More articles from Original Articles
- SMS versus voice messaging to deliver MNCH communication in rural Malawi: assessment of delivery success and user experience
Mobile SMS health messages had higher successful delivery and led to higher intended or actual behavior change among subscribers than voice messages. Providing multiple delivery modalities led to greater overall access.
- Keeping community health workers in Uganda motivated: key challenges, facilitators, and preferred program inputs
In Uganda, community-based health programs using volunteers should focus on strengthening support systems to address transportation and stockout issues and on improving links with the health structure while reinforcing effort recognition, status, and acquisition of new skills.
- Meningococcal vaccine introduction in Mali through mass campaigns and its impact on the health system
The meningococcal A vaccine campaign led to major disruption of routine vaccination services and reduced other services, notably antenatal care.
- “A cup of tea with our CBD agent … ”: community provision of injectable contraceptives in Kenya is safe and feasible
Community health workers can safely provide the injectable DMPA when appropriately trained and supervised. We also found a fivefold increase in contraceptive uptake—a finding that builds on evidence from other countries for supportive policy change.
- Early pregnancy detection by female community health volunteers in Nepal facilitated referral for appropriate reproductive health services
Trained female community health volunteers provided low-cost urine pregnancy tests in their communities, leading to counseling and appropriate referrals for antenatal care, family planning, or comprehensive abortion care.
- As good as physicians: patient perceptions of physicians and non-physician clinicians in rural primary health centers in India
Non-physician clinicians (NPCs), including both specially trained medical assistants and physicians trained in India systems of medicine, perform similarly to physicians in terms of patient satisfaction, trust, and perceived quality, thus supporting the use and scale up of NPCs in primary care.
- Obesity as a public health problem among adult women in rural Tanzania
Even in rural areas of Tanzania, an early stage of the nutrition transition is underway: 3 times as many women were overweight or obese than were undernourished. Overweight and obese women mainly follow a diet characterized by high consumption of bread and cakes (usually fried or baked in oil), sugar, and black tea.
- Building on safety, feasibility, and acceptability: the impact and cost of community health worker provision of injectable contraception
This project in Zambia contributes to our understanding of the impact of community-based provision of injectables on method choice and uptake and of the costs of adding DMPA to an established community-based family planning program. The project also illustrates the importance of involving stakeholders from the outset, analyzing costs relevant to scale up, and engaging in policy change dialogue not at the end, but rather throughout project implementation.
- Simulated clients reveal factors that may limit contraceptive use in Kisumu, Kenya
While the quality of family planning service delivery was often good, clients reported barriers including: excessively long waiting times, provider absences, informal fees, inappropriate pregnancy tests, misinformation, and provider disrespect. Improved monitoring and oversight of facility practices and examination of provider needs and motivations may increase quality of service.
- Does free pregnancy testing reduce service denial in family planning clinics? A cluster-randomized experiment in Zambia and Ghana
Pregnancy tests, which cost very little (∼US$0.10) and are often required for successful family planning service delivery, may reduce service denial, and should be available in all family planning clinics at no or minimal cost to clients.