Index by author
A
Afenyadu, Godwin Y
- Open AccessFemale Health Workers at the Doorstep: A Pilot of Community-Based Maternal, Newborn, and Child Health Service Delivery in Northern NigeriaCharles A Uzondu, Henry V Doctor, Sally E Findley, Godwin Y Afenyadu and Alastair AgerGlobal Health: Science and Practice March 2015, 3(1):97-108; https://doi.org/10.9745/GHSP-D-14-00117
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.
Ager, Alastair
- Open AccessFemale Health Workers at the Doorstep: A Pilot of Community-Based Maternal, Newborn, and Child Health Service Delivery in Northern NigeriaCharles A Uzondu, Henry V Doctor, Sally E Findley, Godwin Y Afenyadu and Alastair AgerGlobal Health: Science and Practice March 2015, 3(1):97-108; https://doi.org/10.9745/GHSP-D-14-00117
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.
Amin, Ruhul
- Open AccessEngaging Communities With a Simple Tool to Help Increase Immunization CoverageManish Jain, Gunjan Taneja, Ruhul Amin, Robert Steinglass and Michael FavinGlobal Health: Science and Practice March 2015, 3(1):117-125; https://doi.org/10.9745/GHSP-D-14-00180
Use of a simple, publicly placed tool that monitors vaccination coverage in a community has potential to broaden program coverage by keeping both the community and the health system informed about every infant's vaccination status.
B
Barnhart, Matthew
- Open AccessARVs: The Next Generation. Going Boldly Together to New Frontiers of HIV TreatmentMatthew Barnhart and James D SheltonGlobal Health: Science and Practice March 2015, 3(1):1-11; https://doi.org/10.9745/GHSP-D-14-00243
New antiretrovirals (ARVs), particularly the potentially “game-changing” ARV dolutegravir, offer major potential to meet the compelling need for simpler and better HIV treatment for tens of millions of people in the coming decade. Advantages include substantially lower manufacturing cost, fewer side effects, and less risk of resistance. But key obstacles must be addressed in order to develop and introduce new ARVs in specific combinations optimized for the needs of low- and middle-income countries. Strong leadership will be essential from the global health community to nurture more focused collaboration between the private and public sectors.
Bellows, Benjamin W
- Open AccessA False Dichotomy: RCTs and Their Contributions to Evidence-Based Public HealthLaurel E Hatt, Minki Chatterji, Leslie Miles, Alison B Comfort, Benjamin W Bellows and Francis O OkelloGlobal Health: Science and Practice March 2015, 3(1):138-140; https://doi.org/10.9745/GHSP-D-14-00245
Global public health should rely on those research methods that best answer the pressing questions at hand. Randomized controlled trials (RCTs) and other rigorous impact evaluation methods have a critical role to play in public health.
Bulakali, Joseph
- Open AccessA Resource Planning Analysis of District Hospital Surgical Services in the Democratic Republic of the CongoMelanie Sion, Dheepa Rajan, Hyppolite Kalambay, Jean-Pierre Lokonga, Joseph Bulakali, Mathias Mossoko, Dieudonne Kwete, Gerard Schmets, Edward Kelley, Tarcisse Elongo, Luis Sambo and Meena CherianGlobal Health: Science and Practice March 2015, 3(1):56-70; https://doi.org/10.9745/GHSP-D-14-00165
District hospitals in the DRC, on average, could not provide 21% of lifesaving surgical interventions due to deficiencies in basic infrastructure and essential surgical equipment and supplies. Surgery's important health impact and proportionally low service delivery budget argue for greater emphasis on surgical interventions, including for obstetric care.
C
Chatterji, Minki
- Open AccessA False Dichotomy: RCTs and Their Contributions to Evidence-Based Public HealthLaurel E Hatt, Minki Chatterji, Leslie Miles, Alison B Comfort, Benjamin W Bellows and Francis O OkelloGlobal Health: Science and Practice March 2015, 3(1):138-140; https://doi.org/10.9745/GHSP-D-14-00245
Global public health should rely on those research methods that best answer the pressing questions at hand. Randomized controlled trials (RCTs) and other rigorous impact evaluation methods have a critical role to play in public health.
Cherian, Meena
- Open AccessA Resource Planning Analysis of District Hospital Surgical Services in the Democratic Republic of the CongoMelanie Sion, Dheepa Rajan, Hyppolite Kalambay, Jean-Pierre Lokonga, Joseph Bulakali, Mathias Mossoko, Dieudonne Kwete, Gerard Schmets, Edward Kelley, Tarcisse Elongo, Luis Sambo and Meena CherianGlobal Health: Science and Practice March 2015, 3(1):56-70; https://doi.org/10.9745/GHSP-D-14-00165
District hospitals in the DRC, on average, could not provide 21% of lifesaving surgical interventions due to deficiencies in basic infrastructure and essential surgical equipment and supplies. Surgery's important health impact and proportionally low service delivery budget argue for greater emphasis on surgical interventions, including for obstetric care.
Comfort, Alison B
- Open AccessA False Dichotomy: RCTs and Their Contributions to Evidence-Based Public HealthLaurel E Hatt, Minki Chatterji, Leslie Miles, Alison B Comfort, Benjamin W Bellows and Francis O OkelloGlobal Health: Science and Practice March 2015, 3(1):138-140; https://doi.org/10.9745/GHSP-D-14-00245
Global public health should rely on those research methods that best answer the pressing questions at hand. Randomized controlled trials (RCTs) and other rigorous impact evaluation methods have a critical role to play in public health.
Cooper, Chelsea M
- Open AccessSuccessful Proof of Concept of Family Planning and Immunization Integration in LiberiaChelsea M Cooper, Rebecca Fields, Corinne I Mazzeo, Nyapu Taylor, Anne Pfitzer, Mary Momolu and Cuallau Jabbeh-HoweGlobal Health: Science and Practice March 2015, 3(1):71-84; https://doi.org/10.9745/GHSP-D-14-00156
Mobilizing vaccinators to provide mothers key family planning information and referrals to co-located, same-day family planning services was feasible in resource-limited areas of Liberia, leading to substantial increases in contraceptive use. Conversely, impact on immunization rates was less clear, but at a minimum there was no decrease in doses administered.
