Most read article(s)
- Universal Health Coverage in Francophone Sub-Saharan Africa: Assessment of Global Health Experts' Confidence in Policy Options
Even within the fairly homogenous context of francophone Africa, among 18 options presented to experts on how to proceed toward universal health coverage (UHC), consensus was reached on only 1 with respect to effectiveness and another with respect to feasibility. The complexity and challenges of UHC as well as the weak evidence base likely contribute to this uncertainty.
- Management of Preeclampsia, Severe Preeclampsia, and Eclampsia at Primary Care Facilities in Bangladesh
Program introduction, including cascade training, to screen for severe preeclampsia and eclampsia and initiate treatment with magnesium sulfate was somewhat successful. Challenges included inconsistent adherence to the national protocol, data quality, and some issues with supplies and equipment.
- The 6 domains of behavior change: the missing health system building block
Behavior is crucial throughout global health interventions. The discipline of behavior change offers distinct expertise needed across 6 different domains of behavior. Such expertise is in short supply, however. We will not have effective and sustainable health systems, nor achieve our ambitious global health goals, without seriously addressing behavior change.
- Social Entrepreneurship: A Case Study From Brazil
Through careful sourcing of commodities, cost-cutting efficiencies, and realistic pricing, 3 large contraceptive social marketing programs evolved into profit-making enterprises while continuing to make low-priced contraceptives available to low-income consumers on a substantial scale.
- Task Sharing Implant Insertion by Community Health Workers: Not Just Can It Work, but How Might It Work Practically and With Impact in the Real World
Demonstrating that a health service, such as providing contraceptive implants, can be safely task shared to less highly trained workers is crucial but is only one step toward effective implementation at scale. Providers need dedicated time, enough clients, supplies, supervision, and other system support, allowing them to maintain their competency, confidence, and productivity.
- Human Papillomavirus Vaccine Introduction in South Africa: Implementation Lessons From an Evaluation of the National School-Based Vaccination Campaign
Evaluation of the campaign confirmed its feasibility in this setting: it achieved high coverage, few adverse events, and mostly positive media coverage. However, challenges occurred in data and cold chain management. Future implementation requires improved partnerships between government ministries, simplified informed consent, and closer monitoring of social media messaging.
- Maximizing the benefits of improved cookstoves: moving from acquisition to correct and consistent use
The adoption of clean cooking technologies goes beyond mere product acquisition and requires attention to issues of cooking traditions, user engagement, gender dynamics, culture, and religion to effect correct and consistent use.
- The State of Digital Interventions for Demand Generation in Low- and Middle-Income Countries: Considerations, Emerging Approaches, and Research Gaps
Despite advances in digital technology to generate demand for health services, considerable gaps remain in our understanding of which interventions are effective, which characteristics mediate their benefit for different target populations and health domains, and what is necessary to ensure effective deployment. Future research should examine the long-term effects of, equity in access to, and cost-effectiveness and efficiency of digital demand generation interventions.
- Decentralized, Community-Based Treatment for Drug-Resistant Tuberculosis: Bangladesh Program Experience
Shifting from hospital- to community-based management of drug-resistant TB, increased treatment enrollment, reduced treatment initiation delays, improved follow-up and adherence, and lowered treatment failure, and was associated with higher cure rates and lower mortality.
- Large-Scale Evaluation of Quality of Care in 6 Countries of Eastern Europe and Central Asia Using Clinical Performance and Value Vignettes
When providers in 6 different countries were asked how they would care for the same patient, there was wide variation within and between countries. Nevertheless, 11% of the physicians scored over 80%, suggesting good quality of care is possible even with resource constraints. Use of validated clinical vignettes, which can be applied affordably at scale, could help improve quality of services in low- and middle-income countries.