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Global Health: Science and Practice

Dedicated to what works in global health programs

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More articles from ORIGINAL ARTICLE

  • Open Access
    The Net Promoter Score (NPS) for Insight Into Client Experiences in Sexual and Reproductive Health Clinics
    Rebecca Koladycz, Gwendolyn Fernandez, Kate Gray and Heidi Marriott
    Global Health: Science and Practice October 2018, 6(3):413-424; https://doi.org/10.9745/GHSP-D-18-00068

    The NPS measures a customer's likeliness to recommend a company to a friend or colleague on a 0-to-10 scale. Pilot testing in 4 countries suggests the NPS can also be successfully used in nonprofit clinics and among low-literacy populations. Combining the NPS with client demographic and service-use data can provide a powerful tool for identifying populations for whom the client experience can be improved.

  • Open Access
    Human Papillomavirus Vaccine Introduction in South Africa: Implementation Lessons From an Evaluation of the National School-Based Vaccination Campaign
    Sinead Delany-Moretlwe, Karen F. Kelley, Shamagonam James, Fiona Scorgie, Hasina Subedar, Nonhlanhla R Dlamini, Yogan Pillay, Nicolette Naidoo, Admire Chikandiwa and Helen Rees
    Global Health: Science and Practice October 2018, 6(3):425-438; https://doi.org/10.9745/GHSP-D-18-00090

    Evaluation of the campaign confirmed its feasibility in this setting: it achieved high coverage, few adverse events, and mostly positive media coverage. However, challenges occurred in data and cold chain management. Future implementation requires improved partnerships between government ministries, simplified informed consent, and closer monitoring of social media messaging.

  • Open Access
    Expanding Access to Injectable Contraception: Results From Pilot Introduction of Subcutaneous Depot Medroxyprogesterone Acetate (DMPA-SC) in 4 African Countries
    Anna Stout, Siri Wood, George Barigye, Alain Kaboré, Daouda Siddo and Ida Ndione
    Global Health: Science and Practice March 2018, 6(1):55-72; https://doi.org/10.9745/GHSP-D-17-00250

    Nearly half a million doses of DMPA-SC were administered over 2 years in Burkina Faso, Niger, Senegal, and Uganda, with 29% of doses provided to first-time family planning users and 44% (in 3 countries) to adolescent girls and young women under age 25. Switching from intramuscular DMPA (DMPA-IM) was not widespread and generally decreased over time. Community health workers provided a higher proportion of DMPA-SC than DMPA-IM injections. Stock-outs in 2 countries hindered product uptake, highlighting the need to strengthen logistics systems when introducing a new method.

  • Open Access
    Rapid Uptake of the Subcutaneous Injectable in Burkina Faso: Evidence From PMA2020 Cross-Sectional Surveys
    Georges Guiella, Shani Turke, Hamadou Coulibaly, Scott Radloff and Yoonjoung Choi
    Global Health: Science and Practice March 2018, 6(1):73-81; https://doi.org/10.9745/GHSP-D-17-00260

    Availability and use of the subcutaneous injectable increased rapidly during national scale-up in 2016. Substantial increases were found in rural areas, where unmet need for family planning is higher. Since the method is amenable to community-based distribution, a new pilot is testing provision by community health workers to further improve access.

  • Open Access
    Using Program Data to Improve Access to Family Planning and Enhance the Method Mix in Conflict-Affected Areas of the Democratic Republic of the Congo
    Lara S Ho and Erin Wheeler
    Global Health: Science and Practice March 2018, 6(1):161-177; https://doi.org/10.9745/GHSP-D-17-00365

    Analysis of program data and a formative assessment informed several program changes, including improved coaching and supportive supervision, introduction of postpartum IUDs and the levonorgestrel-releasing intrauterine system, and enhanced behavior change communication. These changes substantially increased family planning adoption, from a monthly average of 14 adopters per facility to 37 per facility. Implants continued to be the most popular method, but the percentage of adopters choosing the IUD increased from 2% in 2012 to 13% in 2016, and it was the most popular method among postabortion care clients.

