More articles from EDITORIAL
- A Tablet-Based Tool for Care During Labor+Attention to System Requirements
Evidence on using a tablet-based labor decision-support tool suggests the potential for improved practices in labor management. Further rigorous study on these tools is needed to assess the improvements in labor care and outcomes as well as the system requirements needed to achieve such improvements.
- Healthy Timing and Spacing of Pregnancy: Reducing Mortality Among Women and Their Children
Accessible, affordable, and high-quality postabortion care (PAC) can prevent maternal death and disability and provides an important opportunity to prevent future unintended pregnancies. This supplement offers learnings on PAC provision from the community of partners around the world, including service delivery and community engagement models, approaches to support facility-based providers, best practices in pre- and post-procedure counseling, and approaches to institutionalize PAC in public- and private-sector health systems.
- Postabortion Care and the Voluntary Family Planning Component: Expanding Contraceptive Choices and Service Options
Universal access to voluntary postabortion family planning is a critical and compelling component of postabortion care. Such access should be joined with postpartum family planning services in national programs, health information systems, and training programs. The same providers and facilities deliver both services, and integration could yield cost efficiencies and increased coverage for women receiving postabortion care.
- Saving Mothers, Giving Life: A Systems Approach to Reducing Maternal and Perinatal Deaths in Uganda and Zambia
The 5-year public-private partnership boldly addressed maternal mortality in Uganda and Zambia using a systems approach at the district level to avoid delays in women seeking, reaching, and receiving timely, quality services. This supplement provides details on the Saving Mothers, Giving Life partnership and approach, including the model, impact, costs, and sustainability.
- Digital Health and Health Systems of the Future
Digital strategies have been formally recognized as a critical health systems strengthening strategy to help meet the Sustainable Development Goals and universal health coverage targets. This landscaping collection reviews multiple possible approaches across health system pillars, from digital referrals to decision support systems, identifying key knowledge gaps across these domains and recognizing the growth needed in the field to realize its full potential.
- Modeling Outputs Can Be Valuable When Uncertainty Is Appropriately Acknowledged, but Misleading When Not
While modeling approaches seek to draw on the best available evidence to project health impact of improved coverage of specific interventions, uncertainty around the outputs often remains. When the modeling estimates are used for advocacy, these uncertainties should be communicated to policy makers clearly and openly to ensure they understand the model's limits and to maintain their confidence in the process.
- Maternal Death Surveillance and Response: A Tall Order for Effectiveness in Resource-Poor Settings
Most countries with high maternal (and newborn) mortality have very limited resources, overstretched health workers, and relatively weak systems and governance. To make important progress in reducing mortality, therefore, they need to carefully prioritize where to invest effort and funds. Given the demanding requirements to effectively implement the maternal death surveillance and response (MDSR) approach, in many settings it makes more sense to focus effort on the known drivers of high mortality, e.g., reducing geographic, financial, and systems barriers to lifesaving maternal and newborn care.
- Routine Health Facility and Community Information Systems: Creating an Information Use Culture
Substantial progress has been made to strengthen health information systems, with most efforts focusing on digitization, improving data quality and analysis, and identifying problems. But the ultimate goal is using information to solve problems, which requires building an information use culture over time. How? Human-centered design, role modeling by senior managers in use of data, and incentive-based systems hold considerable promise.
- Long-Acting HIV Treatment and Prevention: Closer to the Threshold
Substantial progress has been made toward viable, practical long-acting approaches to deliver HIV treatment and prevention through: (1) continued improvements in long-acting antiretrovirals (ARVs); (2) better innovative delivery systems; and (3) collaboration of willing partners to advance new ARVs. More progress on those 3 fronts is still needed to arrive at the goal of optimized HIV treatment and prevention for all who would benefit—and of finally controlling the HIV epidemic.
- Reducing Sepsis Deaths in Newborns Through Home Visitation and Active Case Detection: Is it Realistic?
Severe bacterial infection remains one of the major causes of newborn deaths in low-income countries. A key challenge for reducing this burden is making definitive treatment more easily available. Active case detection through early postnatal home visits can work under trial conditions but is difficult to implement at scale under routine conditions. In many settings, making treatment available at peripheral-level primary health care facilities may be more feasible.