More articles from ORIGINAL ARTICLE
- Availability and Quality of Family Planning Services in the Democratic Republic of the Congo: High Potential for Improvement
A few facilities provided good access to and quality of family planning services, particularly urban, private, and higher-level facilities. Yet only one-third offered family planning services at all, and only 20% of these facilities met a basic measure of quality. Condoms, oral contraceptives, and injectables were most available, whereas long-acting, permanent methods, and emergency contraception were least available. Responding to the DRC's high unmet need for family planning calls for substantial expansion of services.
- Effect on Neonatal Mortality of Newborn Infection Management at Health Posts When Referral Is Not Possible: A Cluster-Randomized Trial in Rural Ethiopia
Health Extension Workers (HEWs), in general, properly provided antibiotic treatment of possible severe bacterial infections in newborns at the health post level. But only about half of newborns estimated to have infections in the intervention area received treatment by HEWs, and home visits and referrals declined in the final months of the study. Cluster-level analysis suggests a mortality reduction consistent with this level of treatment coverage, although the finding did not reach statistical significance.
- Limited Service Availability, Readiness, and Use of Facility-Based Delivery Care in Haiti: A Study Linking Health Facility Data and Population Data
Proximity to a health facility offering delivery services and readiness of the facilities to provide such services were poor in both rural and urban areas outside of Port-au-Prince. Availability of a proximate facility was significantly associated with women in rural and urban areas delivering at a facility, as was the quality of delivery care available at the facilities but only in urban areas.
- Benefits and Limitations of Text Messages to Stimulate Higher Learning Among Community Providers: Participants' Views of an mHealth Intervention to Support Continuing Medical Education in Vietnam
The original intention was to deliver technical content through brief text messages to stimulate participants to undertake deeper learning. While participants appreciated the convenience and relevance of the text messages, their scores of higher-order knowledge did not improve. The intervention may not have been successful because the messages lacked depth and interactivity, and participants were not explicitly encouraged to seek deeper learning.
- A Non–Gas-Based Cryotherapy System for the Treatment of Cervical Intraepithelial Neoplasia: A Mixed-Methods Approach for Initial Development and Testing
A non–gas-based treatment device for early cervical cancer treatment, adapted for use in low-resource settings to improve ease of use, portability, and durability, performed similarly to a standard gas-based cryotherapy device in small-scale testing. A large randomized clinical trial is currently underway for further assessment.
- Women's Limited Choice and Availability of Modern Contraception at Retail Outlets and Public-Sector Facilities in Luanda, Angola, 2012–2015
Despite high rates of unintended pregnancy, access to a wide range of contraceptive methods, especially injectables and long-acting reversible contraceptives (LARCs), is severely limited in both public and private facilities. Knowledge of contraceptive choices is likewise limited, yet a substantial proportion of women are not using their preferred method among the methods they know of.
- Comparing Women's Contraceptive Preferences With Their Choices in 5 Urban Family Planning Clinics in Ghana
Women's method choice largely matched their stated desired duration of effectiveness but not their desires to avoid certain side effects. While most women reported they were counseled about side effects, many fewer reported being specifically counseled about common menstrual side effects with their chosen method, including side effects the women said would cause them to stop using the method.
- Youth Voucher Program in Madagascar Increases Access to Voluntary Family Planning and STI Services for Young People
Program accomplishments during the first 18 months:
More than 58,000 free vouchers distributed to young people, of which 74% were redeemed.
79% chose long-acting reversible contraceptives (LARCs) and 51% received STI counseling.
Client profile data snapshot:
69% had never previously used contraception and 96% were 20 or younger.
- Community Health Workers as Social Marketers of Injectable Contraceptives: A Case Study from Ethiopia
Volunteer community health workers (CHWs) administered injectable contraceptives to women in the community for a small fee while providing counseling and referrals for other methods. Over nearly 3 years, more than 600 CHWs provided an estimated 15,410 injections. The model has the potential to improve sustainability of community-based distribution programs by incorporating social marketing principles to partially recover commodity costs and compensate CHWs.
- 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.