Cumba, Luisa
- Open AccessBarriers to Health Care in Rural Mozambique: A Rapid Ethnographic Assessment of Planned Mobile Health Clinics for ARTAmee Schwitters, Philip Lederer, Leah Zilversmit, Paula Samo Gudo, Isaias Ramiro, Luisa Cumba, Epifanio Mahagaja and Kebba JobartehGlobal Health: Science and Practice March 2015, 3(1):109-116; https://doi.org/10.9745/GHSP-D-14-00145
Mobile health clinics can markedly decrease clients' transportation time and cost to access antiretroviral therapy (ART) and other health services in rural areas, potentially improving use. Close coordination with community leaders and regularly scheduled visits by the mobile clinics are critical.
Curry, Dora Ward
- Open AccessDelivering High-Quality Family Planning Services in Crisis-Affected Settings I: Program ImplementationDora Ward Curry, Jesse Rattan, Jean Jose Nzau and Kamlesh GiriGlobal Health: Science and Practice March 2015, 3(1):14-24; https://doi.org/10.9745/GHSP-D-14-00164
Extending access to a wide variety of contraceptive methods, including long-acting reversible methods, is feasible in crisis-affected countries by focusing on best practices such as competency-based training, supply chain support, systematic supervision, and community mobilization. Prudent use of data helps drive program improvements.
- Open AccessDelivering High-Quality Family Planning Services in Crisis-Affected Settings II: ResultsDora Ward Curry, Jesse Rattan, Shuyuan Huang and Elizabeth NozneskyGlobal Health: Science and Practice March 2015, 3(1):25-33; https://doi.org/10.9745/GHSP-D-14-00112
A family planning program in 5 crisis-affected settings reached more than 52,000 new contraceptive users in just 2.5 years. Long-acting reversible contraceptives (LARCs) made up 61% of the method mix, with implants predominating in most countries. IUD use also increased over time as the program intensified its efforts to improve provider skills and user awareness. These findings demonstrate the strong popularity of LARCs and the feasibility of providing them in fragile settings even though they require more training and infrastructure support than short-acting methods.
D
Dixon, Cinnamon A
- Open AccessPatient Flow Analysis in Resource-Limited Settings: A Practical Tutorial and Case StudyCinnamon A Dixon, Damien Punguyire, Melinda Mahabee-Gittens, Mona Ho and Christopher J LindsellGlobal Health: Science and Practice March 2015, 3(1):126-134; https://doi.org/10.9745/GHSP-D-14-00121
Patient flow analysis (PFA), a simple quality improvement tool to identify patient flow patterns, can be used in resource-limited settings to inform service delivery improvements. A PFA at a Ghanaian hospital found that personnel constraints and a mismatch between staffing and patient arrival surges led to long wait and total attendance times. The median time from arrival to first-provider contact was 4.6 hours.
Doctor, Henry V
- Open AccessFemale Health Workers at the Doorstep: A Pilot of Community-Based Maternal, Newborn, and Child Health Service Delivery in Northern NigeriaCharles A Uzondu, Henry V Doctor, Sally E Findley, Godwin Y Afenyadu and Alastair AgerGlobal Health: Science and Practice March 2015, 3(1):97-108; https://doi.org/10.9745/GHSP-D-14-00117
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.
E
Elongo, Tarcisse
- Open AccessA Resource Planning Analysis of District Hospital Surgical Services in the Democratic Republic of the CongoMelanie Sion, Dheepa Rajan, Hyppolite Kalambay, Jean-Pierre Lokonga, Joseph Bulakali, Mathias Mossoko, Dieudonne Kwete, Gerard Schmets, Edward Kelley, Tarcisse Elongo, Luis Sambo and Meena CherianGlobal Health: Science and Practice March 2015, 3(1):56-70; https://doi.org/10.9745/GHSP-D-14-00165
District hospitals in the DRC, on average, could not provide 21% of lifesaving surgical interventions due to deficiencies in basic infrastructure and essential surgical equipment and supplies. Surgery's important health impact and proportionally low service delivery budget argue for greater emphasis on surgical interventions, including for obstetric care.
F
Favin, Michael
- Open AccessEngaging Communities With a Simple Tool to Help Increase Immunization CoverageManish Jain, Gunjan Taneja, Ruhul Amin, Robert Steinglass and Michael FavinGlobal Health: Science and Practice March 2015, 3(1):117-125; https://doi.org/10.9745/GHSP-D-14-00180
Use of a simple, publicly placed tool that monitors vaccination coverage in a community has potential to broaden program coverage by keeping both the community and the health system informed about every infant's vaccination status.
Fields, Rebecca
- Open AccessSuccessful Proof of Concept of Family Planning and Immunization Integration in LiberiaChelsea M Cooper, Rebecca Fields, Corinne I Mazzeo, Nyapu Taylor, Anne Pfitzer, Mary Momolu and Cuallau Jabbeh-HoweGlobal Health: Science and Practice March 2015, 3(1):71-84; https://doi.org/10.9745/GHSP-D-14-00156
Mobilizing vaccinators to provide mothers key family planning information and referrals to co-located, same-day family planning services was feasible in resource-limited areas of Liberia, leading to substantial increases in contraceptive use. Conversely, impact on immunization rates was less clear, but at a minimum there was no decrease in doses administered.
Findley, Sally E
- Open AccessFemale Health Workers at the Doorstep: A Pilot of Community-Based Maternal, Newborn, and Child Health Service Delivery in Northern NigeriaCharles A Uzondu, Henry V Doctor, Sally E Findley, Godwin Y Afenyadu and Alastair AgerGlobal Health: Science and Practice March 2015, 3(1):97-108; https://doi.org/10.9745/GHSP-D-14-00117
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.
G
Geoffroy, Elizabeth
- Open AccessPredictors of Workforce Retention Among Malawian Nurse Graduates of a Scholarship Program: A Mixed-Methods StudyKelly Schmiedeknecht, Melanie Perera, Ellen Schell, Joyce Jere, Elizabeth Geoffroy and Sally RankinGlobal Health: Science and Practice March 2015, 3(1):85-96; https://doi.org/10.9745/GHSP-D-14-00170
Several non-remuneration strategies may help improve retention of public-sector nurses: availability of supplies, adequate housing, advancement opportunities, and a positive work environment. A scholarship program with close follow-up of graduates may also help improve retention.
