Latest Articles
- Limited electricity access in health facilities of sub-Saharan Africa: a systematic review of data on electricity access, sources, and reliability
Only 34% of hospitals have reliable electricity access in surveyed sub-Saharan African countries. However, analysis in 2 countries indicates modest improvements in electricity access over time. Ambitious plans to improve health service delivery in sub-Saharan Africa need to address this critical issue.
- Successful use of tablet personal computers and wireless technologies for the 2011 Nepal Demographic and Health Survey
Using tablet personal computers and wireless technologies in place of paper-based questionnaires to administer the Nepal DHS in a geographically diverse setting appeared to improve data quality and reduce data collection time. Challenges include inconsistent electricity supply, safe storage and transport of equipment, and screen readability issues under direct sunlight, which limited confidential interview spaces.
- Client-centered counseling improves client satisfaction with family planning visits: evidence from Irbid, Jordan
In Irbid, Jordan, a combination of community outreach, using home visits, plays, women's groups, and religious leaders, and improved client-provider counseling based on the “Consult and Choose” approach increased family planning demand and client satisfaction. Service statistic trends suggest increased contraceptive use.
- High and equitable mass vitamin A supplementation coverage in Sierra Leone: a post-event coverage survey
In Sierra Leone, an intensive mass vitamin A supplementation (VAS) campaign to reduce under-5 mortality reached over 90% of children ages 6–59 months, eliminating coverage disparities among districts and between age groups. Delivering VAS with other essential maternal and child health interventions was key to the success.
- Improving performance of Zambia Defence Force antiretroviral therapy providers: evaluation of a standards-based approach
A detailed standards-based performance approach modestly improved providers' performance and facility readiness to offer antiretroviral therapy. The approach included mutually reinforcing activities: (1) training, (2) supportive supervision, (3) assessments of service quality, and (4) facility-based action plans.
- Focusing on implementation: the power of executing many small advances well
Success often comes through many small, incremental, well-executed improvements.
- Use of modern contraception increases when more methods become available: analysis of evidence from 1982–2009
International data over 27 years show that as each additional contraceptive method became available to most of the population, overall modern contraceptive use rose. But in 2009 only 3.5 methods, on average, were available to at least half the population in surveyed countries. Family planning programs should strive to provide widespread access to a range of methods.
- Multiplicity in public health supply systems: a learning agenda
Supply chain integration—merging products for health programs into a single supply chain—tends to be the dominant model in health sector reform. However, multiplicity in a supply system may be justified as a risk management strategy that can better ensure product availability, advance specific health program objectives, and increase efficiency.
- GeneXpert for TB diagnosis: planned and purposeful implementation
Xpert MTB/RIF is a major advance for TB diagnostics, especially for multidrug-resistant (MDR) TB and HIV-associated TB. But implementation concerns including cost, technical support requirements, and challenging demands of providing second-line TB drugs for diagnosed MDR-TB cases call for gradual, careful introduction based on country circumstances.
- Lessons learned from scaling up a community-based health program in the Upper East Region of northern Ghana
The original CHPS model deployed nurses to the community and engaged local leaders, reducing child mortality and fertility substantially. Key scaling-up lessons: (1) place nurses in home districts but not home villages, (2) adapt uniquely to each district, (3) mobilize local resources, (4) develop a shared project vision, and (5) conduct “exchanges” so that staff who are initiating operations can observe the model working in another setting, pilot the approach locally, and expand based on lessons learned.