More articles from EDITORIAL
- Strength in Diversity: Integrating Community in Primary Health Care to Advance Universal Health Coverage
The supplement highlights a systems approach that recognizes the communities' roles and their interactions with other health system actors to accelerate outcomes and reflect the diversity of the community health ecosystem. Several cross-cutting priorities emerge from the articles, namely coverage, community health financing, policy change, institutionalization, resilience, accountability, community engagement, and whole-of-society efforts.
- 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.
- Community Ownership in Primary Health Care—Managing the Intangible
Although enduringly intangible, community ownership is foundational to primary health care. This intangibility is a reminder of what programs can and should do (create space for dialogue, question their own choices, expand diversity in stakeholder voices making sense of program-induced changes, including through evaluation) and what they cannot do (manage someone else’s ownership).
- Counseling Is a Relationship Not Just a Skill: Re-conceptualizing Health Behavior Change Communication by India’s Accredited Social Health Activists
The capacity for India’s community health workers—accredited social health activists (ASHAs)—to promote healthy behaviors must be understood within the health system and community context. Their ability to influence health behaviors depends on the strength of their relationships with families and support they receive from the health system.
- Institutionalization of Projects Into Districts in Low- and Middle-Income Countries Needs Stewardship, Autonomy, and Resources
Important attributes for project institutionalization include strong stewardship and champions, affordability, demand for the intervention and perceived benefit, minimal complexity, and optimal intervention design and period of support.
- Learning from Community Health Worker Programs, Big and Small
Small, well-implemented, well-evaluated community health worker programs can provide useful insights and inspiration. Testing, learning, and adapting at progressively larger scale can ultimately lead to national-scale programs that achieve sustainable impact.
- Will the Higher-Income Country Blueprint for COVID-19 Work in Low- and Lower Middle-Income Countries?
Strategies to radically suppress incidence of COVID-19, as used in higher-income countries, may be unrealistic and counterproductive in most low- and lower middle-income countries. Instead, strategies should be tailored to the setting, balancing expected benefits, potential harms, and feasibility.
- 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.
- It Takes a System: Magnesium Sulfate for Prevention of Eclampsia in a Resource-Limited Community Setting
Magnesium sulfate is not a silver bullet to reduce maternal mortality associated with preeclampsia/eclampsia. We believe a well-functioning health care system, especially at the hospital level, with competent well-trained providers, adequate equipment, and medications will likely be necessary.