Giri, Kamlesh
- Open AccessDelivering High-Quality Family Planning Services in Crisis-Affected Settings I: Program ImplementationDora Ward Curry, Jesse Rattan, Jean Jose Nzau and Kamlesh GiriGlobal Health: Science and Practice March 2015, 3(1):14-24; https://doi.org/10.9745/GHSP-D-14-00164
Extending access to a wide variety of contraceptive methods, including long-acting reversible methods, is feasible in crisis-affected countries by focusing on best practices such as competency-based training, supply chain support, systematic supervision, and community mobilization. Prudent use of data helps drive program improvements.
Grigore, Alexandra
- Open AccessBiometric Fingerprint System to Enable Rapid and Accurate Identification of BeneficiariesDaniel Matthew L Storisteanu, Toby L Norman, Alexandra Grigore and Tristram L NormanGlobal Health: Science and Practice March 2015, 3(1):135-137; https://doi.org/10.9745/GHSP-D-15-00010
Inability to uniquely identify clients impedes access to services and contributes to inefficiencies. Using a pocket-sized fingerprint scanner that wirelessly syncs with a health worker's smartphone, the SimPrints biometric system can link individuals' fingerprints to their health records. A pilot in Bangladesh will assess its potential.
Gudo, Paula Samo
- Open AccessBarriers to Health Care in Rural Mozambique: A Rapid Ethnographic Assessment of Planned Mobile Health Clinics for ARTAmee Schwitters, Philip Lederer, Leah Zilversmit, Paula Samo Gudo, Isaias Ramiro, Luisa Cumba, Epifanio Mahagaja and Kebba JobartehGlobal Health: Science and Practice March 2015, 3(1):109-116; https://doi.org/10.9745/GHSP-D-14-00145
Mobile health clinics can markedly decrease clients' transportation time and cost to access antiretroviral therapy (ART) and other health services in rural areas, potentially improving use. Close coordination with community leaders and regularly scheduled visits by the mobile clinics are critical.
H
Hardee, Karen
- Open AccessTrends in the Contraceptive Method Mix in Low- and Middle-Income Countries: Analysis Using a New “Average Deviation” MeasureJohn Ross, Jill Keesbury and Karen HardeeGlobal Health: Science and Practice March 2015, 3(1):34-55; https://doi.org/10.9745/GHSP-D-14-00199
Applying a standard measure of the method mix evenness suggests 4 patterns among 15 countries moving toward a more balanced mix: (1) rise of one previously underrepresented or new method, (2) replacement of traditional with modern methods, (3) continued but declining domination by a single method, and (4) general movement toward a balanced mix. Improving availability of underutilized or new methods can improve the method mix, although better implementation of more popular methods might increase contraceptive use more expeditiously.
Hatt, Laurel E
- Open AccessA False Dichotomy: RCTs and Their Contributions to Evidence-Based Public HealthLaurel E Hatt, Minki Chatterji, Leslie Miles, Alison B Comfort, Benjamin W Bellows and Francis O OkelloGlobal Health: Science and Practice March 2015, 3(1):138-140; https://doi.org/10.9745/GHSP-D-14-00245
Global public health should rely on those research methods that best answer the pressing questions at hand. Randomized controlled trials (RCTs) and other rigorous impact evaluation methods have a critical role to play in public health.
Ho, Mona
- Open AccessPatient Flow Analysis in Resource-Limited Settings: A Practical Tutorial and Case StudyCinnamon A Dixon, Damien Punguyire, Melinda Mahabee-Gittens, Mona Ho and Christopher J LindsellGlobal Health: Science and Practice March 2015, 3(1):126-134; https://doi.org/10.9745/GHSP-D-14-00121
Patient flow analysis (PFA), a simple quality improvement tool to identify patient flow patterns, can be used in resource-limited settings to inform service delivery improvements. A PFA at a Ghanaian hospital found that personnel constraints and a mismatch between staffing and patient arrival surges led to long wait and total attendance times. The median time from arrival to first-provider contact was 4.6 hours.
Huang, Shuyuan
- Open AccessDelivering High-Quality Family Planning Services in Crisis-Affected Settings II: ResultsDora Ward Curry, Jesse Rattan, Shuyuan Huang and Elizabeth NozneskyGlobal Health: Science and Practice March 2015, 3(1):25-33; https://doi.org/10.9745/GHSP-D-14-00112
A family planning program in 5 crisis-affected settings reached more than 52,000 new contraceptive users in just 2.5 years. Long-acting reversible contraceptives (LARCs) made up 61% of the method mix, with implants predominating in most countries. IUD use also increased over time as the program intensified its efforts to improve provider skills and user awareness. These findings demonstrate the strong popularity of LARCs and the feasibility of providing them in fragile settings even though they require more training and infrastructure support than short-acting methods.
J
Jabbeh-Howe, Cuallau
- Open AccessSuccessful Proof of Concept of Family Planning and Immunization Integration in LiberiaChelsea M Cooper, Rebecca Fields, Corinne I Mazzeo, Nyapu Taylor, Anne Pfitzer, Mary Momolu and Cuallau Jabbeh-HoweGlobal Health: Science and Practice March 2015, 3(1):71-84; https://doi.org/10.9745/GHSP-D-14-00156
Mobilizing vaccinators to provide mothers key family planning information and referrals to co-located, same-day family planning services was feasible in resource-limited areas of Liberia, leading to substantial increases in contraceptive use. Conversely, impact on immunization rates was less clear, but at a minimum there was no decrease in doses administered.
Jain, Manish
- Open AccessEngaging Communities With a Simple Tool to Help Increase Immunization CoverageManish Jain, Gunjan Taneja, Ruhul Amin, Robert Steinglass and Michael FavinGlobal Health: Science and Practice March 2015, 3(1):117-125; https://doi.org/10.9745/GHSP-D-14-00180
Use of a simple, publicly placed tool that monitors vaccination coverage in a community has potential to broaden program coverage by keeping both the community and the health system informed about every infant's vaccination status.
