More articles from ORIGINAL ARTICLE
- Benefits and Limitations of a Community-Engaged Emergency Referral System in a Remote, Impoverished Setting of Northern Ghana
A low-cost emergency and communication transportation system used 3-wheeled motorcycles driven by trained community volunteers. Delivery referrals were redirected from health centers to hospitals capable of advanced services including cesarean deliveries, which was associated with reduced facility-based maternal mortality.
- Key Role of Drug Shops and Pharmacies for Family Planning in Urban Nigeria and Kenya
Pharmacies and drug shops provide a rich opportunity for expanding family planning access to urban women, especially unmarried and younger women. In urban Nigeria and Kenya, drug shops and pharmacies were the major sources for most short-acting methods, including oral contraceptive pills, emergency contraceptives, and condoms.
- Strengthening Government Leadership in Family Planning Programming in Senegal: From Proof of Concept to Proof of Implementation in 2 Districts
Based on a previous pilot experience, in a next proof-of-implementation phase, district authorities enthusiastically assumed leadership and mobilized local resources to implement a simplified package of family planning interventions, with outside technical support. Comparing a 6-month baseline period with a 6-month implementation period, couple-years of protection increased from about 2,000 to about 4,000 (82% increase) in one district, and from nearly 6,000 to about 9,000 (56% increase) in the second. Longer implementation periods could further support institutionalization and sustainability.
- Referral Systems to Integrate Health and Economic Strengthening Services for People with HIV: A Qualitative Assessment in Malawi
Two types of referral systems were implemented in this low-resource context: (1) a simple paper-based system connecting clinical HIV and nutrition support to village savings and loans services, and (2) a complex mHealth-based system with more than 20 types of health, economic strengthening, livelihoods, and food security services. Clients reported the referrals improved their health and nutrition and ability to save money in both models but more with the simple model. Providers had difficulty using the mobile app under the mHealth system, even after repeated trainings, considerable ongoing technical assistance, and multiple rounds of revisions to the interface.
- Limited Effectiveness of a Skills and Drills Intervention to Improve Emergency Obstetric and Newborn Care in Karnataka, India: A Proof-of-Concept Study
Skills refresher training combined with emergency drills improved knowledge, skills, and confidence of providers but was not sufficient to improve diagnosis and management of maternal and newborn complications. Systems-level changes, including consistent availability of equipment and supplies, adequate human resource staffing, and supportive supervision, are likely needed to improve maternal and newborn outcomes.
- Indoor Residual Spraying Delivery Models to Prevent Malaria: Comparison of Community- and District-Based Approaches in Ethiopia
Integrating indoor residual spraying into the institutionalized community-based health system in 5 districts was more efficient than the district-based model and did not compromise quality or compliance with environmental standards.
- Social Mobilization and Community Engagement Central to the Ebola Response in West Africa: Lessons for Future Public Health Emergencies
Key lessons for the crucial components of social mobilization and community engagement in this context:
Invest in trusted local community members to facilitate community entrance and engagement.
Use key communication networks and channels with wide reach and relevance to the community, such as radio in low-resource settings or faith-based organizations.
Invest in strategic partnerships to tap relevant capacities and resources.
Support a network of communication professionals who can deploy rapidly for lengthy periods.
Balance centralized mechanisms to promote consistency and quality with decentralized programming for flexibility and adaptation to local needs.
Evolve communication approaches and messaging over time with the changing outbreak patterns, e.g., from halting disease transmission to integration and support of survivors.
Establish clear communication indicators and analyze and share data in real time.
- Successful Implementation of a Multicountry Clinical Surveillance and Data Collection System for Ebola Virus Disease in West Africa: Findings and Lessons Learned
Despite resource and logistical constraints, International Medical Corps cared for thousands at 5 Ebola treatment units in Liberia and Sierra Leone between 2014 and 2015 while collecting hundreds of data points on each patient. To facilitate data collection and global reporting in future humanitarian responses, standardized data forms and databases, with clear definitions of clinical and epidemiological variables, should be developed and adopted by the international community.
- Safety and Acceptability of Community-Based Distribution of Injectable Contraceptives: A Pilot Project in Mozambique
Trained community health workers, including traditional birth attendants (TBAs), safely and effectively administered injectables in northern Mozambique; two-thirds of the women choosing injectables had never used contraception before. Including TBAs in the Ministry of Health’s recent task sharing strategy can improve rural women’s access to injectables and help meet women’s demand for contraception.
- Progress in Harmonizing Tiered HIV Laboratory Systems: Challenges and Opportunities in 8 African Countries
Countries have had mixed results in adhering to laboratory instrument procurement lists, with some limiting instrument brand expansion and others experiencing substantial growth in instrument counts and brand diversity. Important challenges to advancing laboratory harmonization strategies include:
Lack of adherence to procurement policies
Lack of an effective coordinating body
Misalignment of laboratory policies, treatment guidelines, and minimum service packages