More articles from ORIGINAL ARTICLE
- Experiences With the Levonorgestrel Intrauterine System Among Clients, Providers, and Key Opinion Leaders: A Mixed-Methods Study in Nigeria
Between September 2016 and December 2017, Marie Stopes International Organisation Nigeria introduced the LNG IUS in 16 Nigerian states to increase method choice. Just under 1,000 devices were inserted, representing less than 1% of all long-acting reversible contraceptives provided. Qualitative feedback from opinion leaders, providers, and LNG IUS users found important benefits to users and suggested coordinated demand- and supply-side activities, including user champions and supportive providers to generate interest in the method, would be needed for successful scale-up.
- Introduction of Subcutaneous Depot Medroxyprogesterone Acetate (DMPA-SC) Injectable Contraception at Facility and Community Levels: Pilot Results From 4 Districts of Uganda
Over 1 year, the NGO-led project provided more than 14,000 units of DMPA-SC, mostly in community settings and to a substantial proportion (43%) of young women. The share of injectables increased significantly, as did the volume of all methods provided, including short-acting, long-acting, and permanent methods.
- Unpacking the “Black Box”: How an SMS-Based Continuing Medical Education Intervention Improved Medical Knowledge Among HIV Clinicians in Vietnam
Daily SMS quizzes sent to medical practitioners seem to act as a stimulus for further self-study when paired with access to additional readings and online courses, improving medical knowledge as a result.
- Implementing an Integrated Pharmaceutical Management Information System for Antiretrovirals and Other Medicines: Lessons From Namibia
Integrating patient and commodity data into one system while maintaining specialized functionality has allowed managers to monitor and mitigate stock-out risks more effectively, as well as provide earlier warning for HIV drug resistance.
- Antenatal Corticosteroids for Women at Risk of Imminent Preterm Birth in 7 sub-Saharan African Countries: A Policy and Implementation Landscape Analysis
Countries have put in place some elements necessary for safe and effective antenatal corticosteroid (ACS) use, but significant challenges remain including: ensuring accurate gestational age determination, establishing clear treatment guidelines, strengthening provider capacity, incorporating obstetric indications for ACS use in national essential medicines lists, and collecting and using ACS-related data in the HMIS. Most importantly, the quality of maternal and newborn care, including specialized newborn care, needs improvement to ensure a strong foundation for the safe and effective use of ACS.
- Evolution of a Large-Scale Community-Based Contraceptive Distribution Program in Kinshasa, DRC Based on Process Evaluation
Midterm process evaluation results indicated that design and implementation failures hindered the program's success, notably: (1) the short-acting methods provided by community-based distributors (CBDs) offered limited choice; (2) the nominal revenue retained from selling the methods provided limited motivation for the volunteer CBDs; and (3) the model was poorly coordinated with the existing clinical service system, partly because of challenging systems issues. In the revised model, the CBDs will also provide subcutaneous injectables and emergency contraceptive pills, retain more revenue from contraceptive sales, and have better interaction with the existing system including conducting monthly mini-campaigns to increase visibility and attract more clients.
- mLearning in the Democratic Republic of the Congo: A Mixed-Methods Feasibility and Pilot Cluster Randomized Trial Using the Safe Delivery App
Health worker knowledge and self-confidence in basic emergency obstetric and newborn care (BEmONC) increased significantly 3 months after introduction of the Safe Delivery App in intervention facilities compared with controls.
- The State of Digital Interventions for Demand Generation in Low- and Middle-Income Countries: Considerations, Emerging Approaches, and Research Gaps
Despite advances in digital technology to generate demand for health services, considerable gaps remain in our understanding of which interventions are effective, which characteristics mediate their benefit for different target populations and health domains, and what is necessary to ensure effective deployment. Future research should examine the long-term effects of, equity in access to, and cost-effectiveness and efficiency of digital demand generation interventions.
- What Does It Take to Be an Effective National Steward of Digital Health Integration for Health Systems Strengthening in Low- and Middle-Income Countries?
A purposeful literature review of peer-reviewed and gray literature identified 4 broad thematic areas of digital health stewardship—strategic direction, policies and procedures, roles and responsibilities, and health service delivery—that need further research and development in order for digital health to be better positioned to positively impact low- and middle-income country health systems.
- Digital Technologies for Health Workforce Development in Low- and Middle-Income Countries: A Scoping Review
Digital health interventions have the potential to improve the health workforce by supporting training, supervision, and communication. More evidence is needed on the effectiveness of interventions implemented at scale, including the return on investment, the effect of government and donor policies on scale up, and the role of the private sector.