Jere, Joyce
- Open AccessPredictors of Workforce Retention Among Malawian Nurse Graduates of a Scholarship Program: A Mixed-Methods StudyKelly Schmiedeknecht, Melanie Perera, Ellen Schell, Joyce Jere, Elizabeth Geoffroy and Sally RankinGlobal Health: Science and Practice March 2015, 3(1):85-96; https://doi.org/10.9745/GHSP-D-14-00170
Several non-remuneration strategies may help improve retention of public-sector nurses: availability of supplies, adequate housing, advancement opportunities, and a positive work environment. A scholarship program with close follow-up of graduates may also help improve retention.
Jobarteh, Kebba
- Open AccessBarriers to Health Care in Rural Mozambique: A Rapid Ethnographic Assessment of Planned Mobile Health Clinics for ARTAmee Schwitters, Philip Lederer, Leah Zilversmit, Paula Samo Gudo, Isaias Ramiro, Luisa Cumba, Epifanio Mahagaja and Kebba JobartehGlobal Health: Science and Practice March 2015, 3(1):109-116; https://doi.org/10.9745/GHSP-D-14-00145
Mobile health clinics can markedly decrease clients' transportation time and cost to access antiretroviral therapy (ART) and other health services in rural areas, potentially improving use. Close coordination with community leaders and regularly scheduled visits by the mobile clinics are critical.
K
Kalambay, Hyppolite
- Open AccessA Resource Planning Analysis of District Hospital Surgical Services in the Democratic Republic of the CongoMelanie Sion, Dheepa Rajan, Hyppolite Kalambay, Jean-Pierre Lokonga, Joseph Bulakali, Mathias Mossoko, Dieudonne Kwete, Gerard Schmets, Edward Kelley, Tarcisse Elongo, Luis Sambo and Meena CherianGlobal Health: Science and Practice March 2015, 3(1):56-70; https://doi.org/10.9745/GHSP-D-14-00165
District hospitals in the DRC, on average, could not provide 21% of lifesaving surgical interventions due to deficiencies in basic infrastructure and essential surgical equipment and supplies. Surgery's important health impact and proportionally low service delivery budget argue for greater emphasis on surgical interventions, including for obstetric care.
Keesbury, Jill
- Open AccessTrends in the Contraceptive Method Mix in Low- and Middle-Income Countries: Analysis Using a New “Average Deviation” MeasureJohn Ross, Jill Keesbury and Karen HardeeGlobal Health: Science and Practice March 2015, 3(1):34-55; https://doi.org/10.9745/GHSP-D-14-00199
Applying a standard measure of the method mix evenness suggests 4 patterns among 15 countries moving toward a more balanced mix: (1) rise of one previously underrepresented or new method, (2) replacement of traditional with modern methods, (3) continued but declining domination by a single method, and (4) general movement toward a balanced mix. Improving availability of underutilized or new methods can improve the method mix, although better implementation of more popular methods might increase contraceptive use more expeditiously.
Kelley, Edward
- Open AccessA Resource Planning Analysis of District Hospital Surgical Services in the Democratic Republic of the CongoMelanie Sion, Dheepa Rajan, Hyppolite Kalambay, Jean-Pierre Lokonga, Joseph Bulakali, Mathias Mossoko, Dieudonne Kwete, Gerard Schmets, Edward Kelley, Tarcisse Elongo, Luis Sambo and Meena CherianGlobal Health: Science and Practice March 2015, 3(1):56-70; https://doi.org/10.9745/GHSP-D-14-00165
District hospitals in the DRC, on average, could not provide 21% of lifesaving surgical interventions due to deficiencies in basic infrastructure and essential surgical equipment and supplies. Surgery's important health impact and proportionally low service delivery budget argue for greater emphasis on surgical interventions, including for obstetric care.
Kuilman, Luppo
- Open AccessTightening Up the Nomenclature for Non-Physician Clinicians: Why Not Call All of Them Physician Assistants?Luppo Kuilman and Gomathi SundarGlobal Health: Science and Practice March 2015, 3(1):144-145; https://doi.org/10.9745/GHSP-D-14-00217
Kwete, Dieudonne
- Open AccessA Resource Planning Analysis of District Hospital Surgical Services in the Democratic Republic of the CongoMelanie Sion, Dheepa Rajan, Hyppolite Kalambay, Jean-Pierre Lokonga, Joseph Bulakali, Mathias Mossoko, Dieudonne Kwete, Gerard Schmets, Edward Kelley, Tarcisse Elongo, Luis Sambo and Meena CherianGlobal Health: Science and Practice March 2015, 3(1):56-70; https://doi.org/10.9745/GHSP-D-14-00165
District hospitals in the DRC, on average, could not provide 21% of lifesaving surgical interventions due to deficiencies in basic infrastructure and essential surgical equipment and supplies. Surgery's important health impact and proportionally low service delivery budget argue for greater emphasis on surgical interventions, including for obstetric care.
L
Lederer, Philip
- Open AccessBarriers to Health Care in Rural Mozambique: A Rapid Ethnographic Assessment of Planned Mobile Health Clinics for ARTAmee Schwitters, Philip Lederer, Leah Zilversmit, Paula Samo Gudo, Isaias Ramiro, Luisa Cumba, Epifanio Mahagaja and Kebba JobartehGlobal Health: Science and Practice March 2015, 3(1):109-116; https://doi.org/10.9745/GHSP-D-14-00145
Mobile health clinics can markedly decrease clients' transportation time and cost to access antiretroviral therapy (ART) and other health services in rural areas, potentially improving use. Close coordination with community leaders and regularly scheduled visits by the mobile clinics are critical.
Lindsell, Christopher J
- Open AccessPatient Flow Analysis in Resource-Limited Settings: A Practical Tutorial and Case StudyCinnamon A Dixon, Damien Punguyire, Melinda Mahabee-Gittens, Mona Ho and Christopher J LindsellGlobal Health: Science and Practice March 2015, 3(1):126-134; https://doi.org/10.9745/GHSP-D-14-00121
Patient flow analysis (PFA), a simple quality improvement tool to identify patient flow patterns, can be used in resource-limited settings to inform service delivery improvements. A PFA at a Ghanaian hospital found that personnel constraints and a mismatch between staffing and patient arrival surges led to long wait and total attendance times. The median time from arrival to first-provider contact was 4.6 hours.
