Most read article(s)
- Using the Unmanned Aerial Vehicle Delivery Decision Tool to Consider Transporting Medical Supplies via Drone
We developed an unmanned aerial vehicle (UAV) Delivery Decision Tool to help health system decision makers identify their transport challenges and explore the potential utility and impact of UAVs on the broader health system.
- Extended Effectiveness of the Etonogestrel-Releasing Contraceptive Implant and the 20 µg Levonorgestrel-Releasing Intrauterine System for 2 Years Beyond U.S. Food and Drug Administration Product Labeling
Recently published evidence from 2 large studies find that the duration of effectiveness of the etonorgestrel-releasing contraceptive implant to be at least 5 years (compared with the current 3-year label), and for the 20 µg levonorgestrel-releasing intrauterine system at least 7 years (compared with the current 5-year label).
- A Mobile-Based Community Health Management Information System for Community Health Workers and Their Supervisors in 2 Districts of Zambia
Using simple-feature mobile phones, CHWs sent weekly reports on disease caseloads and commodities consumed, ordered drugs and supplies, and sent pre-referral notices to health centers. Supervisors provided feedback to CHWs on referred patient outcomes and received monthly SMS reminders to set up mentoring sessions with the CHWs. Scale-up limitations include: (1) staff shortages at health centers to supervise the CHWs, (2) need for ongoing technical support to troubleshoot challenges with mobile phones and software, and (3) recurring costs for data bundles.
- Evidence-based public health: not only whether it works, but how it can be made to work practicably at scale
Because public health must operate at scale in widely diverse, complex situations, randomized controlled trials (RCTs) have limited utility for public health. Other methodologies are needed. A key conceptual backbone is a detailed “theory of change” to apply appropriate evidence for each operational component. Synthesizing patterns of findings across multiple methodologies provides key insights. Programs operating successfully across a variety of settings can provide some of the best evidence. Challenges include judging the quality of such evidence and assisting programs to apply it. WHO and others should shift emphasis from RCTs to more relevant evidence when assessing public health issues.
- 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.
- Interventions for Preventing Unintended, Rapid Repeat Pregnancy Among Adolescents: A Review of the Evidence and Lessons From High-Quality Evaluations
Evidence shows that effective prevention of rapid repeat pregnancy among adolescents links adolescent-friendly clinical contraceptive services with non-clinical interventions that contribute to positive youth development.
- Safety and Acceptability of Community-Based Distribution of Injectable Contraceptives: A Pilot Project in Mozambique
Trained community health workers, including traditional birth attendants (TBAs), safely and effectively administered injectables in northern Mozambique; two-thirds of the women choosing injectables had never used contraception before. Including TBAs in the Ministry of Health’s recent task sharing strategy can improve rural women’s access to injectables and help meet women’s demand for contraception.
- Global health diplomacy: advancing foreign policy and global health interests
Attention to global health diplomacy has been rising but the future holds challenges, including a difficult budgetary environment. Going forward, both global health and foreign policy practitioners would benefit from working more closely together to achieve greater mutual understanding and to advance respective mutual goals.
- Limited electricity access in health facilities of sub-Saharan Africa: a systematic review of data on electricity access, sources, and reliability
Only 34% of hospitals have reliable electricity access in surveyed sub-Saharan African countries. However, analysis in 2 countries indicates modest improvements in electricity access over time. Ambitious plans to improve health service delivery in sub-Saharan Africa need to address this critical issue.
- Will the Higher-Income Country Blueprint for COVID-19 Work in Low- and Lower Middle-Income Countries?
Strategies to radically suppress incidence of COVID-19, as used in higher-income countries, may be unrealistic and counterproductive in most low- and lower middle-income countries. Instead, strategies should be tailored to the setting, balancing expected benefits, potential harms, and feasibility.