Table of Contents
EDITORIALS
- Learning From Neighbors
We can learn valuable lessons from program efforts that at first glance may seem to be far removed from our own work.
ORIGINAL ARTICLES
- Prevention of COVID-19 in Internally Displaced Persons Camps in War-Torn North Kivu, Democratic Republic of the Congo: A Mixed-Methods Study
Internally displaced persons fleeing violent conflict represent a neglected population with heightened vulnerability to pandemic COVID-19. We provide a rare snapshot of the overwhelming challenges faced by internally displaced persons in Eastern Democratic Republic of the Congo as they brace for COVID-19.
- Meeting the Global Target in Reproductive, Maternal, Newborn, and Child Health Care Services in Low- and Middle-Income Countries
What progress has been achieved toward reproductive, maternal, newborn, and child health service related Sustainable Development Goals? Analyzing data to estimate coverage of these indicators, we observed that acceleration is needed in coordinated global efforts and government policies to ensure universal access to RMNCH care services by 2030.
- Contraceptive Method Mix: Updates and Implications
Trends in contraceptive method mix show that dominance of 1 method in the mix remains very common, though countries and regions throughout the world are diverse as to which method is dominant. Our analysis argues for continued concerted efforts of programs to increase contraceptive method choice.
- Health Care Worker Preferences and Perspectives on Doses per Container for 2 Lyophilized Vaccines in Senegal, Vietnam, and Zambia
When providing immunization services, health care workers balance the mandate of achieving high coverage with limiting vaccine wastage. Workers in 3 countries said that containers with fewer vaccine doses for measles and BCG would enable them to immunize all children who present, while reducing concerns about wasting vaccine.
- Remote Mentorship Using Video Conferencing as an Effective Tool to Strengthen Laboratory Quality Management in Clinical Laboratories: Lessons From Cambodia
This program to strengthen laboratory quality management systems in Cambodia demonstrated significant improvements in conformity to ISO 15189 standards in participating laboratories, correlating with laboratory participation time in video conference training activities led by quality improvement mentors over the program implementation period.
- Using Community Health Workers and a Smartphone Application to Improve Diabetes Control in Rural Guatemala
A smartphone application providing algorithmic clinical decision support enabled community health workers to improve diabetes control for a group of patients in rural Guatemala. This approach enables task sharing with physicians and other advanced practitioners for chronic disease care, which is particularly important in low-resource settings.
- Behavioral Insights Into Micronutrient Powder Use for Childhood Anemia in Arequipa, Peru
Health care provider-caregiver interactions and caregivers’ shifting emotional states between intention formation and use affected their adherence to a government-provided micronutrient powder intervention to prevent childhood anemia. In counseling directed to caregivers, we suggest providers offer clear messaging on MNP impact and planning for challenges during MNP use.
- A Cluster-Randomized Trial to Test Sharing Histories as a Training Method for Community Health Workers in Peru
Women naturally communicate using life narratives. Through systematic recall and sharing memories of their own childbearing and child rearing experiences, community health workers (CHWs) become engaged and empowered to change their own and other mothers’ health behaviors. Training CHW with sharing histories can improve capabilities as change agents for better child health.
- A Rapid Cost Modeling Tool for Evaluating and Improving Public Health Supply Chain Designs
The Rapid Supply Chain Modeling Tool enables health system leaders to quickly estimate and compare the cost impact of potential supply chain design improvements in situations where time and budget do not allow for more in-depth modeling approaches.
- Lessons Learned From Implementing Prospective, Multicountry Mixed-Methods Evaluations for Gavi and the Global Fund
Lessons learned from implementing evaluations for Gavi, the Vaccine Alliance and the Global Fund for AIDS, Tuberculosis, and Malaria can help inform the design and implementation of ongoing or future evaluations of complex interventions. We share 5 lessons distilled from over 7 years of experience implementing evaluations in 7 countries.
- Effects of a Community-Based Program on Voluntary Modern Contraceptive Uptake Among Young First-Time Parents in Cross River State, Nigeria
Among young first-time mothers, participation in a comprehensive, community-based program led to a 3-fold increase in voluntary modern contraceptive use and other positive changes. These results demonstrate the importance of investing in interventions for this youth population that ideally address a range of priorities across the first-time parent lifestage.
REVIEWS
- Routine Family Planning Data in the Low- and Middle-Income Country Context: A Synthesis of Findings From 17 Small Research Grants
A review of 5 years of small grant-funded research highlighted overarching barriers to and opportunities for using family planning data in routine health information systems in low- and middle-income countries. We report on factors affecting data quality, analysis, and use, and suggest strategies to improve routine family planning data.
- Effectiveness of mHealth Interventions for Improving Contraceptive Use in Low- and Middle-Income Countries: A Systematic Review
Do mHealth interventions help reduce unmet contraceptive needs in low- and middle-income countries by attempting to increase the uptake of modern contraceptive methods? Which mHealth features and behavior change communication components were used in these mHealth interventions? This review aimed to answer these questions and assess the impact of these interventions on contraceptive uptake outcomes.
METHODOLOGIES
- A Practical Guide to Using Time-and-Motion Methods to Monitor Compliance With Hand Hygiene Guidelines: Experience From Tanzanian Labor Wards
Understanding hand hygiene behaviors is critical in hospitals. We developed the HANDS at birth tool—and provide information on its design and implementation–to capture the complex patterns of health care workers’ hand hygiene including hand rubbing/washing, glove use, and recontamination.
FIELD ACTION REPORTS
- Implementation of a Pediatric Early Warning Score to Improve Communication and Nursing Empowerment in a Rural District Hospital in Rwanda
Implementation of the Pediatric Early Warning Score for Resource-Limited Settings tool improved nurses’ competency and confidence in their triage capabilities. This tool has the potential to improve patient outcomes. However, staff turnover and limited physician buy-in were barriers to sustainability of the tool in low-resource settings.
PROGRAM CASE STUDIES
- Juntos: A Support Program for Families Impacted by Congenital Zika Syndrome in Brazil
Development of Juntos, a community-based family support program for caregivers of children with congenital Zika syndrome, contained innovative approaches such as using mothers as facilitators, fast-track learning, and de-isolation of families affected by Zika.
TECHNICAL NOTES
- Improving Hospital Oxygen Systems for COVID-19 in Low-Resource Settings: Lessons From the Field
Hospitals in low- and middle-income countries urgently need to improve their oxygen systems for COVID-19 and other health emergencies. We share practical tips to improve pulse oximetry and oxygen use, support biomedical engineers to optimize existing oxygen supplies, and expand existing oxygen systems with robust equipment and smart design.
COMMENTARIES
Essentially all HIV transmission is from people living with HIV who are not virally suppressed. An HIV micro-epidemic control approach that differentiates treatment support and prevention services for people living with HIV and their network members according to viral burden could optimize the impact of epidemic control efforts.
The undeniable benefit of mentorship by experience senior mentors can meaningfully increase the breadth of their experience and contributions to society as well as address the dire inequality in global health. This model captures wisdom lost to retirement, enables opportunities for purposeful lifespan, underpins sustainable health care systems, and has the potential for building multinational partnerships.