Most read article(s)
- Female Health Workers at the Doorstep: A Pilot of Community-Based Maternal, Newborn, and Child Health Service Delivery in Northern Nigeria
Deployment of resident female Community Health Extension Workers (CHEWs) to a remote rural community led to major and sustained increases in service utilization, including antenatal care and facility-based deliveries. Key components to success: (1) providing an additional rural residence allowance to help recruit and retain CHEWs; (2) posting the female CHEWs in pairs to avoid isolation and provide mutual support; (3) ensuring supplies and transportation means for home visits; and (4) allowing CHEWs to perform deliveries.
- Postabortion Care: 20 Years of Strong Evidence on Emergency Treatment, Family Planning, and Other Programming Components
Twenty years of postabortion care (PAC) studies yield strong evidence that:
Misoprostol and vacuum aspiration are comparable in safety and effectiveness for treating incomplete abortion.
Misoprostol, which can be provided by trained nurses and midwives, shows substantial promise for extending PAC services to secondary hospitals and primary health posts.
Postabortion family planning uptake generally increases rapidly-and unintended pregnancies and repeat abortions can decline as a result-when a range of free contraceptives, including long-acting methods, are offered at the point of treatment; male involvement in counseling-always with the woman’s concurrence-can increase family planning uptake and support.
- Predictors of Essential Health and Nutrition Service Delivery in Bihar, India: Results From Household and Frontline Worker Surveys
Only about 35% of sample households reported receiving immunization, food supplements, pregnancy care information, or nutrition information. Monetary incentives for such product-oriented services as immunization improved performance and may have spillover effects for information-oriented services. Immunization day events and good frontline worker recordkeeping also improved service delivery.
- Effective Collaboration for Scaling Up Health Technologies: A Case Study of the Chlorhexidine for Umbilical Cord Care Experience
Facilitating factors for the Chlorhexidine Working Group: (1) strong, transparent leadership by a neutral broker, promoting shared ownership among all members; (2) reliable internal and external communication; (3) well-defined terms of reference building on common interest around a simple, effective health intervention; (4) clear benefits of participation, including access to evidence and technical assistance; and (5) adequate resources to support the secretariat functions.
- Palm Oil in Myanmar: A Spatiotemporal Analysis of the Effects of Industrial Farming on Biodiversity Loss
Satellite imagery analysis reveals a progressive shift from smallholder farming to industrial oil palm plantations in rural Myanmar, concomitant with biodiversity loss. Although industrial palm oil cultivation may help the local economy flourish, rural communities assume the dual burden of ecosystem instability from deforestation and potential health risks from increased palm oil consumption.
- Meeting Postpartum Women’s Family Planning Needs Through Integrated Family Planning and Immunization Services: Results of a Cluster-Randomized Controlled Trial in Rwanda
Integrating contraceptive services into infant immunization services was effective, acceptable, and feasible without negatively affecting immunization uptake. Yet unmet need for contraception remained high, including among a substantial number of women who were waiting for menses to return even though, at 6 months or more postpartum, they were at risk of an unintended pregnancy. More effort is needed to educate women about postpartum return to fertility and to encourage those desiring to space or limit pregnancy to use effective contraception.
- Preventing Peer Violence Against Children: Methods and Baseline Data of a Cluster Randomized Controlled Trial in Pakistan
Peer violence was remarkably high at baseline. Among urban public school students, 94% of 6th-grade boys and 85% of girls reported being victimized by peers in the last 4 weeks. And 85% of boys and 66% of girls reported perpetrating such violence. Boys scored worse on a number of mental health measures. A cluster RCT is underway to evaluate a well-established school-based intervention using sports and games to reduce peer violence.
- Family Planning in the Democratic Republic of the Congo: Encouraging Momentum, Formidable Challenges
Formidable challenges: uncertain political situation, cultural norms favoring high fertility, a thin patchwork of service delivery institutions, logistical issues in a vast country with weak infrastructure, and low capacity of the population to pay for contraceptive services. Encouraging progress: increasing government and donor support, openness to progressive service delivery policies, innovative programming including robust social marketing and initiatives with nursing schools and the military, strong collaboration among stakeholders, high unmet need suggesting strong latent demand for family planning, and an increasingly balanced method mix including long-acting methods.
- A Dedicated Postpartum Intrauterine Device Inserter: Pilot Experience and Proof of Concept
Use of the inserter was found to be safe, with high fundal placement in 82% of cases. Complete expulsion occurred in 7.5% of cases and partial expulsion was detected in 10%, comparable with rates in other studies using standard IUD insertion techniques. Further study and use of the dedicated inserter may reveal increased convenience and reduced risk of infection among users and could improve acceptability of postpartum IUD provision among providers.
- A Global Learning Agenda for the Levonorgestrel Intrauterine System (LNG IUS): Addressing Challenges and Opportunities to Increase Access
The LNG IUS is one of the most effective forms of reversible contraception and has important noncontraceptive benefits but is currently not used at scale in any Family Planning 2020 focus country. A global working group developed a shared learning agenda to answer critical questions, harmonize approaches, avoid duplication, and facilitate introduction of the method within the context of informed choice.