Latest Articles
- 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of essential commodities, particularly misoprostol; limitations on midwives' scope of practice; incomplete or out-of-date service delivery guidelines; and weak reporting systems.
- Taking Exception. Reduced mortality leads to population growth: an inconvenient truth
Reduced mortality has been the predominant cause of the marked global population growth over the last 3/4 of a century. While improved child survival increases motivation to reduce fertility, it comes too little and too late to forestall substantial population growth. And, beyond motivation, couples need effective means to control their fertility. It is an inconvenient truth that reducing child mortality contributes considerably to the population growth destined to compromise the quality of life of many, particularly in sub-Saharan Africa. Vigorous child survival programming is of course imperative. Wide access to voluntary family planning can help mitigate that growth and provide many other benefits.
- Local markets for global health technologies: lessons learned from advancing 6 new products
Key components to support local institutional and consumer markets are: supply chain, finance, clinical use, and consumer use. Key lessons learned: (1) Build supply and demand simultaneously. (2) Support a lead organization to drive the introduction process. (3) Plan for scale up from the start. (4) Profitability for the private sector is an absolute.
- Systems approach to monitoring and evaluation guides scale up of the Standard Days Method of family planning in Rwanda
Scaling-up lessons included: (1) simplifying provider training and client materials; (2) ensuring core aspects of the intervention, for example, that the CycleBeads client tool was integrated into the supply chain system; (3) addressing provider-generated medical barriers; and (4) managing threats from changing political and policy environments. A focus on systems, the use of multiple M&E data sources, maintaining fidelity of the innovation, and ongoing environmental scans facilitated scale-up success.
- Evaluation of community-based interventions to improve TB case detection in a rural district of Tanzania
Enlisting traditional healers and pharmacists to improve TB detection contributed 38% to 70% of new smear-positive case notifications per quarter in a rural district of Tanzania.
- Rising cesarean deliveries among apparently low-risk mothers at university teaching hospitals in Jordan: analysis of population survey data, 2002–2012
Cesarean deliveries nationally in Jordan have increased to 30%, including substantial increases among births that are likely low risk for cesarean delivery for the most part. This level is double the threshold that WHO considers reasonable.
- Are pregnant women prioritized for bed nets? An assessment using survey data from 10 African countries
Women of reproductive age are generally more likely to sleep under an insecticide-treated net (ITN) than other household members. Universal coverage increases ITN use by all family members, including pregnant women. However, BCC efforts are needed to achieve desired levels of bed net use, which is especially important for pregnant women.
- The quality–coverage gap in antenatal care: toward better measurement of effective coverage
The proportion of pregnant women receiving 4 or more antenatal care (ANC) visits has no necessary relationship with the actual content of those visits. We propose a simple alternative to measure program performance that aggregates key services that are common across countries and measured in Demographic and Health Surveys, such as blood pressure measurement, tetanus toxoid vaccination, first ANC visit before 4 months gestation, urine testing, counseling about pregnancy danger signs, and iron–folate supplementation.