Lokonga, Jean-Pierre
- Open AccessA Resource Planning Analysis of District Hospital Surgical Services in the Democratic Republic of the CongoMelanie Sion, Dheepa Rajan, Hyppolite Kalambay, Jean-Pierre Lokonga, Joseph Bulakali, Mathias Mossoko, Dieudonne Kwete, Gerard Schmets, Edward Kelley, Tarcisse Elongo, Luis Sambo and Meena CherianGlobal Health: Science and Practice March 2015, 3(1):56-70; https://doi.org/10.9745/GHSP-D-14-00165
District hospitals in the DRC, on average, could not provide 21% of lifesaving surgical interventions due to deficiencies in basic infrastructure and essential surgical equipment and supplies. Surgery's important health impact and proportionally low service delivery budget argue for greater emphasis on surgical interventions, including for obstetric care.
M
Mahabee-Gittens, Melinda
- Open AccessPatient Flow Analysis in Resource-Limited Settings: A Practical Tutorial and Case StudyCinnamon A Dixon, Damien Punguyire, Melinda Mahabee-Gittens, Mona Ho and Christopher J LindsellGlobal Health: Science and Practice March 2015, 3(1):126-134; https://doi.org/10.9745/GHSP-D-14-00121
Patient flow analysis (PFA), a simple quality improvement tool to identify patient flow patterns, can be used in resource-limited settings to inform service delivery improvements. A PFA at a Ghanaian hospital found that personnel constraints and a mismatch between staffing and patient arrival surges led to long wait and total attendance times. The median time from arrival to first-provider contact was 4.6 hours.
Mahagaja, Epifanio
- Open AccessBarriers to Health Care in Rural Mozambique: A Rapid Ethnographic Assessment of Planned Mobile Health Clinics for ARTAmee Schwitters, Philip Lederer, Leah Zilversmit, Paula Samo Gudo, Isaias Ramiro, Luisa Cumba, Epifanio Mahagaja and Kebba JobartehGlobal Health: Science and Practice March 2015, 3(1):109-116; https://doi.org/10.9745/GHSP-D-14-00145
Mobile health clinics can markedly decrease clients' transportation time and cost to access antiretroviral therapy (ART) and other health services in rural areas, potentially improving use. Close coordination with community leaders and regularly scheduled visits by the mobile clinics are critical.
Mazzeo, Corinne I
- Open AccessSuccessful Proof of Concept of Family Planning and Immunization Integration in LiberiaChelsea M Cooper, Rebecca Fields, Corinne I Mazzeo, Nyapu Taylor, Anne Pfitzer, Mary Momolu and Cuallau Jabbeh-HoweGlobal Health: Science and Practice March 2015, 3(1):71-84; https://doi.org/10.9745/GHSP-D-14-00156
Mobilizing vaccinators to provide mothers key family planning information and referrals to co-located, same-day family planning services was feasible in resource-limited areas of Liberia, leading to substantial increases in contraceptive use. Conversely, impact on immunization rates was less clear, but at a minimum there was no decrease in doses administered.
Miles, Leslie
- Open AccessA False Dichotomy: RCTs and Their Contributions to Evidence-Based Public HealthLaurel E Hatt, Minki Chatterji, Leslie Miles, Alison B Comfort, Benjamin W Bellows and Francis O OkelloGlobal Health: Science and Practice March 2015, 3(1):138-140; https://doi.org/10.9745/GHSP-D-14-00245
Global public health should rely on those research methods that best answer the pressing questions at hand. Randomized controlled trials (RCTs) and other rigorous impact evaluation methods have a critical role to play in public health.
Momolu, Mary
- Open AccessSuccessful Proof of Concept of Family Planning and Immunization Integration in LiberiaChelsea M Cooper, Rebecca Fields, Corinne I Mazzeo, Nyapu Taylor, Anne Pfitzer, Mary Momolu and Cuallau Jabbeh-HoweGlobal Health: Science and Practice March 2015, 3(1):71-84; https://doi.org/10.9745/GHSP-D-14-00156
Mobilizing vaccinators to provide mothers key family planning information and referrals to co-located, same-day family planning services was feasible in resource-limited areas of Liberia, leading to substantial increases in contraceptive use. Conversely, impact on immunization rates was less clear, but at a minimum there was no decrease in doses administered.
Mossoko, Mathias
- Open AccessA Resource Planning Analysis of District Hospital Surgical Services in the Democratic Republic of the CongoMelanie Sion, Dheepa Rajan, Hyppolite Kalambay, Jean-Pierre Lokonga, Joseph Bulakali, Mathias Mossoko, Dieudonne Kwete, Gerard Schmets, Edward Kelley, Tarcisse Elongo, Luis Sambo and Meena CherianGlobal Health: Science and Practice March 2015, 3(1):56-70; https://doi.org/10.9745/GHSP-D-14-00165
District hospitals in the DRC, on average, could not provide 21% of lifesaving surgical interventions due to deficiencies in basic infrastructure and essential surgical equipment and supplies. Surgery's important health impact and proportionally low service delivery budget argue for greater emphasis on surgical interventions, including for obstetric care.
N
Norman, Toby L
- Open AccessBiometric Fingerprint System to Enable Rapid and Accurate Identification of BeneficiariesDaniel Matthew L Storisteanu, Toby L Norman, Alexandra Grigore and Tristram L NormanGlobal Health: Science and Practice March 2015, 3(1):135-137; https://doi.org/10.9745/GHSP-D-15-00010
Inability to uniquely identify clients impedes access to services and contributes to inefficiencies. Using a pocket-sized fingerprint scanner that wirelessly syncs with a health worker's smartphone, the SimPrints biometric system can link individuals' fingerprints to their health records. A pilot in Bangladesh will assess its potential.