  • Open Access
    Building Support for Adolescent Sexuality and Reproductive Health Education and Responding to Resistance in Conservative Contexts: Cases From Pakistan
    Venkatraman Chandra-Mouli, Marina Plesons, Sheena Hadi, Qadeer Baig and Iliana Lang
    Global Health: Science and Practice March 2018, 6(1):128-136; https://doi.org/10.9745/GHSP-D-17-00285

    While there is no one-size-fits-all approach to building community support for such programs, key strategies in Pakistan included: (1) sensitizing and engaging key stakeholders, including religious groups, schools, health and education government officials, parents, and adolescents themselves; (2) tactfully designing and framing the curricula with careful consideration of context and sensitive topics; (3) institutionalizing the programs within the school system; (4) showcasing school programs to increase transparency; and (5) engaging the media to build positive public perceptions.

  • Open Access
    Effective Collaboration for Scaling Up Health Technologies: A Case Study of the Chlorhexidine for Umbilical Cord Care Experience
    Patricia S Coffey, Steve Hodgins and Amie Bishop
    Global Health: Science and Practice March 2018, 6(1):178-191; https://doi.org/10.9745/GHSP-D-17-00380

    Facilitating factors for the Chlorhexidine Working Group: (1) strong, transparent leadership by a neutral broker, promoting shared ownership among all members; (2) reliable internal and external communication; (3) well-defined terms of reference building on common interest around a simple, effective health intervention; (4) clear benefits of participation, including access to evidence and technical assistance; and (5) adequate resources to support the secretariat functions.

  • Open Access
    Medical Education Partnership Initiative (MEPI) in Zimbabwe: Outcomes and Challenges
    James G Hakim, Midion M Chidzonga, Margaret Z Borok, Kusum J Nathoo, Jonathan Matenga, Edward Havranek, Frances Cowan, Melanie Abas, Eva Aagaard, Susan Connors, Sanele Nkomani, Chiratidzo E Ndhlovu, Antony Matsika, Michele Barry and Thomas B Campbell
    Global Health: Science and Practice March 2018, 6(1):82-92; https://doi.org/10.9745/GHSP-D-17-00052

    The 5-year medical education and research strengthening initiative in Zimbabwe increased faculty retention and student enrollment, improved information technology infrastructure, provided mentoring for postgraduates and clinical training in specialty areas, instituted a competency-based curriculum reform process, and created new departments and centers to institutionalize health education and research implementation. A comprehensive review of the curriculum is still underway and uptake of technology-assisted teaching has been slower than expected.

  • Open Access
    Evolution and Resistance to Sexuality Education in Mexico
    Venkatraman Chandra-Mouli, Lucia Gómez Garbero, Marina Plesons, Iliana Lang and Esther Corona Vargas
    Global Health: Science and Practice March 2018, 6(1):137-149; https://doi.org/10.9745/GHSP-D-17-00284

    Mexico's efforts at sexuality education have progressively evolved, from a biological focus in the socialist era in the 1930s, to adding a demographically concerned family planning component in the 1970s and including a wider reproductive health perspective in the 1990s, and finally shifting to a broader sociological context in the early 21st century. Opposition to sexuality education rose steadily in the time period considered, with a growing range of more organized and well-financed actors. Despite this opposition, alliances between academic, government, civil society, and NGO champions have helped ensure sustainability.

  • Open Access
    Let's Stop Trying to Quantify Household Vulnerability: The Problem With Simple Scales for Targeting and Evaluating Economic Strengthening Programs
    Whitney M Moret
    Global Health: Science and Practice March 2018, 6(1):150-160; https://doi.org/10.9745/GHSP-D-17-00291

    Simple scales developed to measure broad constructs of household economic vulnerability in 3 countries did not accurately measure susceptibility to negative economic outcomes or generate valid classifications of economic status to use for targeting and monitoring and evaluation. We recommend designing tailored monitoring and evaluation instruments to capture narrower definitions of economic vulnerability based on characteristics that economic strengthening programs intend to affect and using separate tools for client targeting based on presence of context-specific “red flag” indicators.

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US AIDJohns Hopkins Center for Communication ProgramsUniversity of Alberta

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