Table of Contents
EDITORIALS
- Micronutrient Powders for Infants and Young Children
Providing standalone micronutrient products for household use is not an easy strategy, but under the right conditions, it can work. To be effective, micronutrient powder programs require robust commodity logistics and support of uptake and adherence.
VIEWPOINTS
- The COVID-19 Pandemic Exposes Another Commercial Determinant of Health: The Global Firearm Industry
Firearm violence is a public health crisis worsened by lobbying, marketing, and supply chain tactics from the private industry. During the heightened burden of the COVID-19 pandemic, public health practitioners should use a commercial determinant of health lens to combat this threat.
ORIGINAL ARTICLES
- A Mixed-Methods Study of Factors Influencing Access to and Use of Micronutrient Powders in Rwanda
Gaps in complementary feeding practices hinder the use of multiple micronutrients powder (MNP) in Rutsiro district in Rwanda. Successful MNP program implementation requires uninterrupted availability and accessibility to the product, as well as greater understanding of health benefits of the MNP.
- STEPS: A Solution for Ensuring Standards of TB Care for Patients Reaching Private Hospitals in India
A low-cost model for engaging the private sector to address gaps in TB care and ensuring that patients in the private sector receive the standards of care in India was feasible. The pilot project showed improvements in standards of care, which benefits the patient, government, private hospitals, and society.
- Differentiated Service Delivery Models for HIV Treatment in Malawi, South Africa, and Zambia: A Landscape Analysis
Observing the diversity of differentiated service delivery models for HIV treatment in use in sub-Saharan Africa can help policy makers and program planners to improve decision making for treatment delivery in the future. This effort can inform decisions about how to optimize the distribution of models across facilities and regions and how to plan for budget and resource allocation.
- Initiation of Breastfeeding in Low- and Middle-Income Countries: A Time-to-Event Analysis
This article uses country-specific data to provide information for stakeholders about delays in breastfeeding, especially for babies born via cesarean delivery, and provide evidence to support skin-to-skin contact to promote early breastfeeding.
- Use of Fertility Awareness-Based Methods for Pregnancy Prevention Among Ghanaian Women: A Nationally Representative Cross-Sectional Survey
At least 18% of Ghanaian female contraceptors rely primarily upon a fertility awareness-based method (FABM), and most wish to learn how to improve its effectiveness but are insufficiently supported to do so. Researchers, programmers, and funders should better understand and address FABM users' needs, in commitment to reproductive autonomy and choice.
- New Mixed Methods Approach for Monitoring Community Perceptions of Ebola and Response Efforts in the Democratic Republic of the Congo
The Red Cross community feedback system enabled rapid collection and analysis of extensive verbal feedback during an Ebola outbreak in eastern DRC. Using this information, Ebola response leaders adapted strategies to address community concerns. In an epidemic, community feedback is critical to ensure that response strategies are accepted and appropriate.
FIELD ACTION REPORTS
- Navigating the COVID-19 Crisis to Sustain Community-Based Malaria Interventions in Cambodia
Despite the impacts of an unforeseen concomitant disaster such as COVID-19, malaria elimination efforts were able to continue because of successful efforts to build trust, relevance, and connection with communities to promote community health malaria workers' acceptance. With lessons learned from the COVID-19 response, community health workers can be repurposed for broader public health interventions in preparation for future disease outbreaks.
- Real-Time Tracking of COVID-19 Rumors Using Community-Based Methods in Côte d'Ivoire
Addressing rumors is critical for managing and ending a public health emergency. We piloted a system for real-time rumor tracking using community-based collection methods, open-source software, and a rapid coding and visualization process to systematically understand and help actors respond to COVID-19 misinformation in Côte d'Ivoire.
- Institutionalizing a Regional Model for Improving Quality of Newborn Care at Birth Across Hospitals in Eastern Uganda: A 4-Year Story
A locally developed, low-cost package of interventions implemented in a regional network of hospitals resulted in significant reductions in mortality for mothers and newborns as well as the institutionalization of the quality improvement initiative. This work demonstrates that it is possible to achieve the World Health Organization/United Nations Children's Fund Quality of Care targets in hospitals.
- From Passive Surveillance to Response: Suriname's Efforts to Implement Maternal Death Surveillance and Response
To implement Maternal Death Surveillance and Response successfully in Suriname, recommendations to reduce maternal death should be acted upon. Delineating the roles and responsibilities for action, establishing accountability mechanisms, and influencing stakeholders in a position to act are critical to ensure a response to recommendations to avert maternal mortality.
SHORT REPORTS
- The Demographic and Health Surveys Faculty Fellows Program: Successes, Challenges, and Lessons Learned
Since 2011, the Demographic and Health Surveys (DHS) Faculty Fellows Program has strengthened individual skills in conducting research with data from large surveys and increased institutional capacity to analyze DHS data through fellows' capacity-building activities at their home universities. The lessons learned can inform models for strengthening capacity in analyzing and using data in low- and middle-income countries.
- Improving Services for HIV-Exposed Infants in Zambia and Cameroon Using a Quality Improvement Collaborative Approach
To bridge the gap between what is known and what is done, quality improvement collaboratives (QICs) enable health programs to rapidly address quality challenges at scale. Two QICs in Cameroon and Zambia improved coverage of early infant HIV testing and initiating antiretroviral therapy in HIV-exposed infants. The QIC approach empowers health care workers to design solutions tailored for their specific settings.
METHODOLOGIES
- Systematic Process Framework for Conducting Implementation Science Research in Food Fortification Programs
Many challenges still exist to fully scaling up food fortification in lower resource settings. To address this need, a collective group of experts in the fields of food fortification and implementation science developed a systematic process framework to provide a tool for identifying and working through challenges.
LETTERS TO THE EDITOR
- Regarding “A Cluster-Randomized Trial to Test Sharing Histories as a Training Method for Community Health Workers in Peru”
Improving communication between mothers and health systems will grow cost-effective, potentially scalable health impact. By developing an approach of how health systems and mothers can communicate to increase mutual understanding, a "health language" that is grounded in mothers' reproductive life narratives can be developed to help bridge the long-standing gap in how health systems and mothers engage.
COMMENTARIES
We reflect on and review India's COVID-19 pandemic response through the lens of modeling and data. The lessons learned from the Indian context may be beneficial for other countries.
In the era of COVID-19, pregnant and postpartum women, an already vulnerable group, are facing unforeseen and compounding stressful events with reduced social protections. We argue that to prevent harmful consequences that may surpass the effects of the crisis itself for pregnant women and their families, it is imperative to prioritize maintaining formal and informal sources of social support for mothers in proposed infection control policies.
India lacks a functional public policy framework to guide health data use and sharing practices, which stymies data quality. Embedding data governance in health data systems can promote quality and make service delivery more efficient. Much of the discourse on health information systems has focused on technology while the concern of using data for health system management and improving quality of care remains largely unaddressed.
To enable greater reach, quality, and impact of investments in social and behavior change, donors need to be intentional in building collaborative relationships that apply proven practices. We offer recommendations for maximizing the impact of donors' investments.
Faith-based organizations and religious leaders can be effective family planning advocates for policy change, funding, and services. To do so, they need evidence-based knowledge, training, support within their faith communities, as well as respect for their beliefs and values.