Table of Contents
VIEWPOINTS
- Global Access to Technology-Enhanced Medical Education During the COVID-19 Pandemic: The Role of Students in Narrowing the Gap
Althoughsome medical education institutions in high-income countries have the capacity to shift education to eLearning during the COVID-19 pandemic, educational institutions in low- and middle-income countries might struggle to fully implement it. We argue for medical students to advocate for national and international collaboration in adopting technology-enhanced learning globally.
ORIGINAL ARTICLES
- Pathways to Care for Patients With Type 2 Diabetes and HIV/AIDS Comorbidities in Soweto, South Africa: An Ethnographic Study
Patients with type 2 diabetes are referred to tertiary hospitals in Soweto although their care could be managed at primary health care clinics. Primary health care needs to be strengthened by addressing health systemic challenges to provide integrated care for comorbid type 2 diabetes and HIV/AIDS.
- Inpatient Point-of-Care HIV Early Infant Diagnosis in Mozambique to Improve Case Identification and Linkage to Antiretroviral Therapy
Introduction of point-of-care early infant diagnosis on the inpatient wards of 2 of the largest pediatric referral hospitals in Mozambique increased HIV testing volume and pediatric HIV case identification with improved linkage to antiretroviral therapy.
- Test and Prevent: Evaluation of a Pilot Program Linking Clients With Negative HIV Test Results to Pre-exposure Prophylaxis in Zimbabwe
Widespread HIV testing is identifying individuals who are not infected but are at high risk of HIV exposure. These individuals may be good candidates for pre-exposure prophylaxis (PrEP). We developed an intervention called Test and Prevent to intentionally link individuals with negative HIV test results to PrEP, which led to high rates of completed PrEP referrals and uptake.
- Bugs in the Bed: Addressing the Contradictions of Embedded Science with Agile Implementation Research
Implementation research often fails to have its intended impact on what programs actually do. Embedding research within target organizational systems is an effective response to this problem. We present case examples from Bangladesh, Ghana, and Tanzania that demonstrate challenges associated with embedded science. We propose “agile science” as a means of sustaining scientific rigor while simultaneously catalyzing evidence utilization.
- Levels, Trends, and Inequalities in Using Institutional Delivery Services in Low- and Middle-Income Countries: A Stratified Analysis by Facility Type
Despite improvements in the use of institutional delivery services around the world, progress has not been uniform across low- and middle-income countries. Persistent and growing inequalities in the utilization of institutional delivery services warrant the attention of policy makers for further investments and policy reviews.
- Expanding Contraceptive Method Choice With a Hormonal Intrauterine System: Results From Mixed Methods Studies in Kenya and Zambia
Although the hormonal intrauterine system has limited availability in low- and middle-income countries, this highly effective long-acting reversible contraceptive method has the potential to be an important addition to the method mix. Introduction of the method in the public sector under “real-world” conditions in Kenya and Zambia shows promise to increase contraception use and continuation.
- Economic Evaluation of Provision of Postpartum Intrauterine Device Services in Bangladesh and Tanzania
Provision of a postpartum intrauterine device (PPIUD) within 48 hours of delivery was highly cost-effective compared with standard practice in 2 lower middle-income countries. Policy makers should consider expansion of postpartum family planning counseling and introduction of immediate PPIUD services as an added tool to address the unmet need for contraception.
- Implementing a Social Accountability Approach for Maternal, Neonatal, and Child Health Service Performances in Ethiopia: A Pre-Post Study Design
Implementing a community scorecard approach may help increase utilization of maternal, neonatal, and child health services in primary health care facilities. The results of our study show the importance of engaging both the community and health workers to measure and continuously improve health care processes and improve the health system performance.
- The Evolving Landscape of Medical Device Regulation in East, Central, and Southern Africa
Most existing medical devices were not built for the challenges often present in many African countries. Regulatory systems for medical devices are essential to ensuring device safety and efficacy. Yet, currently, most African countries do not have a well-defined regulatory process. This discourages both innovators within Africa and companies outside of Africa from developing quality medical devices suitable for these challenges.
- Curbing the Rise of Noncommunicable Diseases in Uganda: Perspectives of Policy Actors
To respond to the growing burden of noncommunicable diseases (NCDs) in Uganda, technical, managerial, and financial resources must be increased in the Ministry of Health as well as in primary and secondary health care facilities. This investment would help further Uganda's efforts to achieve sustainable development goals and build the government's capacity to meet the increasing needs for NCD services.
REVIEWS
- Human Resources for Health-Related Challenges to Ensuring Quality Newborn Care in Low- and Middle-Income Countries: A Scoping Review
We mapped evidence from low- and middle-income countries of the human resources for health-related challenges to providing quality facility-based newborn care into tangible thematic areas. The mapping provides valuable insight that informed new World Health Organization strategies to systematically address the challenges identified and to strengthen human resources for health for newborn care globally and nationally.
FIELD ACTION REPORTS
- Remote Interviewer Training for COVID-19 Data Collection: Challenges and Lessons Learned From 3 Countries in Sub-Saharan Africa
Remote training of interviewers in low-resource settings can be an effective approach during the COVID-19 pandemic when data are critically needed and in-person learning is not possible. We demonstrate that remote interviewer training is possible when interviewers: have at least an intermittent Internet connection, have select physical materials available, and are experienced and part of a cohesive team.
PROGRAM CASE STUDIES
- Egypt's Ambitious Strategy to Eliminate Hepatitis C Virus: A Case Study
A national hepatitis C virus elimination strategy rooted in mass screening and treatment can be effective in many middle-income countries. A strong public health infrastructure, political commitment, and technological advances are essential to such initiatives.
- Blended Learning Using Peer Mentoring and WhatsApp for Building Capacity of Health Workers for Strengthening Immunization Services in Kenya
Innovative learning strategies are needed to improve frontline health workers' skills for achieving immunization coverage goals—now even more important with COVID-19. Peer mentoring and WhatsApp networking are low-cost and useful blended learning methods for need-based and individualized capacity building of health workers for improving immunization services that don't disrupt the health care workers' regular work.
COMMENTARIES
National community health worker programs are at the dawn of a new era, given the growing recognition of their importance for achieving global health goals and for controlling the COVID-19 pandemic. Now is the time to provide them with the respect and funding that they need and deserve.