More articles from METHODOLOGY
- A Practical Guide to Using Time-and-Motion Methods to Monitor Compliance With Hand Hygiene Guidelines: Experience From Tanzanian Labor Wards
Understanding hand hygiene behaviors is critical in hospitals. We developed the HANDS at birth tool—and provide information on its design and implementation–to capture the complex patterns of health care workers’ hand hygiene including hand rubbing/washing, glove use, and recontamination.
- Mask Reuse in the COVID-19 Pandemic: Creating an Inexpensive and Scalable Ultraviolet System for Filtering Facepiece Respirator Decontamination
We outline a simple, low-cost design—both scalable and adaptable worldwide—to decontaminate filtering facepiece respirators (FFRs) using ultraviolet bulbs and supplies found in most hardware stores. The setup will help health care workers safely reuse FFRs in light of the shortages during the COVID-19 pandemic.
- Using a Chord Diagram to Visualize Dynamics in Contraceptive Use: Bringing Data Into Practice
A chord diagram is an innovative tool that can be used to visualize switching and quitting in contraceptive use between 2 discrete time points. It complements existing analysis of contraceptive failure rates and provides a richer understanding of contraceptive discontinuation and method switching that can lead to fresh insights to improve family planning programs.
- Harmonizing Methods for Estimating the Impact of Contraceptive Use on Unintended Pregnancy, Abortion, and Maternal Health
Five models estimate the impact of family planning on health outcomes, but the estimates previously have diverged because the models used different assumptions, inputs, and algorithms. After a collective harmonization process, the models now produce more similar estimates although they retain some minimal differences. These models assist in planning, resource allocation, and evaluation.
- Strategies for Optimal Implementation of Simulated Clients for Measuring Quality of Care in Low- and Middle-Income Countries
When properly implemented, use of simulated clients (“mystery clients”) can provide insight into actual experiences of real clients and evaluate quality of care. Successful implementation calls for recruiting mystery clients who represent the facility's clientele, have strong recall of recent events, and are comfortable being undercover data collectors. Developing training protocols and checklists to standardize mystery client behavior and responses is also key.
- Preventing Peer Violence Against Children: Methods and Baseline Data of a Cluster Randomized Controlled Trial in Pakistan
Peer violence was remarkably high at baseline. Among urban public school students, 94% of 6th-grade boys and 85% of girls reported being victimized by peers in the last 4 weeks. And 85% of boys and 66% of girls reported perpetrating such violence. Boys scored worse on a number of mental health measures. A cluster RCT is underway to evaluate a well-established school-based intervention using sports and games to reduce peer violence.
- Qualitative Assessment of the Application of a Discrete Choice Experiment With Community Health Workers in Uganda: Aligning Incentives With Preferences
Conducting a discrete choice experiment (DCE) with CHWs via survey versus interviews gave similar findings: the most appealing attributes for these CHWs were a bicycle, transportation refund, and mobile phone. To promote meaningful and valid results, particularly when applying DCEs to lower-literacy populations such as CHWs, DCEs should (1) use a small number of job attributes to facilitate comprehension, (2) choose attribute levels (e.g., mobile phone vs. no mobile phone) that are realistic yet show sufficient range, and (3) clearly define attributes and their levels.
- Simplified Asset Indices to Measure Wealth and Equity in Health Programs: A Reliability and Validity Analysis Using Survey Data From 16 Countries
Many program implementers have difficulty collecting and analyzing data on program beneficiaries’ wealth because a large number of survey questions are required to construct the standard wealth index. We created country-specific measures of household wealth with as few as 6 questions that are highly reliable and valid in both urban and rural contexts.
- Measurement of Health Program Equity Made Easier: Validation of a Simplified Asset Index Using Program Data From Honduras and Senegal
Piggy-backing on an existing representative household survey that includes an asset index, it is possible to assess the socioeconomic distribution of program beneficiaries at low cost. The typically large number of questions used to construct the asset index, however, deters many implementers from adopting this approach. This study demonstrates that the number of questions can be significantly reduced to a subset that takes only a few minutes to administer without substantially altering findings or policy recommendations. The relevant subset is country-specific and thus necessitates tailored country questionnaires.
- Operations research to add postpartum family planning to maternal and neonatal health to improve birth spacing in Sylhet District, Bangladesh
This quasi-experimental study integrated family planning, including the Lactational Amenorrhea Method, into community-based maternal and newborn health care and encouraged transition to other modern methods after 6 months to increase birth-to-pregnancy intervals. Community-based distribution of pills, condoms, and injectables, and referral for clinical methods, was added to meet women's demand.