Latest Articles
- Stunning Popularity of LARCs With Good Access and Quality: A Major Opportunity to Meet Family Planning Needs
Given true choice, a very high proportion of women, perhaps most, would select one of the long-acting reversible contraceptives (LARCs)—implants or IUDs—for contraception. If implemented on a wide scale, it would not only drastically alter the current method mix but also serve client needs much better and prevent unintended pregnancy more successfully.
- Trends in the Contraceptive Method Mix in Low- and Middle-Income Countries: Analysis Using a New “Average Deviation” Measure
Applying a standard measure of the method mix evenness suggests 4 patterns among 15 countries moving toward a more balanced mix: (1) rise of one previously underrepresented or new method, (2) replacement of traditional with modern methods, (3) continued but declining domination by a single method, and (4) general movement toward a balanced mix. Improving availability of underutilized or new methods can improve the method mix, although better implementation of more popular methods might increase contraceptive use more expeditiously.
- Predictors of Workforce Retention Among Malawian Nurse Graduates of a Scholarship Program: A Mixed-Methods Study
Several non-remuneration strategies may help improve retention of public-sector nurses: availability of supplies, adequate housing, advancement opportunities, and a positive work environment. A scholarship program with close follow-up of graduates may also help improve retention.
- Delivering High-Quality Family Planning Services in Crisis-Affected Settings I: Program Implementation
Extending access to a wide variety of contraceptive methods, including long-acting reversible methods, is feasible in crisis-affected countries by focusing on best practices such as competency-based training, supply chain support, systematic supervision, and community mobilization. Prudent use of data helps drive program improvements.
- Successful Proof of Concept of Family Planning and Immunization Integration in Liberia
Mobilizing vaccinators to provide mothers key family planning information and referrals to co-located, same-day family planning services was feasible in resource-limited areas of Liberia, leading to substantial increases in contraceptive use. Conversely, impact on immunization rates was less clear, but at a minimum there was no decrease in doses administered.
- A Resource Planning Analysis of District Hospital Surgical Services in the Democratic Republic of the Congo
District hospitals in the DRC, on average, could not provide 21% of lifesaving surgical interventions due to deficiencies in basic infrastructure and essential surgical equipment and supplies. Surgery's important health impact and proportionally low service delivery budget argue for greater emphasis on surgical interventions, including for obstetric care.
- Caution on corticosteroids for preterm delivery: learning from missteps
An important new study in lower-level health facilities in low- and middle-income countries found an increased risk of neonatal deaths with corticosteroid use in pregnant women with imminent preterm birth, in contrast with the positive results previously found in high-income countries. The surprising finding demonstrates that context matters. The increase appears largely due to steroids administered in cases that were not actually preterm, probably due to inaccurate pregnancy dating and challenges with diagnostic capacity. Promoting public health often requires decisions based on less-than-perfect evidence, but we must be vigilant about gathering and assessing new evidence and ready to change strategies.
- Maternal mental health in Amhara region, Ethiopia: a cross-sectional survey
Poor mental health, including suicidal thoughts, affects a substantial proportion of surveyed women who are up to 2 years postpartum in the Amhara region of Ethiopia. Opportunities for integrating basic psychosocial mental health services into maternal and child health services should be explored.
- It's not Ebola … it's the systems
The 2014 Ebola outbreak in West Africa demonstrates key deficiencies in investment in health systems. Despite some modest investment in health systems, our field has instead largely chosen to pursue shorter-term, vertical efforts to more rapidly address key global health issues such as smallpox, polio, malaria, and HIV/AIDS. While those efforts have yielded substantial benefits, we have paid a price for the lack of investments in general systems strengthening. The Ebola deaths we have seen represent a small portion of deaths from many other causes resulting from weak systems. Major systems strengthening including crucial nonclinical elements will not happen overnight but should proceed in a prioritized, systematic way.
- Breaking new ground in family planning communication
The Urban Reproductive Health Initiative has shown impact on contraceptive use from its communication components even within a few years, as described in 2 GHSP articles. One specifically addressed “ideation” about family planning in detail and was able to show both changes in ideation due to program exposure and correlated changes in contraceptive use. The other used a sophisticated analytical technique that indicated the observed changes in contraceptive use resulted from exposure to the communication efforts, and not just because people more prone to adopt family planning were also more likely to recall exposure to the communication messages.