (4) development of capacity-building materials for training. Challenges remain in the areas of: (1) commodities; (2) quality assurance; (3) monitoring and evaluation; and (4) financing.
- Scaling up delivery of contraceptive implants in sub-Saharan Africa: operational experiences of Marie Stopes International
Between 2008 and 2012, Marie Stopes International (MSI) provided 1.7 million contraceptive implants in sub-Saharan Africa as part of a comprehensive method mix, primarily through mobile outreach using dedicated MSI providers and also through social franchising and MSI-run clinics. Large-scale access, quality, and informed choice were key elements of MSI's strategy.