Norman, Tristram L
- Open AccessBiometric Fingerprint System to Enable Rapid and Accurate Identification of BeneficiariesDaniel Matthew L Storisteanu, Toby L Norman, Alexandra Grigore and Tristram L NormanGlobal Health: Science and Practice March 2015, 3(1):135-137; https://doi.org/10.9745/GHSP-D-15-00010
Inability to uniquely identify clients impedes access to services and contributes to inefficiencies. Using a pocket-sized fingerprint scanner that wirelessly syncs with a health worker's smartphone, the SimPrints biometric system can link individuals' fingerprints to their health records. A pilot in Bangladesh will assess its potential.
Noznesky, Elizabeth
- Open AccessDelivering High-Quality Family Planning Services in Crisis-Affected Settings II: ResultsDora Ward Curry, Jesse Rattan, Shuyuan Huang and Elizabeth NozneskyGlobal Health: Science and Practice March 2015, 3(1):25-33; https://doi.org/10.9745/GHSP-D-14-00112
A family planning program in 5 crisis-affected settings reached more than 52,000 new contraceptive users in just 2.5 years. Long-acting reversible contraceptives (LARCs) made up 61% of the method mix, with implants predominating in most countries. IUD use also increased over time as the program intensified its efforts to improve provider skills and user awareness. These findings demonstrate the strong popularity of LARCs and the feasibility of providing them in fragile settings even though they require more training and infrastructure support than short-acting methods.
Nzau, Jean Jose
- Open AccessDelivering High-Quality Family Planning Services in Crisis-Affected Settings I: Program ImplementationDora Ward Curry, Jesse Rattan, Jean Jose Nzau and Kamlesh GiriGlobal Health: Science and Practice March 2015, 3(1):14-24; https://doi.org/10.9745/GHSP-D-14-00164
Extending access to a wide variety of contraceptive methods, including long-acting reversible methods, is feasible in crisis-affected countries by focusing on best practices such as competency-based training, supply chain support, systematic supervision, and community mobilization. Prudent use of data helps drive program improvements.
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Okello, Francis O
- Open AccessA False Dichotomy: RCTs and Their Contributions to Evidence-Based Public HealthLaurel E Hatt, Minki Chatterji, Leslie Miles, Alison B Comfort, Benjamin W Bellows and Francis O OkelloGlobal Health: Science and Practice March 2015, 3(1):138-140; https://doi.org/10.9745/GHSP-D-14-00245
Global public health should rely on those research methods that best answer the pressing questions at hand. Randomized controlled trials (RCTs) and other rigorous impact evaluation methods have a critical role to play in public health.
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Perera, Melanie
- Open AccessPredictors of Workforce Retention Among Malawian Nurse Graduates of a Scholarship Program: A Mixed-Methods StudyKelly Schmiedeknecht, Melanie Perera, Ellen Schell, Joyce Jere, Elizabeth Geoffroy and Sally RankinGlobal Health: Science and Practice March 2015, 3(1):85-96; https://doi.org/10.9745/GHSP-D-14-00170
Several non-remuneration strategies may help improve retention of public-sector nurses: availability of supplies, adequate housing, advancement opportunities, and a positive work environment. A scholarship program with close follow-up of graduates may also help improve retention.
Pfitzer, Anne
- Open AccessSuccessful Proof of Concept of Family Planning and Immunization Integration in LiberiaChelsea M Cooper, Rebecca Fields, Corinne I Mazzeo, Nyapu Taylor, Anne Pfitzer, Mary Momolu and Cuallau Jabbeh-HoweGlobal Health: Science and Practice March 2015, 3(1):71-84; https://doi.org/10.9745/GHSP-D-14-00156
Mobilizing vaccinators to provide mothers key family planning information and referrals to co-located, same-day family planning services was feasible in resource-limited areas of Liberia, leading to substantial increases in contraceptive use. Conversely, impact on immunization rates was less clear, but at a minimum there was no decrease in doses administered.
Punguyire, Damien
- Open AccessPatient Flow Analysis in Resource-Limited Settings: A Practical Tutorial and Case StudyCinnamon A Dixon, Damien Punguyire, Melinda Mahabee-Gittens, Mona Ho and Christopher J LindsellGlobal Health: Science and Practice March 2015, 3(1):126-134; https://doi.org/10.9745/GHSP-D-14-00121
Patient flow analysis (PFA), a simple quality improvement tool to identify patient flow patterns, can be used in resource-limited settings to inform service delivery improvements. A PFA at a Ghanaian hospital found that personnel constraints and a mismatch between staffing and patient arrival surges led to long wait and total attendance times. The median time from arrival to first-provider contact was 4.6 hours.
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Rajan, Dheepa
- Open AccessA Resource Planning Analysis of District Hospital Surgical Services in the Democratic Republic of the CongoMelanie Sion, Dheepa Rajan, Hyppolite Kalambay, Jean-Pierre Lokonga, Joseph Bulakali, Mathias Mossoko, Dieudonne Kwete, Gerard Schmets, Edward Kelley, Tarcisse Elongo, Luis Sambo and Meena CherianGlobal Health: Science and Practice March 2015, 3(1):56-70; https://doi.org/10.9745/GHSP-D-14-00165
District hospitals in the DRC, on average, could not provide 21% of lifesaving surgical interventions due to deficiencies in basic infrastructure and essential surgical equipment and supplies. Surgery's important health impact and proportionally low service delivery budget argue for greater emphasis on surgical interventions, including for obstetric care.
Ramiro, Isaias
- Open AccessBarriers to Health Care in Rural Mozambique: A Rapid Ethnographic Assessment of Planned Mobile Health Clinics for ARTAmee Schwitters, Philip Lederer, Leah Zilversmit, Paula Samo Gudo, Isaias Ramiro, Luisa Cumba, Epifanio Mahagaja and Kebba JobartehGlobal Health: Science and Practice March 2015, 3(1):109-116; https://doi.org/10.9745/GHSP-D-14-00145
Mobile health clinics can markedly decrease clients' transportation time and cost to access antiretroviral therapy (ART) and other health services in rural areas, potentially improving use. Close coordination with community leaders and regularly scheduled visits by the mobile clinics are critical.
