Latest Articles
- Community-Based Management of Acute Malnutrition to Reduce Wasting in Urban Informal Settlements of Mumbai, India: A Mixed-Methods Evaluation
Under the NGO–government partnership, wasting among children under age 3 decreased by 28% in intervention areas and by only 5% in comparison areas. Success factors included persuading and engaging with communities including delivery of tailored information, close presence and supervision of field staff, and holistic management of other issues beyond acute malnutrition. This intensive approach may be challenging for the government to adapt effectively at large scale.
- Let's Stop Trying to Quantify Household Vulnerability: The Problem With Simple Scales for Targeting and Evaluating Economic Strengthening Programs
Simple scales developed to measure broad constructs of household economic vulnerability in 3 countries did not accurately measure susceptibility to negative economic outcomes or generate valid classifications of economic status to use for targeting and monitoring and evaluation. We recommend designing tailored monitoring and evaluation instruments to capture narrower definitions of economic vulnerability based on characteristics that economic strengthening programs intend to affect and using separate tools for client targeting based on presence of context-specific “red flag” indicators.
- A New World Health Era
Unprecedented economic progress and demands for social protection have engendered an economic transition in health in many low- and middle-income countries, characterized by major increases in domestic health spending and growing national autonomy. At the global level, development assistance is refocusing on fragile states, the poorest communities, and cooperation on global public goods like health security, technical norms, and innovation. Intergovernmental organizations like WHO need the wherewithal and support to provide leadership and to properly advance this new world health era.
- Positive Influence of Behavior Change Communication on Knowledge, Attitudes, and Practices for Visceral Leishmaniasis/Kala-azar in India
After 8 months of behavior change communication activities, largely using group and interpersonal communication, refusal of indoor residual spraying to prevent visceral leishmaniasis was significantly lower among households in intervention villages (8%) than control villages (25%). Knowledge and attitudes were also better among the households in the intervention villages than control villages.
- Expanding Access to Injectable Contraception: Results From Pilot Introduction of Subcutaneous Depot Medroxyprogesterone Acetate (DMPA-SC) in 4 African Countries
Nearly half a million doses of DMPA-SC were administered over 2 years in Burkina Faso, Niger, Senegal, and Uganda, with 29% of doses provided to first-time family planning users and 44% (in 3 countries) to adolescent girls and young women under age 25. Switching from intramuscular DMPA (DMPA-IM) was not widespread and generally decreased over time. Community health workers provided a higher proportion of DMPA-SC than DMPA-IM injections. Stock-outs in 2 countries hindered product uptake, highlighting the need to strengthen logistics systems when introducing a new method.
- Can Family Planning Service Statistics Be Used to Track Population-Level Outcomes?
Estimates of the modern contraceptive prevalence rate (mCPR), a population-level indicator, that are derived directly from family planning service statistics lack sufficient accuracy to serve as stand-alone substitutes for survey-based estimates. However, data on contraceptive commodities distributed to clients, family planning service visits, and current users tend to track trends in mCPR fairly accurately and, when combined with survey data in new tools, can be used to approximate the annual mCPR in the absence of annual surveys.
- Rapid Uptake of the Subcutaneous Injectable in Burkina Faso: Evidence From PMA2020 Cross-Sectional Surveys
Availability and use of the subcutaneous injectable increased rapidly during national scale-up in 2016. Substantial increases were found in rural areas, where unmet need for family planning is higher. Since the method is amenable to community-based distribution, a new pilot is testing provision by community health workers to further improve access.
- Human Resources for Health: The Best Learning, the Best Skill Mix, and the Most Impact
Acting in a difficult environment, constructive efforts to improve medical education in Zimbabwe included revised curricula, investing in faculty and improved teaching skills, competency-based learning, and modern technology. But an ideal approach to health systems strengthening would put more emphasis on primary care and prevention, equity, and the many other vital health cadres besides physicians.
- The Coming-of-Age of Subcutaneous Injectable Contraception
DMPA-SC is a contraceptive injectable formulation that provides women and couples another important voluntary family planning option. It offers characteristics that many women like, including cost and time savings, and has the potential to be delivered by a range of health care cadres in a variety of service delivery channels.