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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
    Private-Sector Social Franchising to Accelerate Family Planning Access, Choice, and Quality: Results From Marie Stopes International
    Erik Munroe, Brendan Hayes and Julia Taft
    Global Health: Science and Practice June 2015, 3(2):195-208; https://doi.org/10.9745/GHSP-D-15-00056

    In just 7 years, Marie Stopes International (MSI) has scaled-up social franchising across Africa and Asia, from 7 countries to 17, cumulatively reaching an estimated 3.75 million clients including young adults and the poor. In 2014, 68% of clients chose long-acting reversible contraceptives, and many clients were adopters of family planning. Service quality and efficiency (couple-years of protection delivered per outlet) also improved significantly.

  • Open Access
    PEPFAR Transitions to Country Ownership: Review of Past Donor Transitions and Application of Lessons Learned to the Eastern Caribbean
    Abigail Vogus and Kylie Graff
    Global Health: Science and Practice June 2015, 3(2):274-286; https://doi.org/10.9745/GHSP-D-14-00227

    Six key steps for effective transition: (1) develop a roadmap; (2) involve stakeholders; (3) communicate the plan; (4) support midterm evaluations; (5) strengthen financial, technical, and management capacity; and (6) support ongoing M&E. The Eastern Caribbean will need to identify HIV champions; strengthen leadership and management; improve policies to protect key populations; engage the private sector and civil society more; integrate HIV programs into primary care; improve supply chain capacity; and address health worker shortages.

  • Open Access
    Appropriate Management of Acute Diarrhea in Children Among Public and Private Providers in Gujarat, India: A Cross-Sectional Survey
    Christa L Fischer Walker, Sunita Taneja, Amnesty LeFevre, Robert E Black and Sarmila Mazumder
    Global Health: Science and Practice June 2015, 3(2):230-241; https://doi.org/10.9745/GHSP-D-14-00209

    Training public-sector providers to treat diarrhea in children with low-osmolarity oral rehydration salts and zinc appeared to be effective. Among private providers, drug-detailing visits by pharmaceutical representatives seemed less effective, particularly in improving knowledge of the correct dosage and duration of zinc treatment. Consistent supplies and sufficient attention to training all health care cadres, especially community health workers who may be new to diarrhea treatment and informal-sector providers who are typically excluded from formal training, are critical to improving knowledge and prescribing behaviors.

  • Open Access
    Motivations and Constraints to Family Planning: A Qualitative Study in Rwanda’s Southern Kayonza District
    Didi Bertrand Farmer, Leslie Berman, Grace Ryan, Lameck Habumugisha, Paulin Basinga, Cameron Nutt, Francois Kamali, Elias Ngizwenayo, Jacklin St Fleur, Peter Niyigena, Fidele Ngabo, Paul E Farmer and Michael L Rich
    Global Health: Science and Practice June 2015, 3(2):242-254; https://doi.org/10.9745/GHSP-D-14-00198

    Community members and health workers recognized the value of spacing and limiting births but a variety of traditional and gender norms constrain their use of contraception. Limited method choice, persistent side effects, transportation fees, stock-outs, long wait times, and hidden service costs also inhibit contraceptive use.

  • Open Access
    Female Health Workers at the Doorstep: A Pilot of Community-Based Maternal, Newborn, and Child Health Service Delivery in Northern Nigeria
    Charles A Uzondu, Henry V Doctor, Sally E Findley, Godwin Y Afenyadu and Alastair Ager
    Global Health: Science and Practice March 2015, 3(1):97-108; https://doi.org/10.9745/GHSP-D-14-00117

    Deployment of resident female Community Health Extension Workers (CHEWs) to a remote rural community led to major and sustained increases in service utilization, including antenatal care and facility-based deliveries. Key components to success: (1) providing an additional rural residence allowance to help recruit and retain CHEWs; (2) posting the female CHEWs in pairs to avoid isolation and provide mutual support; (3) ensuring supplies and transportation means for home visits; and (4) allowing CHEWs to perform deliveries.

  • Open Access
    Delivering High-Quality Family Planning Services in Crisis-Affected Settings I: Program Implementation
    Dora Ward Curry, Jesse Rattan, Jean Jose Nzau and Kamlesh Giri
    Global Health: Science and Practice March 2015, 3(1):14-24; https://doi.org/10.9745/GHSP-D-14-00164

    Extending access to a wide variety of contraceptive methods, including long-acting reversible methods, is feasible in crisis-affected countries by focusing on best practices such as competency-based training, supply chain support, systematic supervision, and community mobilization. Prudent use of data helps drive program improvements.

  • Open Access
    Successful Proof of Concept of Family Planning and Immunization Integration in Liberia
    Chelsea M Cooper, Rebecca Fields, Corinne I Mazzeo, Nyapu Taylor, Anne Pfitzer, Mary Momolu and Cuallau Jabbeh-Howe
    Global Health: Science and Practice March 2015, 3(1):71-84; https://doi.org/10.9745/GHSP-D-14-00156

    Mobilizing vaccinators to provide mothers key family planning information and referrals to co-located, same-day family planning services was feasible in resource-limited areas of Liberia, leading to substantial increases in contraceptive use. Conversely, impact on immunization rates was less clear, but at a minimum there was no decrease in doses administered.

  • Open Access
    A Resource Planning Analysis of District Hospital Surgical Services in the Democratic Republic of the Congo
    Melanie Sion, Dheepa Rajan, Hyppolite Kalambay, Jean-Pierre Lokonga, Joseph Bulakali, Mathias Mossoko, Dieudonne Kwete, Gerard Schmets, Edward Kelley, Tarcisse Elongo, Luis Sambo and Meena Cherian
    Global Health: Science and Practice March 2015, 3(1):56-70; https://doi.org/10.9745/GHSP-D-14-00165

    District hospitals in the DRC, on average, could not provide 21% of lifesaving surgical interventions due to deficiencies in basic infrastructure and essential surgical equipment and supplies. Surgery's important health impact and proportionally low service delivery budget argue for greater emphasis on surgical interventions, including for obstetric care.

  • Open Access
    Delivering High-Quality Family Planning Services in Crisis-Affected Settings II: Results
    Dora Ward Curry, Jesse Rattan, Shuyuan Huang and Elizabeth Noznesky
    Global Health: Science and Practice March 2015, 3(1):25-33; https://doi.org/10.9745/GHSP-D-14-00112

    A family planning program in 5 crisis-affected settings reached more than 52,000 new contraceptive users in just 2.5 years. Long-acting reversible contraceptives (LARCs) made up 61% of the method mix, with implants predominating in most countries. IUD use also increased over time as the program intensified its efforts to improve provider skills and user awareness. These findings demonstrate the strong popularity of LARCs and the feasibility of providing them in fragile settings even though they require more training and infrastructure support than short-acting methods.

  • Open Access
    Trends in the Contraceptive Method Mix in Low- and Middle-Income Countries: Analysis Using a New “Average Deviation” Measure
    John Ross, Jill Keesbury and Karen Hardee
    Global Health: Science and Practice March 2015, 3(1):34-55; https://doi.org/10.9745/GHSP-D-14-00199

    Applying a standard measure of the method mix evenness suggests 4 patterns among 15 countries moving toward a more balanced mix: (1) rise of one previously underrepresented or new method, (2) replacement of traditional with modern methods, (3) continued but declining domination by a single method, and (4) general movement toward a balanced mix. Improving availability of underutilized or new methods can improve the method mix, although better implementation of more popular methods might increase contraceptive use more expeditiously.

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US AIDJohns Hopkins Center for Communication ProgramsUniversity of Alberta

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