Latest Articles
- Exclusive breastfeeding: aligning the indicator with the goal
While the global objective is exclusive breastfeeding (EBF) for a full 6 months duration, the standard indicator is a “prevalence” indicator, that is, the percentage of all children under age 6 months who are exclusively breastfed at a point in time. That yields a higher percentage than a more direct indicator of duration and can be easily misunderstood, exaggerating the amount of EBF. A measurement of actual percentage of children exclusively breastfeeding for a full 6 months can be easily calculated from standard DHS and MICS data.
- Combating trafficking in persons: a call to action for global health professionals
Health care professionals can help identify victims of human trafficking, who commonly come into contact with providers during captivity. Providers can also help restore the physical and mental health of trafficking survivors. Training should focus on recognizing trafficking signs, interviewing techniques, and recommended responses when a victim is identified.
- Oxytocin: taking the heat
Oxytocin-in-Uniject satisfied the standards of its temperature-time indicator (TTI) in severe home storage conditions, although that required resupply every 30 days—a logistically onerous programmatic standard. Possible advances include: (1) incorporating TTIs with packaged batches of less expensive and more widely used conventional vials of oxytocin; (2) using TTIs calibrated more closely to the actual temperature sensitivity of oxytocin; and (3) researching whether a lower dose of oxytocin would be equally efficacious in preventing postpartum hemorrhage.
- Medical barriers to emergency contraception: a cross-sectional survey of doctors in North India
Emergency contraceptive pills (ECPs) are extremely safe and do not interfere with implantation. Yet many surveyed physicians in India did not know that there are no contraindications to using ECPs, and many had negative attitudes about ECP users. Most were against having ECPs available over-the-counter and wanted to impose age restrictions. Efforts are needed to address such misconceptions that might lead to limiting ECP availability.
- Informed push distribution of contraceptives in Senegal reduces stockouts and improves quality of family planning services
Dedicated logisticians restocked contraceptives monthly at facilities to maintain defined minimum stock levels, freeing up clinic staff. High stockout rates were virtually eliminated. Also, quality and timely data on contraceptives distributed allowed for better program management.
- Integrating family planning into postpartum care through modern quality improvement: experience from Afghanistan
Modern quality improvement approaches enabled hospital staff to analyze barriers and identify solutions for “how” to integrate family planning into postpartum care. Private spaces for postpartum family planning (PPFP) counseling, along with involving husbands and mothers-in-law in counseling, substantially increased the percentage of women receiving PPFP counseling and their preferred method before discharge. Self-reported pregnancy was also significantly lower up to 18 months post-discharge compared with women receiving routine services.
- Urban health: it's time to get moving!
The global health community should mainstream urban health and implement urban health programs to address the triple health burden of communicable diseases, noncommunicable diseases, and injuries in low- and middle-income countries.
- Preferences for a potential longer-acting injectable contraceptive: perspectives from women, providers, and policy makers in Kenya and Rwanda
High effectiveness, predictable return to fertility, and a single, prepackaged, disposable delivery system ranked high. Side effects were generally acceptable to women if they did not last long or disrupt daily activities. Cost was considered important for providers but not so much for most potential users.
- 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.