More articles from Field Action Report
- Early Lessons From Launching an Innovative Community Health Household Model Across 3 Country Contexts
Community health worker programs can contribute substantively to health systems working to implement universal health coverage, but there is no one-size-fits-all model. Program leaders should anticipate needing to adapt their plans as local realities demand, but lessons learned in other contexts can provide guidance on how to best proceed.
- Learnings From a Pilot Study to Strengthen Primary Health Care Services: The Community-Clinic-Centered Health Service Model in Barishal District, Bangladesh
The community-clinic-centered health service model piloted in Bangladesh strengthened community and local government engagement, harmonized the work of different community health worker cadres, and improved client satisfaction. The approach has the potential to strengthen the delivery of close-to-community primary health care services and accelerate progress toward achieving universal health coverage.
- Implementation of a Pediatric Early Warning Score to Improve Communication and Nursing Empowerment in a Rural District Hospital in Rwanda
Implementation of the Pediatric Early Warning Score for Resource-Limited Settings tool improved nurses’ competency and confidence in their triage capabilities. This tool has the potential to improve patient outcomes. However, staff turnover and limited physician buy-in were barriers to sustainability of the tool in low-resource settings.
- Using Patient-Reported Outcome Measures to Promote Patient-Centered Practice: Building Capacity Among Pediatric Physiotherapists in Rwanda
Tracking outcomes is integral to assessing effectiveness of health systems. Multimodal training was offered in the use of a contextually appropriate, patient-centered outcome measure in a low-resource setting. Results offer insights for designing future capacity-building programs.
- Recall Efforts Successfully Increase Follow-Up for Cervical Cancer Screening Among Women With Human Papillomavirus in Honduras
A reminder phone call had a substantial impact on high rates of women returning for rescreening among those at high risk of developing cervical precancer. Scaling up routine cervical screening coverage must be accompanied by efforts to retain women throughout the screening cascade and continuum of care.
- Increasing Family Planning Access in Kenya Through Engagement of Faith-Based Health Facilities, Religious Leaders, and Community Health Volunteers
The Christian Health Association of Kenya (CHAK) partnered with health facilities managed by faith-based organizations (FBOs), religious leaders, and community health volunteers to increase access to family planning in western Kenya. FBO-managed health facilities saw large increases in family planning uptake over the 5-year project, particularly for implants.
- Getting to the First 90: Incentivized Peer Mobilizers Promote HIV Testing Services to Men Who Have Sex With Men Using Social Media in Mumbai, India
This peer mobilization pilot for HIV and syphilis testing used messaging on gay dating sites, clinic referrals, and peer recruitment to reach men who have sex with men in Mumbai. In 6 months, the pilot reached a relatively modest 247 individuals, 244 of whom had never tested for HIV. Challenges included low recruitment and loss to follow-up for posttest counseling and treatment initiation for individuals with HIV.
- Management of Preeclampsia, Severe Preeclampsia, and Eclampsia at Primary Care Facilities in Bangladesh
Program introduction, including cascade training, to screen for severe preeclampsia and eclampsia and initiate treatment with magnesium sulfate was somewhat successful. Challenges included inconsistent adherence to the national protocol, data quality, and some issues with supplies and equipment.
- Exploring Barriers: How to Overcome Roadblocks Impeding the Provision of Postabortion Care to Young People in Togo
Before providers were trained in offering youth-friendly postabortion care (PAC), including provision of voluntary contraceptive methods, no youth PAC client chose a modern method before leaving the facility. After training, over a 6-month period 41% of youth PAC clients chose a modern method, most commonly oral contraceptive pills followed by implants and injectables.
- Identifying and Reengaging Patients Lost to Follow-Up in Rural Africa: The “Horizontal” Hospital-Based Approach in Uganda
Between 30% and 60% of hospital outpatient clinic patients were lost to follow-up. A defaulter-tracking service using performance-based remuneration for outreach workers, cutting across different clinical services, improved patient retention overall but varied by disease, with the poorest outcomes among patients with HIV.