Latest Articles
- Factors Associated With Community Health Worker Performance Differ by Task in a Multi-Tasked Setting in Rural Zimbabwe
Programs should consider specific tasks and how they relate to health worker factors, community support, and the work context. In a setting where community health workers were responsible for multiple tasks, those who referred more pregnant women were female, unmarried, under 40 years old, and from larger households, and they felt they had adequate work resources and positive feedback from supervisors and the community. In contrast, workers with high scores on delivering household behavior change lessons were from smaller households and received more supportive supervision.
- Enhancing the Supervision of Community Health Workers With WhatsApp Mobile Messaging: Qualitative Findings From 2 Low-Resource Settings in Kenya
CHWs used WhatsApp with their supervisors to document their work, spurring healthy competition and team building between CHWs in the 2 pilot sites. While there was considerable variation in the number of times each participant posted messages—from 1 message to 270 messages—in total they posted nearly 2,000 messages over 6 months. 88% of messages corresponded to at least 1 of 3 defined supervisory objectives of (1) creating a social environment, (2) sharing communication and information, or (3) promoting quality of services.
- Investing in Family Planning: Key to Achieving the Sustainable Development Goals
Voluntary family planning brings transformational benefits to women, families, communities, and countries. Investing in family planning is a development “best buy” that can accelerate achievement across the 5 Sustainable Development Goal themes of People, Planet, Prosperity, Peace, and Partnership.
- Family Planning Counseling in Your Pocket: A Mobile Job Aid for Community Health Workers in Tanzania
Using mobile job aids can help CHWs deliver integrated counseling on family planning and HIV/STI screening by following a step-by-step service delivery algorithm. Lessons learned during the pilot led to the development of additional features during scale-up to exploit the other major advantages that mHealth offers including:
Better supervision of health workers and accountability for their performance
Improved communication between supervisors and workers
Access to real-time data and reports to support quality improvement
- mHealth for Tuberculosis Treatment Adherence: A Framework to Guide Ethical Planning, Implementation, and Evaluation
Promising mHealth approaches for TB treatment adherence include:
Video observation
Patient- or device-facilitated indirect monitoring
Direct monitoring through embedded sensors or metabolite testing
To mitigate ethical concerns, our framework considers accuracy of monitoring technologies, stigmatization and intrusiveness of the technologies, use of incentives, and the balance of individual and public good.
- School Distribution as Keep-Up Strategy to Maintain Universal Coverage of Long-Lasting Insecticidal Nets: Implementation and Results of a Program in Southern Tanzania
A school-based net distribution program, piloted in the Southern Zone of Tanzania to sustain ≥80% universal net coverage previously attained through mass campaigns, successfully issued nets to nearly all eligible students and teachers. Keys to success included:
Effective collaboration between the Ministry of Health, local government, and implementing partners
Social mobilization to sensitize the community about the importance of net use
Development of a mobile application to facilitate data collection and analysis
- Expanding Access to the Intrauterine Device in Public Health Facilities in Ethiopia: A Mixed-Methods Study
Following the introduction of IUDs into the Ethiopian public health sector, use of the method increased from <1% in 2011 to 6% in 2014 in a sample of 40 health facilities. This shift occurred in the context of wide method choice, following provider training, provision of post-training supplies, and community-based awareness creation. The IUD was acceptable to a diverse range of clients, including new contraceptive users, those with little to no education, those from rural areas, and younger women, thus suggesting a strong latent demand for IUDs in Ethiopia.
- The Single-Visit Approach as a Cervical Cancer Prevention Strategy Among Women With HIV in Ethiopia: Successes and Lessons Learned
With the single-visit approach for cervical cancer prevention, women with positive “visual inspection of the cervix with acetic acid wash” (VIA) test results receive immediate treatment of the precancerous lesion with cryotherapy. The approach worked successfully for women with HIV in Ethiopia in secondary and tertiary health facilities, with high screening and cryotherapy treatment rates. Sustainability and appropriate scale-up of such programs must address wider health system challenges including human resource constraints and shortage of essential supplies.
- Results-Based Financing in Mozambique’s Central Medical Store: A Review After 1 Year
The RBF scheme, which paid incentives for verified results, steadily improved the CMS's performance over 1 year, particularly for supply and distribution planning. Key apparent success factors:
1) The CMS had full discretion over how to spend the funds
2) Payment was shared with and dependent on all staff, which encouraged teamwork.
3) Performance indicators were challenging yet achievable.
4) The quarterly payment cycle was frequent enough to be motivating.
Recommendations for future programs: focus on both quality and quantity indicators; strengthen results verification processes; and work toward institutionalizing the approach.