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Global Health: Science and Practice
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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
    Associations Between Practices and Behaviors at the Health Facility Level and Supply Chain Management for Antiretrovirals: Evidence from Cameroon, Namibia, and Swaziland
    Diana Bowser, Laura Krech, David Mabirizi, Angela Y. Chang, David Kapaon and Thomas Bossert
    Global Health: Science and Practice June 2019, 7(2):300-316; https://doi.org/10.9745/GHSP-D-19-00063

    Using antiretrovirals (ARVs) as tracer products, we identified the following key practices that may affect supply chain management at the facility level: order verification, actions taken when stock is received, changes in prescription and dispensing due to ARV stock-out, actions to ensure patient adherence, and communication with other affiliated facilities and higher-level supply chain management. We propose a set of indicators to measure these practices.

  • Open Access
    Successfully Engaging Private Providers to Improve Diagnosis, Notification, and Treatment of TB and Drug-Resistant TB: The EQUIP Public-Private Model in Chennai, India
    Ramya Ananthakrishnan, M. D'Arcy Richardson, Susan van den Hof, Radha Rangaswamy, Rajeswaran Thiagesan, Sheela Auguesteen and Netty Kamp
    Global Health: Science and Practice March 2019, 7(1):41-53; https://doi.org/10.9745/GHSP-D-18-00318

    Based on a participatory program design that addressed the self-described needs of private providers, a local NGO offered the providers access to rapid diagnostics and support for notification and patient treatment including free anti-TB drugs. The model resulted in high provider participation, contributing more than 10% of the overall TB case notifications, and an 89% treatment success rate for drug-sensitive TB.

  • Open Access
    Factors Affecting Continued Use of Subcutaneous Depot Medroxyprogesterone Acetate (DMPA-SC): A Secondary Analysis of a 1-Year Randomized Trial in Malawi
    Holly M. Burke, Mario Chen, Mercy Buluzi, Rachael Fuchs, Silver Wevill, Lalitha Venkatasubramanian, Leila Dal Santo and Bagrey Ngwira
    Global Health: Science and Practice March 2019, 7(1):54-65; https://doi.org/10.9745/GHSP-D-18-00433

    Community health workers can adequately provide DMPA-SC directly or train women on self-injection.

  • Open Access
    Scaling Up Misoprostol to Prevent Postpartum Hemorrhage at Home Births in Mozambique: A Case Study Applying the ExpandNet/WHO Framework
    Karen Hobday, Jennifer Hulme, Ndola Prata, Páscoa Zualo Wate, Suzanne Belton and Caroline Homer
    Global Health: Science and Practice March 2019, 7(1):66-86; https://doi.org/10.9745/GHSP-D-18-00475

    Facilitating factors for this community-level scale up in 35 districts included strong government support, local champions, and a national policy on preventing postpartum hemorrhage (PPH). Challenges included a lack of a systematic scale-up strategy, limited communication of the PPH policy, a shift from a universal distribution policy to application of eligibility criteria, difficulties engaging remote traditional birth attendants, and implementation of a parallel M&E system.

  • Open Access
    Association Between the Quality of Contraceptive Counseling and Method Continuation: Findings From a Prospective Cohort Study in Social Franchise Clinics in Pakistan and Uganda
    Nirali M. Chakraborty, Karen Chang, Benjamin Bellows, Karen A. Grépin, Waqas Hameed, Amanda Kalamar, Xaher Gul, Lynn Atuyambe and Dominic Montagu
    Global Health: Science and Practice March 2019, 7(1):87-102; https://doi.org/10.9745/GHSP-D-18-00407

    Higher scores on the 3-question Method Information Index (MII)—measuring client-reported receipt of contraceptive information—was associated with continued use of family planning over 12 months. We recommend incorporating use of the MII in routine assessments of family planning service quality.

  • Open Access
    Addressing the Second Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Reaching Appropriate Maternal Care in a Timely Manner
    Thandiwe Ngoma, Alice R. Asiimwe, Joseph Mukasa, Susanna Binzen, Florina Serbanescu, Elizabeth G. Henry, Davidson H. Hamer, Jody R. Lori, Michelle M. Schmitz, Lawrence Marum, Brenda Picho, Anne Naggayi, Gertrude Musonda, Claudia Morrissey Conlon, Patrick Komakech, Vincent Kamara and Nancy A. Scott on behalf of the Saving Mothers, Giving Life Working Group
    Global Health: Science and Practice March 2019, 7(Supplement 1):S68-S84; https://doi.org/10.9745/GHSP-D-18-00367

    The Saving Mothers, Giving Life initiative employed 2 key strategies to improve the ability of pregnant women to reach maternal care: (1) increase the number of emergency obstetric and newborn care facilities, including upgrading existing health facilities, and (2) improve accessibility to such facilities by renovating and constructing maternity waiting homes, improving communication and transportation systems, and supporting community-based savings groups. These interventions can be adapted in low-resource settings to improve access to maternity care services.

