Latest Articles
- Insights Into Provider Bias in Family Planning from a Novel Shared Decision Making Based Counseling Initiative in Rural, Indigenous Guatemala
Race, ethnicity, and indigenous status should be considered as potential drivers of provider bias in family planning services globally. Efforts to confront provider bias in family planning counseling should include concrete strategies that promote provider recognition of biases and longitudinal curriculums that allow for sustained feedback and self-reflection.
- Two-Way Short Message Service (SMS) Communication May Increase Pre-Exposure Prophylaxis Continuation and Adherence Among Pregnant and Postpartum Women in Kenya
We evaluated a 2-way short messaging service (SMS) communication platform to improve continuation of pre-exposure prophylaxis (PrEP) for HIV prevention among Kenyan pregnant and postpartum women who initiated PrEP within routine maternal child health and family planning clinics. SMS increased support for PrEP, provided opportunities for dialogue beyond the clinic, and enabled women to ask and receive answers in real-time, which facilitated continued PrEP use.
- How Should Home-Based Maternal and Child Health Records Be Implemented? A Global Framework Analysis
Our assessment of home-based record use in low- and middle-income countries indicated that the implementation process consists of 8 interdependent components involving policy makers, funders, and end users—health care workers, pregnant women, and the parents/caregivers of children. Successful implementation can result in improved maternal and child health outcomes and more efficient use of government and donor investments.
- Unmet Need for Family Planning and Experience of Unintended Pregnancy Among Female Sex Workers in Urban Cameroon: Results From a National Cross-Sectional Study
Female sex workers (FSWs) in Cameroon have unmet need for effective contraception, and experience of unintended pregnancy and pregnancy termination is common. Reducing barriers to accessing high-quality, voluntary family planning services in FSW-focused community services is a key strategy to promote client-centered care, promote informed choice, reduce unintended pregnancies, and improve quality of life for FSWs.
- Designing and Evaluating Scalable Child Marriage Prevention Programs in Burkina Faso and Tanzania: A Quasi-Experiment and Costing Study
Minimal, low-cost approaches can be effective in delaying child marriage and increasing school attendance. Program managers should consider the cost, quality, and coverage of interventions, especially because child marriage persists in the most hard-to-reach, rural areas of many countries.
- National Surgical, Obstetric, and Anesthesia Plans Supporting the Vision of Universal Health Coverage
Developing a national surgical, obstetric, and anesthesia plan is an important first step for countries to strengthen their surgical systems and improve surgical care. Barriers to successful implementation of these plans include data collection, scalability, and financing, yet surgical system strengthening efforts are gaining momentum in achieving universal access to emergency and essential surgical care.
- Diagnostic Utility and Impact on Clinical Decision Making of Focused Assessment With Sonography for HIV-Associated Tuberculosis in Malawi: A Prospective Cohort Study
Among patients with HIV and with probable/confirmed TB, using the focused assessment with sonography for HIV-associated TB (FASH) protocol led to a 5-fold increase in the clinician's decision to initiate TB treatment on that day. FASH is a supplementary tool that can help clinicians diagnose patients with HIV-associated TB at the point-of-care and reduce delays in their treatment, particularly when access to other diagnostics is limited or unavailable.
- Coaching Intensity, Adherence to Essential Birth Practices, and Health Outcomes in the BetterBirth Trial in Uttar Pradesh, India
Frequent coaching was associated with increased adherence to evidence-based essential birth practices among birth attendants but not with improved maternal and perinatal health outcomes in the BetterBirth Trial, which assessed the impact of a complex intervention to implement the World Health Organization's Safe Childbirth Checklist. To promote sustainable behavior change, future coaching-based interventions may need to explore cost-effective, feasible mechanisms for providing more frequent coaching delivered with high coverage among health care workers for longer durations.
- Implementation and Scale-Up of the Standard Days Method of Family Planning: A Landscape Analysis
Pilot introductions of the Standard Days Method (SDM) of family planning demonstrated its potential to meet unmet contraceptive needs in key populations, strengthen male involvement, and increase overall contraceptive uptake. Few countries had implemented national scale-up due to barriers, such as competing resource priorities and uneven stakeholder engagement. Demand-side user barriers, including insufficient fertility awareness knowledge, were also constraints. Policy makers should determine the SDM's added value to the contraceptive method mix and identify potential barriers to its implementation.
- A Qualitative Assessment of Provider and Client Experiences With 3- and 6-Month Dispensing Intervals of Antiretroviral Therapy in Malawi
Clients with HIV on antiretroviral therapy (ART) perceived the 6-month ART dispensing interval as highly acceptable due to reduced transport costs and increased time for income-generating activities. Providers reported benefits in reduced clinic workload and improved ability to see clients who need more support. Before implementing this dispensing interval on a large scale, countries should conduct further research on how to encourage client health-seeking behaviors for health problems, ensure women have access to family planning services outside of ART clinic visits, and encourage providers to use best practices for counseling messages.