Latest Articles
- Mapping the Prevalence and Sociodemographic Characteristics of Women Who Deliver Alone: Evidence From Demographic and Health Surveys From 80 Countries
An estimated 2.2 million women surveyed in low- and middle-income countries between 2005 and 2015 gave birth alone. This practice was concentrated in West and Central Africa and parts of East Africa. Women who delivered with no one present were very poor, uneducated, older, and of higher parity. Experience from northern Nigeria suggests the practice can be reduced markedly by mobilizing religious and civil society leaders to improve community awareness about the critical importance of having an attendant present.
- Simplified Asset Indices to Measure Wealth and Equity in Health Programs: A Reliability and Validity Analysis Using Survey Data From 16 Countries
Many program implementers have difficulty collecting and analyzing data on program beneficiaries’ wealth because a large number of survey questions are required to construct the standard wealth index. We created country-specific measures of household wealth with as few as 6 questions that are highly reliable and valid in both urban and rural contexts.
- Birthing Centers Staffed by Skilled Birth Attendants: Can They Be Effective … at Scale?
Peripheral-level birthing centers may be appropriate and effective in some circumstances if crucial systems requirements can be met. But promising models don’t necessarily scale well, so policy makers and program managers need to consider what requirements can and cannot be met feasibly at scale. Apparently successful components of the birthing center model, such as engagement of traditional birth attendants and use of frontline staff who speak the local language, appear conducive to use in other similar settings.
- Is Household Wealth Associated With Use of Long-Acting Reversible and Permanent Methods of Contraception? A Multi-Country Analysis
In general, across the developing world, wealthier women are more likely than poorer women to use long-acting and permanent methods of contraception instead of short-acting methods. Exceptions are Bangladesh, India, and possibly Haiti.
- Family Planning Supply Environment in Kinshasa, DRC: Survey Findings and Their Value in Advancing Family Planning Programming
A series of facility-based surveys that mapped all sites providing family planning services and that assessed readiness to provide services, using mobile phones, was feasible in a low-resource setting, contributing to mobilization of partners and increased donor support. Between 2012 and 2013, readiness to provide services increased from 44% of sites to 63%. Three factors most associated with productivity: type of facility (clinics more than hospitals or health centers), more years in operation, and number of methods available.
- Reducing Motor Vehicle-Related Injuries at an Arizona Indian Reservation: Ten Years of Application of Evidence-Based Strategies
Motor vehicle crashes decreased and seat belt use, including car seat use, increased in an American Indian and Alaska Native community through a multidisciplinary approach using strong partnerships among public health and law enforcement agencies; community outreach; mass media campaigns; and enactment and high-visibility enforcement of key laws, such as lowering the legal blood alcohol concentration limit for drivers and mandating use of occupant restraints.
- Introduction of Mobile Health Tools to Support Ebola Surveillance and Contact Tracing in Guinea
An informatics system consisting of a mobile health application and business intelligence software was used for collecting and analyzing Ebola contact tracing data. This system offered potential to improve data access and quality to support evidence-based decision making for the Ebola response in Guinea. Implementation challenges included software limitations, technical literacy of users, coordination among partners, government capacity for data utilization, and data privacy concerns.
- The Levonorgestrel Intrauterine System: A Pragmatic View of an Excellent Contraceptive
The levonorgestrel intrauterine system (LNG IUS) has major advantages and could be a “game-changer” in improving contraceptive choice and use. It faces important challenges, however, including: (1) high commodity cost; (2) often-strong provider resistance to IUDs and difficult programmatic requirements; (3) need for demand creation, including assessing if markedly reduced menstrual bleeding is attractive to clients; and (4) the many requirements for introducing any new contraceptive. A good next step would be a well-focused and multifaceted “learning introduction” to assess the LNG IUS’s potential in several low-income countries, with rapid scale-up if results are promising.
- Nurse Mentors to Advance Quality Improvement in Primary Health Centers: Lessons From a Pilot Program in Northern Karnataka, India
Trained nurse mentors catalyzed quality improvements in facility-based maternal and newborn care by: (1) encouraging use of self-assessment checklists and team-based problem solving, (2) introducing case sheets to ensure adherence to clinical guidelines, and (3) strengthening clinical skills through on-site demonstrations and bedside teaching. Inadequate leadership and staffing were challenges in some facilities. Some social norms, such as client resistance to referral and to staying 48 hours after delivery, also impact quality and mandate community mobilization efforts.
- Monitoring and Evaluating the Transition of Large-Scale Programs in Global Health
Monitoring and evaluating large-scale global health program transitions can strengthen accountability, facilitate stakeholder engagement, and promote learning about the transition process and how best to manage it. We propose a conceptual framework with 4 main domains relevant to transitions—leadership, financing, programming, and service delivery—along with guiding questions and illustrative indicators to guide users through key aspects of monitoring and evaluating transition. We argue that monitoring and evaluating transitions can bring conceptual clarity to the transition process, provide a mechanism for accountability, facilitate engagement with local stakeholders, and inform the management of transition through learning.