  • Open Access
    The Costs and Cost-Effectiveness of a District-Strengthening Strategy to Mitigate the 3 Delays to Quality Maternal Health Care: Results From Uganda and Zambia
    Benjamin Johns, Peter Hangoma, Lynn Atuyambe, Sophie Faye, Mark Tumwine, Collen Zulu, Marta Levitt, Tannia Tembo, Jessica Healey, Rui Li, Christine Mugasha, Florina Serbanescu and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working Group
    Global Health: Science and Practice March 2019, 7(Supplement 1):S104-S122; https://doi.org/10.9745/GHSP-D-18-00429

    A comprehensive district-strengthening approach to address maternal and newborn health was estimated to cost US$177 per life-year gained in Uganda and $206 per life-year gained in Zambia. The approach represents a very cost-effective health investment compared to GDP per capita.

  • Open Access
    Community Perspectives of a 3-Delays Model Intervention: A Qualitative Evaluation of Saving Mothers, Giving Life in Zambia
    Alice Ngoma-Hazemba, Leoda Hamomba, Adam Silumbwe, Margarate Nzala Munakampe and Fatma Soud on behalf of the Saving Mothers, Giving Life Working Group
    Global Health: Science and Practice March 2019, 7(Supplement 1):S139-S150; https://doi.org/10.9745/GHSP-D-18-00287

    While the Saving Mothers, Giving Life's health systems strengthening approach reduced maternal mortality, respondents still reported significant barriers accessing maternal health services. More research is needed to understand the necessary intervention package to affect system-wide change.

  • Open Access
    Did Saving Mothers, Giving Life Expand Timely Access to Lifesaving Care in Uganda? A Spatial District-Level Analysis of Travel Time to Emergency Obstetric and Newborn Care
    Michelle M. Schmitz, Florina Serbanescu, Vincent Kamara, Joan Marie Kraft, Marc Cunningham, Gregory Opio, Patrick Komakech, Claudia Morrissey Conlon and Mary M. Goodwin on behalf of the Saving Mothers, Giving Life Working Group
    Global Health: Science and Practice March 2019, 7(Supplement 1):S151-S167; https://doi.org/10.9745/GHSP-D-18-00366

    A spatial analysis of facility accessibility, taking into account road networks and environmental constraints on travel, suggests that the Saving Mothers, Giving Life (SMGL) initiative increased access to emergency obstetric and neonatal care in SMGL-supported districts in Uganda. Spatial travel-time analyses can inform policy and program efforts targeting underserved populations in conjunction with the geographic distribution of maternity services.

  • Open Access
    Addressing the First Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Approaches and Results for Increasing Demand for Facility Delivery Services
    Florina Serbanescu, Mary M. Goodwin, Susanna Binzen, Diane Morof, Alice R. Asiimwe, Laura Kelly, Christina Wakefield, Brenda Picho, Jessica Healey, Agnes Nalutaaya, Leoda Hamomba, Vincent Kamara, Gregory Opio, Frank Kaharuza, Curtis Blanton, Fredrick Luwaga, Mona Steffen and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working Group
    Global Health: Science and Practice March 2019, 7(Supplement 1):S48-S67; https://doi.org/10.9745/GHSP-D-18-00343

    The Saving Mothers, Giving Life initiative used 3 coordinated approaches to reduce maternal deaths resulting from a delay in deciding to seek health care, known as the “first delay”: (1) promoting safe motherhood messages and facility delivery using radio, theater, and community engagement; (2) encouraging birth preparedness and increasing demand for facility delivery through community outreach worker visits; and (3) providing clean delivery kits and transportation vouchers to reduce financial barriers for facility delivery. These approaches can be adapted in other low-resource settings to reduce maternal and perinatal mortality.

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US AIDJohns Hopkins Center for Communication ProgramsUniversity of Alberta

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