Latest Articles
- As good as physicians: patient perceptions of physicians and non-physician clinicians in rural primary health centers in India
Non-physician clinicians (NPCs), including both specially trained medical assistants and physicians trained in India systems of medicine, perform similarly to physicians in terms of patient satisfaction, trust, and perceived quality, thus supporting the use and scale up of NPCs in primary care.
- Obesity as a public health problem among adult women in rural Tanzania
Even in rural areas of Tanzania, an early stage of the nutrition transition is underway: 3 times as many women were overweight or obese than were undernourished. Overweight and obese women mainly follow a diet characterized by high consumption of bread and cakes (usually fried or baked in oil), sugar, and black tea.
- Building on safety, feasibility, and acceptability: the impact and cost of community health worker provision of injectable contraception
This project in Zambia contributes to our understanding of the impact of community-based provision of injectables on method choice and uptake and of the costs of adding DMPA to an established community-based family planning program. The project also illustrates the importance of involving stakeholders from the outset, analyzing costs relevant to scale up, and engaging in policy change dialogue not at the end, but rather throughout project implementation.
- Routine immunization: an essential but wobbly platform
Despite their vital role, routine immunization programs are taken for granted. Coverage levels are poor in some countries and have stagnated in others, while addition of new vaccines is an additional stressor. We need to strengthen: (1) policy processes, (2) monitoring and evaluation, (3) human resources, (4) regular delivery and supply systems, (5) local political commitment and ownership, (6) involvement of civil society and communities, and (7) sustainable financing. Rebalancing immunization direction and investment is needed.
- Simulated clients reveal factors that may limit contraceptive use in Kisumu, Kenya
While the quality of family planning service delivery was often good, clients reported barriers including: excessively long waiting times, provider absences, informal fees, inappropriate pregnancy tests, misinformation, and provider disrespect. Improved monitoring and oversight of facility practices and examination of provider needs and motivations may increase quality of service.
- Injectable contraception provided by community-based health workers: one important step toward meeting unmet need
Community-based provision of injectable contraception continues to advance and is gaining wider acceptance—a major step toward meeting unmet need. However, fully addressing family planning need will require access to a much wider range of methods, including long-acting reversible contraception and permanent methods.
- Provider-generated barriers to health services access and quality still persist
Barriers to access and quality, such as long waits, disrespectful provider behavior, and medical barriers, continue to constrain health programs. Reducing them further requires a multipronged management approach that includes understanding and addressing provider behavior and the real problems providers face.
- The 6 domains of behavior change: the missing health system building block
Behavior is crucial throughout global health interventions. The discipline of behavior change offers distinct expertise needed across 6 different domains of behavior. Such expertise is in short supply, however. We will not have effective and sustainable health systems, nor achieve our ambitious global health goals, without seriously addressing behavior change.
- Operations research to add postpartum family planning to maternal and neonatal health to improve birth spacing in Sylhet District, Bangladesh
This quasi-experimental study integrated family planning, including the Lactational Amenorrhea Method, into community-based maternal and newborn health care and encouraged transition to other modern methods after 6 months to increase birth-to-pregnancy intervals. Community-based distribution of pills, condoms, and injectables, and referral for clinical methods, was added to meet women's demand.