Latest Articles
- Private-Sector Social Franchising to Accelerate Family Planning Access, Choice, and Quality: Results From Marie Stopes International
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.
- How Can We Better Evaluate Complex Global Health Initiatives? Reflections From the January 2014 Institute of Medicine Workshop
An IOM workshop on evaluation design drew on recent evaluations of 4 complex initiatives (PEPFAR; the Global Fund to Fight AIDS, TB and Malaria; the President's Malaria Initiative; and the Affordable Medicines Facility-malaria). Key components for good evaluations: (1) a robust theory of change to understand how and why programs should work; (2) use of multiple analytic methods; and (3) triangulation of evidence to validate and deepen understanding of results as well as synthesis of findings to identify lessons for scale-up or broader application.
- PEPFAR Transitions to Country Ownership: Review of Past Donor Transitions and Application of Lessons Learned to the Eastern Caribbean
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.
- Engaging Communities With a Simple Tool to Help Increase Immunization Coverage
Use of a simple, publicly placed tool that monitors vaccination coverage in a community has potential to broaden program coverage by keeping both the community and the health system informed about every infant's vaccination status.
- Biometric Fingerprint System to Enable Rapid and Accurate Identification of Beneficiaries
Inability to uniquely identify clients impedes access to services and contributes to inefficiencies. Using a pocket-sized fingerprint scanner that wirelessly syncs with a health worker's smartphone, the SimPrints biometric system can link individuals' fingerprints to their health records. A pilot in Bangladesh will assess its potential.
- A False Dichotomy: RCTs and Their Contributions to Evidence-Based Public Health
Global public health should rely on those research methods that best answer the pressing questions at hand. Randomized controlled trials (RCTs) and other rigorous impact evaluation methods have a critical role to play in public health.
- Barriers to Health Care in Rural Mozambique: A Rapid Ethnographic Assessment of Planned Mobile Health Clinics for ART
Mobile health clinics can markedly decrease clients' transportation time and cost to access antiretroviral therapy (ART) and other health services in rural areas, potentially improving use. Close coordination with community leaders and regularly scheduled visits by the mobile clinics are critical.
- Female Health Workers at the Doorstep: A Pilot of Community-Based Maternal, Newborn, and Child Health Service Delivery in Northern Nigeria
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.
- Patient Flow Analysis in Resource-Limited Settings: A Practical Tutorial and Case Study
Patient flow analysis (PFA), a simple quality improvement tool to identify patient flow patterns, can be used in resource-limited settings to inform service delivery improvements. A PFA at a Ghanaian hospital found that personnel constraints and a mismatch between staffing and patient arrival surges led to long wait and total attendance times. The median time from arrival to first-provider contact was 4.6 hours.