Table of Contents
Editorials
- 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.
- Making the most of food aid to help prevent child and maternal deaths
Advances in child nutrition over the last several decades are creating momentum for a programmatic push to reduce undernutrition worldwide. The contribution of food aid may be small, but, nonetheless, U.S. food aid policy should be revamped to benefit more effectively and more efficiently the children and mothers in need.
- Focusing on implementation: the power of executing many small advances well
Success often comes through many small, incremental, well-executed improvements.
Viewpoint
- Achieving better maternal and newborn outcomes: coherent strategy and pragmatic, tailored implementation
Maternal and newborn health program effort needs to: shift from mere contact to the actual content or substance of care; respond better to local context; ensure delivery of all key interventions needed during pregnancy, labor and delivery, and postnatally; and actively monitor performance to manage and improve programs.
Technical Concepts
- mHealth innovations as health system strengthening tools: 12 common applications and a visual framework
This new framework lays out 12 common mHealth applications used as health systems strengthening innovations across the reproductive health continuum.
Original Articles
- High and equitable mass vitamin A supplementation coverage in Sierra Leone: a post-event coverage survey
In Sierra Leone, an intensive mass vitamin A supplementation (VAS) campaign to reduce under-5 mortality reached over 90% of children ages 6–59 months, eliminating coverage disparities among districts and between age groups. Delivering VAS with other essential maternal and child health interventions was key to the success.
- Client-centered counseling improves client satisfaction with family planning visits: evidence from Irbid, Jordan
In Irbid, Jordan, a combination of community outreach, using home visits, plays, women's groups, and religious leaders, and improved client-provider counseling based on the “Consult and Choose” approach increased family planning demand and client satisfaction. Service statistic trends suggest increased contraceptive use.
- Food commodity pipeline management in transitional settings: challenges and lessons learned from the first USAID food development program in South Sudan
Efficient and reliable commodity transport is critical to effective food assistance in development settings as well as in emergency situations. Increasing the flexibility of U.S. government Title II food assistance program procurement regulations and more comprehensive contingency planning could improve the effectiveness of these programs in non-emergency settings with high food insecurity and political volatility.
- Use of modern contraception increases when more methods become available: analysis of evidence from 1982–2009
International data over 27 years show that as each additional contraceptive method became available to most of the population, overall modern contraceptive use rose. But in 2009 only 3.5 methods, on average, were available to at least half the population in surveyed countries. Family planning programs should strive to provide widespread access to a range of methods.
- Improving performance of Zambia Defence Force antiretroviral therapy providers: evaluation of a standards-based approach
A detailed standards-based performance approach modestly improved providers' performance and facility readiness to offer antiretroviral therapy. The approach included mutually reinforcing activities: (1) training, (2) supportive supervision, (3) assessments of service quality, and (4) facility-based action plans.
- Islam and family planning: changing perceptions of health care providers and medical faculty in Pakistan
Training health care providers and medical college faculty about the supportive nature of Islam toward family planning principles addressed their misconceptions and enhanced their level of comfort in providing family planning services and teaching the subject.
- Forest cover associated with improved child health and nutrition: evidence from the Malawi Demographic and Health Survey and satellite data
In Malawi, net forest cover loss over time is associated with reduced dietary diversity and consumption of vitamin A-rich foods among children. Greater forest cover is associated with reduced risk of diarrheal disease. These preliminary findings suggest that protection of natural ecosystems could play an important role in improving health outcomes.
Review
- 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.
Methodology
- Operations research to add postpartum family planning to maternal and neonatal health to improve birth spacing in Sylhet District, Bangladesh
This quasi-experimental study integrated family planning, including the Lactational Amenorrhea Method, into community-based maternal and newborn health care and encouraged transition to other modern methods after 6 months to increase birth-to-pregnancy intervals. Community-based distribution of pills, condoms, and injectables, and referral for clinical methods, was added to meet women's demand.
Field Action Report
- Successful use of tablet personal computers and wireless technologies for the 2011 Nepal Demographic and Health Survey
Using tablet personal computers and wireless technologies in place of paper-based questionnaires to administer the Nepal DHS in a geographically diverse setting appeared to improve data quality and reduce data collection time. Challenges include inconsistent electricity supply, safe storage and transport of equipment, and screen readability issues under direct sunlight, which limited confidential interview spaces.
Commentaries
Supply chain integration—merging products for health programs into a single supply chain—tends to be the dominant model in health sector reform. However, multiplicity in a supply system may be justified as a risk management strategy that can better ensure product availability, advance specific health program objectives, and increase efficiency.