Rankin, Sally
- Open AccessPredictors of Workforce Retention Among Malawian Nurse Graduates of a Scholarship Program: A Mixed-Methods StudyKelly Schmiedeknecht, Melanie Perera, Ellen Schell, Joyce Jere, Elizabeth Geoffroy and Sally RankinGlobal Health: Science and Practice March 2015, 3(1):85-96; https://doi.org/10.9745/GHSP-D-14-00170
Several non-remuneration strategies may help improve retention of public-sector nurses: availability of supplies, adequate housing, advancement opportunities, and a positive work environment. A scholarship program with close follow-up of graduates may also help improve retention.
Rattan, Jesse
- Open AccessDelivering High-Quality Family Planning Services in Crisis-Affected Settings I: Program ImplementationDora Ward Curry, Jesse Rattan, Jean Jose Nzau and Kamlesh GiriGlobal Health: Science and Practice March 2015, 3(1):14-24; https://doi.org/10.9745/GHSP-D-14-00164
Extending access to a wide variety of contraceptive methods, including long-acting reversible methods, is feasible in crisis-affected countries by focusing on best practices such as competency-based training, supply chain support, systematic supervision, and community mobilization. Prudent use of data helps drive program improvements.
- Open AccessDelivering High-Quality Family Planning Services in Crisis-Affected Settings II: ResultsDora Ward Curry, Jesse Rattan, Shuyuan Huang and Elizabeth NozneskyGlobal Health: Science and Practice March 2015, 3(1):25-33; https://doi.org/10.9745/GHSP-D-14-00112
A family planning program in 5 crisis-affected settings reached more than 52,000 new contraceptive users in just 2.5 years. Long-acting reversible contraceptives (LARCs) made up 61% of the method mix, with implants predominating in most countries. IUD use also increased over time as the program intensified its efforts to improve provider skills and user awareness. These findings demonstrate the strong popularity of LARCs and the feasibility of providing them in fragile settings even though they require more training and infrastructure support than short-acting methods.
Ross, John
- Open AccessTrends in the Contraceptive Method Mix in Low- and Middle-Income Countries: Analysis Using a New “Average Deviation” MeasureJohn Ross, Jill Keesbury and Karen HardeeGlobal Health: Science and Practice March 2015, 3(1):34-55; https://doi.org/10.9745/GHSP-D-14-00199
Applying a standard measure of the method mix evenness suggests 4 patterns among 15 countries moving toward a more balanced mix: (1) rise of one previously underrepresented or new method, (2) replacement of traditional with modern methods, (3) continued but declining domination by a single method, and (4) general movement toward a balanced mix. Improving availability of underutilized or new methods can improve the method mix, although better implementation of more popular methods might increase contraceptive use more expeditiously.
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Sambo, Luis
- Open AccessA Resource Planning Analysis of District Hospital Surgical Services in the Democratic Republic of the CongoMelanie Sion, Dheepa Rajan, Hyppolite Kalambay, Jean-Pierre Lokonga, Joseph Bulakali, Mathias Mossoko, Dieudonne Kwete, Gerard Schmets, Edward Kelley, Tarcisse Elongo, Luis Sambo and Meena CherianGlobal Health: Science and Practice March 2015, 3(1):56-70; https://doi.org/10.9745/GHSP-D-14-00165
District hospitals in the DRC, on average, could not provide 21% of lifesaving surgical interventions due to deficiencies in basic infrastructure and essential surgical equipment and supplies. Surgery's important health impact and proportionally low service delivery budget argue for greater emphasis on surgical interventions, including for obstetric care.
Schell, Ellen
- Open AccessPredictors of Workforce Retention Among Malawian Nurse Graduates of a Scholarship Program: A Mixed-Methods StudyKelly Schmiedeknecht, Melanie Perera, Ellen Schell, Joyce Jere, Elizabeth Geoffroy and Sally RankinGlobal Health: Science and Practice March 2015, 3(1):85-96; https://doi.org/10.9745/GHSP-D-14-00170
Several non-remuneration strategies may help improve retention of public-sector nurses: availability of supplies, adequate housing, advancement opportunities, and a positive work environment. A scholarship program with close follow-up of graduates may also help improve retention.
Schmets, Gerard
- Open AccessA Resource Planning Analysis of District Hospital Surgical Services in the Democratic Republic of the CongoMelanie Sion, Dheepa Rajan, Hyppolite Kalambay, Jean-Pierre Lokonga, Joseph Bulakali, Mathias Mossoko, Dieudonne Kwete, Gerard Schmets, Edward Kelley, Tarcisse Elongo, Luis Sambo and Meena CherianGlobal Health: Science and Practice March 2015, 3(1):56-70; https://doi.org/10.9745/GHSP-D-14-00165
District hospitals in the DRC, on average, could not provide 21% of lifesaving surgical interventions due to deficiencies in basic infrastructure and essential surgical equipment and supplies. Surgery's important health impact and proportionally low service delivery budget argue for greater emphasis on surgical interventions, including for obstetric care.
Schmiedeknecht, Kelly
- Open AccessPredictors of Workforce Retention Among Malawian Nurse Graduates of a Scholarship Program: A Mixed-Methods StudyKelly Schmiedeknecht, Melanie Perera, Ellen Schell, Joyce Jere, Elizabeth Geoffroy and Sally RankinGlobal Health: Science and Practice March 2015, 3(1):85-96; https://doi.org/10.9745/GHSP-D-14-00170
Several non-remuneration strategies may help improve retention of public-sector nurses: availability of supplies, adequate housing, advancement opportunities, and a positive work environment. A scholarship program with close follow-up of graduates may also help improve retention.
Schwitters, Amee
- Open AccessBarriers to Health Care in Rural Mozambique: A Rapid Ethnographic Assessment of Planned Mobile Health Clinics for ARTAmee Schwitters, Philip Lederer, Leah Zilversmit, Paula Samo Gudo, Isaias Ramiro, Luisa Cumba, Epifanio Mahagaja and Kebba JobartehGlobal Health: Science and Practice March 2015, 3(1):109-116; https://doi.org/10.9745/GHSP-D-14-00145
Mobile health clinics can markedly decrease clients' transportation time and cost to access antiretroviral therapy (ART) and other health services in rural areas, potentially improving use. Close coordination with community leaders and regularly scheduled visits by the mobile clinics are critical.
