Health Topics
- It's about time: WHO and partners release programming strategies for postpartum family planning
The postpartum period is a critical time to address high unmet family planning need and to reduce the risks of closely spaced pregnancies. Practical tools are included in the new resource for integrating postpartum family planning at points when women have frequent health system contact, including during antenatal care, labor and delivery, postnatal care, immunization, and child health 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.
- 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.
- Injectable contraception provided by community-based health workers: one important step toward meeting unmet need
Community-based provision of injectable contraception continues to advance and is gaining wider acceptance—a major step toward meeting unmet need. However, fully addressing family planning need will require access to a much wider range of methods, including long-acting reversible contraception and permanent methods.
- Fulfilling the PEPFAR mandate: a more equitable use of PEPFAR resources across global health
As PEPFAR moves beyond its “emergency stage,” it should now help support a more sustainable development mode, including an equitable platform for meeting a broad range of priority health needs, while continuing to pursue the goal of an AIDS-free generation.
- Routine immunization: an essential but wobbly platform
Despite their vital role, routine immunization programs are taken for granted. Coverage levels are poor in some countries and have stagnated in others, while addition of new vaccines is an additional stressor. We need to strengthen: (1) policy processes, (2) monitoring and evaluation, (3) human resources, (4) regular delivery and supply systems, (5) local political commitment and ownership, (6) involvement of civil society and communities, and (7) sustainable financing. Rebalancing immunization direction and investment is needed.
- Building on safety, feasibility, and acceptability: the impact and cost of community health worker provision of injectable contraception
This project in Zambia contributes to our understanding of the impact of community-based provision of injectables on method choice and uptake and of the costs of adding DMPA to an established community-based family planning program. The project also illustrates the importance of involving stakeholders from the outset, analyzing costs relevant to scale up, and engaging in policy change dialogue not at the end, but rather throughout project implementation.
- Understanding where parents take their sick children and why it matters: a multi-country analysis
To effectively reach children with potentially life-threatening illness with needed treatment, it is important to understand where parents seek care. Data from 42 DHS and MICS surveys conducted since 2005 show that a majority of care in Africa is sought from the public sector; in South Asia, from the private sector; and in Southeast Asia, from a public-private mix. We recommend that such data be made available in standard DHS and MICS reports.
- Does free pregnancy testing reduce service denial in family planning clinics? A cluster-randomized experiment in Zambia and Ghana
Pregnancy tests, which cost very little (∼US$0.10) and are often required for successful family planning service delivery, may reduce service denial, and should be available in all family planning clinics at no or minimal cost to clients.