More articles from Field Action Report
- Family Planning Counseling in Your Pocket: A Mobile Job Aid for Community Health Workers in Tanzania
Using mobile job aids can help CHWs deliver integrated counseling on family planning and HIV/STI screening by following a step-by-step service delivery algorithm. Lessons learned during the pilot led to the development of additional features during scale-up to exploit the other major advantages that mHealth offers including:
Better supervision of health workers and accountability for their performance
Improved communication between supervisors and workers
Access to real-time data and reports to support quality improvement
- Results-Based Financing in Mozambique’s Central Medical Store: A Review After 1 Year
The RBF scheme, which paid incentives for verified results, steadily improved the CMS's performance over 1 year, particularly for supply and distribution planning. Key apparent success factors:
1) The CMS had full discretion over how to spend the funds
2) Payment was shared with and dependent on all staff, which encouraged teamwork.
3) Performance indicators were challenging yet achievable.
4) The quarterly payment cycle was frequent enough to be motivating.
Recommendations for future programs: focus on both quality and quantity indicators; strengthen results verification processes; and work toward institutionalizing the approach.
- Introduction of Mobile Health Tools to Support Ebola Surveillance and Contact Tracing in Guinea
An informatics system consisting of a mobile health application and business intelligence software was used for collecting and analyzing Ebola contact tracing data. This system offered potential to improve data access and quality to support evidence-based decision making for the Ebola response in Guinea. Implementation challenges included software limitations, technical literacy of users, coordination among partners, government capacity for data utilization, and data privacy concerns.
- Nurse Mentors to Advance Quality Improvement in Primary Health Centers: Lessons From a Pilot Program in Northern Karnataka, India
Trained nurse mentors catalyzed quality improvements in facility-based maternal and newborn care by: (1) encouraging use of self-assessment checklists and team-based problem solving, (2) introducing case sheets to ensure adherence to clinical guidelines, and (3) strengthening clinical skills through on-site demonstrations and bedside teaching. Inadequate leadership and staffing were challenges in some facilities. Some social norms, such as client resistance to referral and to staying 48 hours after delivery, also impact quality and mandate community mobilization efforts.
- Covering the Last Kilometer: Using GIS to Scale-Up Voluntary Medical Male Circumcision Services in Iringa and Njombe Regions, Tanzania
Interactive GIS maps created by overlapping facility data including roads and infrastructure with population and service delivery data permitted strategic deployment of mobile voluntary medical male circumcision (VMMC) services to underserved rural communities. The percentage of VMMCs performed in rural areas jumped from 48% in 2011 to 93% in 2014.
- Successful mLearning Pilot in Senegal: Delivering Family Planning Refresher Training Using Interactive Voice Response and SMS
Health workers’ knowledge of contraceptive side effects increased substantially. The mobile phone approach was convenient and flexible and did not disrupt routine service delivery. Clear limitations of the medium are participants can’t practice clinical skills or have interactive discussions. Also, some participants had trouble with network reception.
- Bedside Availability of Prepared Oxytocin and Rapid Administration After Delivery to Prevent Postpartum Hemorrhage: An Observational Study in Karnataka, India
Advance preparation and bedside availability of oxytocin before childbirth was significantly and robustly associated with rapid administration of the utertonic, as recommended to prevent postpartum hemorrhage.
- Barriers to Health Care in Rural Mozambique: A Rapid Ethnographic Assessment of Planned Mobile Health Clinics for ART
Mobile health clinics can markedly decrease clients' transportation time and cost to access antiretroviral therapy (ART) and other health services in rural areas, potentially improving use. Close coordination with community leaders and regularly scheduled visits by the mobile clinics are critical.
- Engaging Communities With a Simple Tool to Help Increase Immunization Coverage
Use of a simple, publicly placed tool that monitors vaccination coverage in a community has potential to broaden program coverage by keeping both the community and the health system informed about every infant's vaccination status.
- Informed push distribution of contraceptives in Senegal reduces stockouts and improves quality of family planning services
Dedicated logisticians restocked contraceptives monthly at facilities to maintain defined minimum stock levels, freeing up clinic staff. High stockout rates were virtually eliminated. Also, quality and timely data on contraceptives distributed allowed for better program management.