More articles from FIELD ACTION REPORT
- The Tobacco-Free Village Program: Helping Rural Areas Implement and Achieve Goals of Tobacco Control Policies in India
Tobacco control and prevention in rural areas are possible as demonstrated by a community-driven tobacco-free village program in India. Success factors included community ownership with supportive program guidance, motivated and committed local leaders, collaboration with grassroots organizations, rewards and sanctions to establish new social norms, and provision of other income-generating options for vendors who sell tobacco. While the program required time and dedicated effort and was not successful in all villages, it holds promise for helping to achieve the goals of tobacco control policies, especially in resource-scarce settings.
- A Mobile-Based Community Health Management Information System for Community Health Workers and Their Supervisors in 2 Districts of Zambia
Using simple-feature mobile phones, CHWs sent weekly reports on disease caseloads and commodities consumed, ordered drugs and supplies, and sent pre-referral notices to health centers. Supervisors provided feedback to CHWs on referred patient outcomes and received monthly SMS reminders to set up mentoring sessions with the CHWs. Scale-up limitations include: (1) staff shortages at health centers to supervise the CHWs, (2) need for ongoing technical support to troubleshoot challenges with mobile phones and software, and (3) recurring costs for data bundles.
- Challenges of Implementing Antenatal Ultrasound Screening in a Rural Study Site: A Case Study From the Democratic Republic of the Congo
In the context of a well-resourced research project on obstetric ultrasound, we encountered major challenges, including security and maintenance of the equipment, electricity requirements, health systems integration, and a variety of other systems issues. We propose future ultrasound interventions have at minimum a functioning health system with skilled and motivated staff, access to a referral hospital capable of providing affordable and higher levels of care, and feasible transportation means.
- mJustice: Preliminary Development of a Mobile App for Medical-Forensic Documentation of Sexual Violence in Low-Resource Environments and Conflict Zones
The MediCapt mobile app has promise for clinicians to capture medical and forensic evidence of sexual violence and securely transmit the data to legal authorities for potential use in prosecution. We believe this application broadens the traditional scope of mHealth to collecting evidence, and thus name it mJustice.
- Pilot Research as Advocacy: The Case of Sayana Press in Kinshasa, Democratic Republic of the Congo
The pilot study obtained Ministry of Health approval to allow medical and nursing students to provide the injectable contraceptive Sayana Press and other methods in the community, paving the way for other task-shifting pilots including self-injection of Sayana Press with supervision by the students as well as injection by community health workers.
- Mobile-Based Nutrition and Child Health Monitoring to Inform Program Development: An Experience From Liberia
Monitoring behavior using mobile phones at food distribution points allowed managers to rapidly adapt project activities. Self-reported breastfeeding, complementary feeding, and use of insecticide-treated nets improved. Applying the same methodology at the household level proved unsuccessful.
- Web-Based Quality Assurance Process Drives Improvements in Obstetric Ultrasound in 5 Low- and Middle-Income Countries
Newly trained sonographers improved performance through a quality assurance process that merged (1) evaluation by remote experts of images uploaded to a website, with (2) periodic in-person skill tests. To promote sustainability, in-country supervisors gradually assumed more responsibility for image evaluation. The user-friendly and efficient interface used simple menus and forms, customized based on the user's role.
- Improving the Quality of Postabortion Care Services in Togo Increased Uptake of Contraception
The quality improvement approach applied at 5 facilities over about 1 year increased family planning counseling to postabortion clients from 31% to 91%. Of those counseled provision of a contraceptive method before discharge increased from 37% to 60%. Oral contraceptives remained the most popular method, but use of injectables and implants increased. The country-driven approach, which tended to use existing resources and minimal external support, has potential for sustainability and scale-up in Togo and application elsewhere.
- Increasing Use of Postpartum Family Planning and the Postpartum IUD: Early Experiences in West and Central Africa
Competency-based training in postpartum family planning and postpartum IUD (PPIUD) service delivery of antenatal, maternity, and postnatal care providers from 5 francophone African countries generated an enthusiastic response from the providers and led to government and donor support for expansion of the approach. More than 2,000 women chose and received the PPIUD between 2014 and 2015. This model of South–South cooperation, when coupled with demand promotion, supportive supervision, and reliable collection of service outcome data, can help to expand PPIUD services in other regions as well.
- Enhancing the Supervision of Community Health Workers With WhatsApp Mobile Messaging: Qualitative Findings From 2 Low-Resource Settings in Kenya
CHWs used WhatsApp with their supervisors to document their work, spurring healthy competition and team building between CHWs in the 2 pilot sites. While there was considerable variation in the number of times each participant posted messages—from 1 message to 270 messages—in total they posted nearly 2,000 messages over 6 months. 88% of messages corresponded to at least 1 of 3 defined supervisory objectives of (1) creating a social environment, (2) sharing communication and information, or (3) promoting quality of services.