Latest Articles
- Family Planning in the Context of Latin America’s Universal Health Coverage Agenda
Latin American countries have expanded family planning along with universal health coverage (UHC). Leveraging UHC-oriented schemes to increase family planning program coverage, equity, and financing requires:
Targeting poor and indigenous populations
Including family planning services in all benefits packages
Ensuring sufficient supply of commodities and human resources to avoid stock-outs and implicit rationing
Reducing nonfinancial barriers to access
- Overcoming Operational Challenges to Ebola Case Investigation in Sierra Leone
Deficiencies in transportation and communication, low frontline staff morale, and mistrust among communities, among other operational challenges, greatly limited Ebola case investigation in Sierra Leone. Recommendations for future outbreaks: (1) timely compensation for frontline staff, (2) context-appropriate transportation and communication resources, (3) systematic data collection, storage, and retrieval systems, (4) sound linkages between frontline staff and communities, (5) daily meetings between frontline staff and epidemiologists, (6) clear and appropriate operational chain of command, and (7) political and funding support to operational agencies.
- The Tobacco-Free Village Program: Helping Rural Areas Implement and Achieve Goals of Tobacco Control Policies in India
Tobacco control and prevention in rural areas are possible as demonstrated by a community-driven tobacco-free village program in India. Success factors included community ownership with supportive program guidance, motivated and committed local leaders, collaboration with grassroots organizations, rewards and sanctions to establish new social norms, and provision of other income-generating options for vendors who sell tobacco. While the program required time and dedicated effort and was not successful in all villages, it holds promise for helping to achieve the goals of tobacco control policies, especially in resource-scarce settings.
- Long-Acting HIV Treatment and Prevention: Closer to the Threshold
Substantial progress has been made toward viable, practical long-acting approaches to deliver HIV treatment and prevention through: (1) continued improvements in long-acting antiretrovirals (ARVs); (2) better innovative delivery systems; and (3) collaboration of willing partners to advance new ARVs. More progress on those 3 fronts is still needed to arrive at the goal of optimized HIV treatment and prevention for all who would benefit—and of finally controlling the HIV epidemic.
- Reducing Sepsis Deaths in Newborns Through Home Visitation and Active Case Detection: Is it Realistic?
Severe bacterial infection remains one of the major causes of newborn deaths in low-income countries. A key challenge for reducing this burden is making definitive treatment more easily available. Active case detection through early postnatal home visits can work under trial conditions but is difficult to implement at scale under routine conditions. In many settings, making treatment available at peripheral-level primary health care facilities may be more feasible.
- Design Improvements for Personal Protective Equipment Used in Ebola and Other Epidemic Outbreaks
We redesigned the personal protective equipment ensemble widely used during the 2014 Ebola outbreak into a relatively simpler and more versatile coverall and hood, to improve protection and usability for frontline workers treating patients in infectious disease outbreaks around the world.
- Increasing Access to Family Planning Choices Through Public-Sector Social Franchising: The Experience of Marie Stopes International in Mali
While social franchising has been highly successful with private-sector providers, in Mali the approach was expanded to public-sector community health clinics. From 2012 to 2015, these clinics served >120,000 family planning clients, 78% of whom chose long-acting reversible methods. Many clients were young, poor, and had not been using a method during the 3 months prior to their visit.
- Challenges of Implementing Antenatal Ultrasound Screening in a Rural Study Site: A Case Study From the Democratic Republic of the Congo
In the context of a well-resourced research project on obstetric ultrasound, we encountered major challenges, including security and maintenance of the equipment, electricity requirements, health systems integration, and a variety of other systems issues. We propose future ultrasound interventions have at minimum a functioning health system with skilled and motivated staff, access to a referral hospital capable of providing affordable and higher levels of care, and feasible transportation means.
- Improving Adherence to Essential Birth Practices Using the WHO Safe Childbirth Checklist With Peer Coaching: Experience From 60 Public Health Facilities in Uttar Pradesh, India
Implementation of the WHO Safe Childbirth Checklist with peer coaching resulted in >90% adherence to 35 of 39 essential birth practices among birth attendants after 8 months, but adherence to some practices was lower when the coach was absent.
- Availability and Quality of Family Planning Services in the Democratic Republic of the Congo: High Potential for Improvement
A few facilities provided good access to and quality of family planning services, particularly urban, private, and higher-level facilities. Yet only one-third offered family planning services at all, and only 20% of these facilities met a basic measure of quality. Condoms, oral contraceptives, and injectables were most available, whereas long-acting, permanent methods, and emergency contraception were least available. Responding to the DRC's high unmet need for family planning calls for substantial expansion of services.