Latest Articles
- Oxytocin: taking the heat
Oxytocin-in-Uniject satisfied the standards of its temperature-time indicator (TTI) in severe home storage conditions, although that required resupply every 30 days—a logistically onerous programmatic standard. Possible advances include: (1) incorporating TTIs with packaged batches of less expensive and more widely used conventional vials of oxytocin; (2) using TTIs calibrated more closely to the actual temperature sensitivity of oxytocin; and (3) researching whether a lower dose of oxytocin would be equally efficacious in preventing postpartum hemorrhage.
- Nationwide implementation of integrated community case management of childhood illness in Rwanda
Between 2008 and 2011, Rwanda introduced iCCM of childhood illness nationwide. One year after iCCM rollout, community-based treatment for diarrhea and pneumonia had increased significantly, and under-5 mortality and overall health facility use had declined significantly.
- Strategic contracting practices to improve procurement of health commodities
Practices such as flexible, pre-established framework agreements can improve timeliness and cost of procurement and help improve commodity security. Addressing legislative barriers and building technical capacity in contract management may facilitate the use of such practices.
- Cumulative effects of heat exposure and storage conditions of Oxytocin-in-Uniject in rural Ghana: implications for scale up
Oxytocin-in-Uniject devices could be stored 30 to 40 days without refrigeration under typical field conditions, with wastage levels below 10%, based on simulation studies.
- Are national policies and programs for prevention and management of postpartum hemorrhage and preeclampsia adequate? A key informant survey in 37 countries
Most surveyed countries have many supportive policies and program elements, but issues remain that impede maternal health efforts, including: inconsistent availability of essential commodities, particularly misoprostol; limitations on midwives' scope of practice; incomplete or out-of-date service delivery guidelines; and weak reporting systems.
- Maximizing the benefits of improved cookstoves: moving from acquisition to correct and consistent use
The adoption of clean cooking technologies goes beyond mere product acquisition and requires attention to issues of cooking traditions, user engagement, gender dynamics, culture, and religion to effect correct and consistent use.
- Development and use of a master health facility list: Haiti's experience during the 2010 earthquake response
Collaboration between the Haitian government and NGOs after the 2010 earthquake contributed to a more accurate and complete master health facility list, which helped coordinate emergency response operations as well as strengthen the routine health information system. Open data and social networks facilitated the collection and sharing of health facility information and in maintenance of the list over time.
- Can traditional birth attendants be trained to accurately identify septic infants, initiate antibiotics, and refer in a rural African setting?
Despite having limited training, these TBAs were able to accurately identify critically ill neonates, initiate treatment in the field, and refer for further care. Given their proximity to the mother/infant pair, and their role in rural communities, training and equipping TBAs in this role could be effective in reducing neonatal mortality.
- Plausible role for CHW peer support groups in increasing care-seeking in an integrated community case management project in Rwanda: a mixed methods evaluation
During national scale up of iCCM in Rwanda, greater improvements in care-seeking were found in the districts where Kabeho Mwana implemented its model than in the rest of the country. Success was attributed to an emphasis on routine data review, intensive monitoring, collaborative supervision, community mobilization, and, in particular, CHW peer support groups.
- Evidence-based public health: not only whether it works, but how it can be made to work practicably at scale
Because public health must operate at scale in widely diverse, complex situations, randomized controlled trials (RCTs) have limited utility for public health. Other methodologies are needed. A key conceptual backbone is a detailed “theory of change” to apply appropriate evidence for each operational component. Synthesizing patterns of findings across multiple methodologies provides key insights. Programs operating successfully across a variety of settings can provide some of the best evidence. Challenges include judging the quality of such evidence and assisting programs to apply it. WHO and others should shift emphasis from RCTs to more relevant evidence when assessing public health issues.