Latest Articles
- Pilot Research as Advocacy: The Case of Sayana Press in Kinshasa, Democratic Republic of the Congo
The pilot study obtained Ministry of Health approval to allow medical and nursing students to provide the injectable contraceptive Sayana Press and other methods in the community, paving the way for other task-shifting pilots including self-injection of Sayana Press with supervision by the students as well as injection by community health workers.
- Mobile-Based Nutrition and Child Health Monitoring to Inform Program Development: An Experience From Liberia
Monitoring behavior using mobile phones at food distribution points allowed managers to rapidly adapt project activities. Self-reported breastfeeding, complementary feeding, and use of insecticide-treated nets improved. Applying the same methodology at the household level proved unsuccessful.
- Limits of “Skills And Drills” Interventions to Improving Obstetric and Newborn Emergency Response: What More Do We Need to Learn?
A “skills and drills” intervention in 4 hospitals in Karnataka, India, produced modest improvement in provider knowledge and skills but not in actual response to obstetric and newborn emergencies. We explore possible explanations, which include (1) the need for a more intensive intervention; (2) other weaknesses in the health system; and (3) behavioral or organizational barriers related to hierarchical structures, roles, and team formation.
- Social Mobilization and Community Engagement Central to the Ebola Response in West Africa: Lessons for Future Public Health Emergencies
Key lessons for the crucial components of social mobilization and community engagement in this context:
Invest in trusted local community members to facilitate community entrance and engagement.
Use key communication networks and channels with wide reach and relevance to the community, such as radio in low-resource settings or faith-based organizations.
Invest in strategic partnerships to tap relevant capacities and resources.
Support a network of communication professionals who can deploy rapidly for lengthy periods.
Balance centralized mechanisms to promote consistency and quality with decentralized programming for flexibility and adaptation to local needs.
Evolve communication approaches and messaging over time with the changing outbreak patterns, e.g., from halting disease transmission to integration and support of survivors.
Establish clear communication indicators and analyze and share data in real time.
- Postabortion Care: 20 Years of Strong Evidence on Emergency Treatment, Family Planning, and Other Programming Components
Twenty years of postabortion care (PAC) studies yield strong evidence that:
Misoprostol and vacuum aspiration are comparable in safety and effectiveness for treating incomplete abortion.
Misoprostol, which can be provided by trained nurses and midwives, shows substantial promise for extending PAC services to secondary hospitals and primary health posts.
Postabortion family planning uptake generally increases rapidly-and unintended pregnancies and repeat abortions can decline as a result-when a range of free contraceptives, including long-acting methods, are offered at the point of treatment; male involvement in counseling-always with the woman’s concurrence-can increase family planning uptake and support.
- Safety and Acceptability of Community-Based Distribution of Injectable Contraceptives: A Pilot Project in Mozambique
Trained community health workers, including traditional birth attendants (TBAs), safely and effectively administered injectables in northern Mozambique; two-thirds of the women choosing injectables had never used contraception before. Including TBAs in the Ministry of Health’s recent task sharing strategy can improve rural women’s access to injectables and help meet women’s demand for contraception.
- Improving the Quality of Postabortion Care Services in Togo Increased Uptake of Contraception
The quality improvement approach applied at 5 facilities over about 1 year increased family planning counseling to postabortion clients from 31% to 91%. Of those counseled provision of a contraceptive method before discharge increased from 37% to 60%. Oral contraceptives remained the most popular method, but use of injectables and implants increased. The country-driven approach, which tended to use existing resources and minimal external support, has potential for sustainability and scale-up in Togo and application elsewhere.
- Progress in Harmonizing Tiered HIV Laboratory Systems: Challenges and Opportunities in 8 African Countries
Countries have had mixed results in adhering to laboratory instrument procurement lists, with some limiting instrument brand expansion and others experiencing substantial growth in instrument counts and brand diversity. Important challenges to advancing laboratory harmonization strategies include:
Lack of adherence to procurement policies
Lack of an effective coordinating body
Misalignment of laboratory policies, treatment guidelines, and minimum service packages
- Scheduled Follow-Up Referrals and Simple Prevention Kits Including Counseling to Improve Post-Discharge Outcomes Among Children in Uganda: A Proof-of-Concept Study
Post-hospital discharge is a vulnerable time for recurrent illness and death among children. An intervention package consisting of (1) referrals for scheduled follow-up visits, (2) discharge counseling, and (3) simple prevention items such as soap and oral rehydration salts resulted in much higher health seeking and hospital readmissions compared with historical controls.
- A Randomized Controlled Trial of a Trauma-Informed Support, Skills, and Psychoeducation Intervention for Survivors of Torture and Related Trauma in Kurdistan, Northern Iraq
Providing survivors of torture, imprisonment, and/or military attacks with a counseling program that includes support, skills and psychoeducation by well-trained and supervised community mental health workers can result in moderate yet meaningful improvements in depression and dysfunction.