Shelton, James D
- Open AccessResponse to “A False Dichotomy: RCTs and Their Contributions to Evidence-Based Public Health”James D SheltonGlobal Health: Science and Practice March 2015, 3(1):141-143; https://doi.org/10.9745/GHSP-D-15-00045
While randomized controlled trials (RCTs) can and do make valuable contributions, they also have severe limitations, including in answering the basic question of “Does it work?” and, even more so, in steering how to proceed with complex public health programming at scale. They deserve no exalted position in the pantheon of methodologies for evidence-based public health.
- Open AccessARVs: The Next Generation. Going Boldly Together to New Frontiers of HIV TreatmentMatthew Barnhart and James D SheltonGlobal Health: Science and Practice March 2015, 3(1):1-11; https://doi.org/10.9745/GHSP-D-14-00243
New antiretrovirals (ARVs), particularly the potentially “game-changing” ARV dolutegravir, offer major potential to meet the compelling need for simpler and better HIV treatment for tens of millions of people in the coming decade. Advantages include substantially lower manufacturing cost, fewer side effects, and less risk of resistance. But key obstacles must be addressed in order to develop and introduce new ARVs in specific combinations optimized for the needs of low- and middle-income countries. Strong leadership will be essential from the global health community to nurture more focused collaboration between the private and public sectors.
Sion, Melanie
- Open AccessA Resource Planning Analysis of District Hospital Surgical Services in the Democratic Republic of the CongoMelanie Sion, Dheepa Rajan, Hyppolite Kalambay, Jean-Pierre Lokonga, Joseph Bulakali, Mathias Mossoko, Dieudonne Kwete, Gerard Schmets, Edward Kelley, Tarcisse Elongo, Luis Sambo and Meena CherianGlobal Health: Science and Practice March 2015, 3(1):56-70; https://doi.org/10.9745/GHSP-D-14-00165
District hospitals in the DRC, on average, could not provide 21% of lifesaving surgical interventions due to deficiencies in basic infrastructure and essential surgical equipment and supplies. Surgery's important health impact and proportionally low service delivery budget argue for greater emphasis on surgical interventions, including for obstetric care.
Steinglass, Robert
- Open AccessEngaging Communities With a Simple Tool to Help Increase Immunization CoverageManish Jain, Gunjan Taneja, Ruhul Amin, Robert Steinglass and Michael FavinGlobal Health: Science and Practice March 2015, 3(1):117-125; https://doi.org/10.9745/GHSP-D-14-00180
Use of a simple, publicly placed tool that monitors vaccination coverage in a community has potential to broaden program coverage by keeping both the community and the health system informed about every infant's vaccination status.
Storisteanu, Daniel Matthew L
- Open AccessBiometric Fingerprint System to Enable Rapid and Accurate Identification of BeneficiariesDaniel Matthew L Storisteanu, Toby L Norman, Alexandra Grigore and Tristram L NormanGlobal Health: Science and Practice March 2015, 3(1):135-137; https://doi.org/10.9745/GHSP-D-15-00010
Inability to uniquely identify clients impedes access to services and contributes to inefficiencies. Using a pocket-sized fingerprint scanner that wirelessly syncs with a health worker's smartphone, the SimPrints biometric system can link individuals' fingerprints to their health records. A pilot in Bangladesh will assess its potential.
Sundar, Gomathi
- Open AccessTightening Up the Nomenclature for Non-Physician Clinicians: Why Not Call All of Them Physician Assistants?Luppo Kuilman and Gomathi SundarGlobal Health: Science and Practice March 2015, 3(1):144-145; https://doi.org/10.9745/GHSP-D-14-00217
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Taneja, Gunjan
- Open AccessEngaging Communities With a Simple Tool to Help Increase Immunization CoverageManish Jain, Gunjan Taneja, Ruhul Amin, Robert Steinglass and Michael FavinGlobal Health: Science and Practice March 2015, 3(1):117-125; https://doi.org/10.9745/GHSP-D-14-00180
Use of a simple, publicly placed tool that monitors vaccination coverage in a community has potential to broaden program coverage by keeping both the community and the health system informed about every infant's vaccination status.
Taylor, Nyapu
- Open AccessSuccessful Proof of Concept of Family Planning and Immunization Integration in LiberiaChelsea M Cooper, Rebecca Fields, Corinne I Mazzeo, Nyapu Taylor, Anne Pfitzer, Mary Momolu and Cuallau Jabbeh-HoweGlobal Health: Science and Practice March 2015, 3(1):71-84; https://doi.org/10.9745/GHSP-D-14-00156
Mobilizing vaccinators to provide mothers key family planning information and referrals to co-located, same-day family planning services was feasible in resource-limited areas of Liberia, leading to substantial increases in contraceptive use. Conversely, impact on immunization rates was less clear, but at a minimum there was no decrease in doses administered.
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Uzondu, Charles A
- Open AccessFemale Health Workers at the Doorstep: A Pilot of Community-Based Maternal, Newborn, and Child Health Service Delivery in Northern NigeriaCharles A Uzondu, Henry V Doctor, Sally E Findley, Godwin Y Afenyadu and Alastair AgerGlobal Health: Science and Practice March 2015, 3(1):97-108; https://doi.org/10.9745/GHSP-D-14-00117
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.
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Zilversmit, Leah
- Open AccessBarriers to Health Care in Rural Mozambique: A Rapid Ethnographic Assessment of Planned Mobile Health Clinics for ARTAmee Schwitters, Philip Lederer, Leah Zilversmit, Paula Samo Gudo, Isaias Ramiro, Luisa Cumba, Epifanio Mahagaja and Kebba JobartehGlobal Health: Science and Practice March 2015, 3(1):109-116; https://doi.org/10.9745/GHSP-D-14-00145
Mobile health clinics can markedly decrease clients' transportation time and cost to access antiretroviral therapy (ART) and other health services in rural areas, potentially improving use. Close coordination with community leaders and regularly scheduled visits by the mobile clinics are critical.
In this issue
