Cross-Cutting Topics
- Using Community Health Workers and a Smartphone Application to Improve Diabetes Control in Rural Guatemala
A smartphone application providing algorithmic clinical decision support enabled community health workers to improve diabetes control for a group of patients in rural Guatemala. This approach enables task sharing with physicians and other advanced practitioners for chronic disease care, which is particularly important in low-resource settings.
- A Cluster-Randomized Trial to Test Sharing Histories as a Training Method for Community Health Workers in Peru
Women naturally communicate using life narratives. Through systematic recall and sharing memories of their own childbearing and child rearing experiences, community health workers (CHWs) become engaged and empowered to change their own and other mothers’ health behaviors. Training CHW with sharing histories can improve capabilities as change agents for better child health.
- A Rapid Cost Modeling Tool for Evaluating and Improving Public Health Supply Chain Designs
The Rapid Supply Chain Modeling Tool enables health system leaders to quickly estimate and compare the cost impact of potential supply chain design improvements in situations where time and budget do not allow for more in-depth modeling approaches.
- Effects of a Community-Based Program on Voluntary Modern Contraceptive Uptake Among Young First-Time Parents in Cross River State, Nigeria
Among young first-time mothers, participation in a comprehensive, community-based program led to a 3-fold increase in voluntary modern contraceptive use and other positive changes. These results demonstrate the importance of investing in interventions for this youth population that ideally address a range of priorities across the first-time parent lifestage.
- Effectiveness of mHealth Interventions for Improving Contraceptive Use in Low- and Middle-Income Countries: A Systematic Review
Do mHealth interventions help reduce unmet contraceptive needs in low- and middle-income countries by attempting to increase the uptake of modern contraceptive methods? Which mHealth features and behavior change communication components were used in these mHealth interventions? This review aimed to answer these questions and assess the impact of these interventions on contraceptive uptake outcomes.
- A Practical Guide to Using Time-and-Motion Methods to Monitor Compliance With Hand Hygiene Guidelines: Experience From Tanzanian Labor Wards
Understanding hand hygiene behaviors is critical in hospitals. We developed the HANDS at birth tool—and provide information on its design and implementation–to capture the complex patterns of health care workers’ hand hygiene including hand rubbing/washing, glove use, and recontamination.
- Implementation of a Pediatric Early Warning Score to Improve Communication and Nursing Empowerment in a Rural District Hospital in Rwanda
Implementation of the Pediatric Early Warning Score for Resource-Limited Settings tool improved nurses’ competency and confidence in their triage capabilities. This tool has the potential to improve patient outcomes. However, staff turnover and limited physician buy-in were barriers to sustainability of the tool in low-resource settings.
- Improving Hospital Oxygen Systems for COVID-19 in Low-Resource Settings: Lessons From the Field
Hospitals in low- and middle-income countries urgently need to improve their oxygen systems for COVID-19 and other health emergencies. We share practical tips to improve pulse oximetry and oxygen use, support biomedical engineers to optimize existing oxygen supplies, and expand existing oxygen systems with robust equipment and smart design.
- The All Babies Count Initiative: Impact of a Health System Improvement Approach on Neonatal Care and Outcomes in Rwanda
A health system improvement program combining facility readiness support, clinical training/mentoring, and improvement collaboratives increased quality improvement capacity, improved maternal and newborn quality of care, and reduced neonatal mortality. These results can be used to inform system improvement approach design to transform quality of care and outcomes for newborns.
- Counseling Is a Relationship Not Just a Skill: Re-conceptualizing Health Behavior Change Communication by India’s Accredited Social Health Activists
The capacity for India’s community health workers—accredited social health activists (ASHAs)—to promote healthy behaviors must be understood within the health system and community context. Their ability to influence health behaviors depends on the strength of their relationships with families and support they receive from the health system.