Latest Articles
- Effect on Neonatal Mortality of Newborn Infection Management at Health Posts When Referral Is Not Possible: A Cluster-Randomized Trial in Rural Ethiopia
Health Extension Workers (HEWs), in general, properly provided antibiotic treatment of possible severe bacterial infections in newborns at the health post level. But only about half of newborns estimated to have infections in the intervention area received treatment by HEWs, and home visits and referrals declined in the final months of the study. Cluster-level analysis suggests a mortality reduction consistent with this level of treatment coverage, although the finding did not reach statistical significance.
- Limited Service Availability, Readiness, and Use of Facility-Based Delivery Care in Haiti: A Study Linking Health Facility Data and Population Data
Proximity to a health facility offering delivery services and readiness of the facilities to provide such services were poor in both rural and urban areas outside of Port-au-Prince. Availability of a proximate facility was significantly associated with women in rural and urban areas delivering at a facility, as was the quality of delivery care available at the facilities but only in urban areas.
- Benefits and Limitations of Text Messages to Stimulate Higher Learning Among Community Providers: Participants' Views of an mHealth Intervention to Support Continuing Medical Education in Vietnam
The original intention was to deliver technical content through brief text messages to stimulate participants to undertake deeper learning. While participants appreciated the convenience and relevance of the text messages, their scores of higher-order knowledge did not improve. The intervention may not have been successful because the messages lacked depth and interactivity, and participants were not explicitly encouraged to seek deeper learning.
- Not Ready for Primetime: Challenges of Antenatal Ultrasound in Low- and Middle-Income Country Settings
Even under optimized trial conditions, antenatal ultrasound was difficult to implement in Equateur Province, DRC. Moreover, the broader study across 5 countries failed to find an impact on pregnancy outcomes. Use of antenatal ultrasound screening appears not to be ready for wide application in low- and middle-income countries.
- The Importance of Mental Well-Being for Health Professionals During Complex Emergencies: It Is Time We Take It Seriously
We call on humanitarian aid organizations to integrate proven mental health strategies to protect the mental health of their workforce and improve staff capacity to provide care for vulnerable populations. Such strategies could include:
Pre-deployment training
Art therapy
Team building
Physical exercise
Mindfulness or contemplative techniques
Mind-body exercises
Narrative Exposure Therapy
Eye movement desensitization and reprocessing
- The BetterBirth Program: Pursuing Effective Adoption and Sustained Use of the WHO Safe Childbirth Checklist Through Coaching-Based Implementation in Uttar Pradesh, India
The BetterBirth Program relied on carefully structured coaching that was multilevel, collaborative, and provider-centered to motivate birth attendants to use the WHO Safe Childbirth Checklist and improve adherence to essential birth practices. It was scaled to 60 sites as part of a randomized controlled trial in Uttar Pradesh, India.
- Integrated Person-Centered Health Care for All Women During Pregnancy: Implementing World Health Organization Recommendations on Antenatal Care for a Positive Pregnancy Experience
The 2016 WHO guideline on routine antenatal care (ANC) recommends several health systems interventions to improve quality of care and increase use of services including:
Midwife-led continuity of care throughout the antenatal, intrapartum, and postnatal periods
Task shifting components of ANC, including promotion of health-related behaviors and distribution of nutrition supplements
Recruitment and retention of health workers in rural and remote areas
Community mobilization to improve communication and support to pregnant women
Women-held case notes
A model with a minimum of 8 antenatal care contacts
- Inequitable Access to Health Care by the Poor in Community-Based Health Insurance Programs: A Review of Studies From Low- and Middle-Income Countries
The poor lack equitable access to health care in community-based health insurance schemes. Flexible installment payment plans, subsidized premiums, and elimination of co-pays can increase enrollment and use of health services by the poor.
- Long-Acting HIV Treatment and Prevention: Closer to the Threshold
Substantial progress has been made toward viable, practical long-acting approaches to deliver HIV treatment and prevention through: (1) continued improvements in long-acting antiretrovirals (ARVs); (2) better innovative delivery systems; and (3) collaboration of willing partners to advance new ARVs. More progress on those 3 fronts is still needed to arrive at the goal of optimized HIV treatment and prevention for all who would benefit—and of finally controlling the HIV epidemic.
- Quality of Care in Performance-Based Financing: How It Is Incorporated in 32 Programs Across 28 Countries
Structural aspects of quality such as equipment and infrastructure were the most frequently measured, with some measurement of processes of clinical care. Further examination is warranted to assess whether variations in how quality of care is incorporated into performance-based financing programs lead to differential effects.