Health Topics
- Eliminating Mother-to-Child Transmission of HIV by 2030: 5 Strategies to Ensure Continued Progress
To keep up momentum in preventing mother-to-child transmission we propose: (1) advocating for greater political and financial commitment; (2) targeting high-risk populations such as adolescent girls and young women; (3) implementing novel service delivery models such as community treatment groups; (4) performing regular viral load monitoring during pregnancy and postpartum to ensure suppression before delivery and during breastfeeding; and (5) harnessing technology in monitoring and evaluation and HIV diagnostics.
- Design, Implementation, and Evaluation of a School Insecticide-Treated Net Distribution Program in Cross River State, Nigeria
Three years following a mass bed net distribution campaign, the addition of school-based distribution to antenatal care (ANC) distribution in Cross River State, Nigeria, increased household ownership of any net to nearly 80%, whereas ownership in the comparison area was below 50%. School distribution was nearly equitable among rich and poor, and very few households obtained nets from both ANC and schools, suggesting complementary reach.
- Expanding the Single-Visit Approach for Cervical Cancer Prevention: Successes and Lessons From Burkina Faso
The single-visit approach was implemented with strong attention to systems in 14 health facilities. In the 2 largest facilities, nearly 14,000 women screened for cervical cancer over 4 years. Of approximately 9% who screened positive, about 66% received same-day cryotherapy. Attention is needed to ensure local technicians can repair cryotherapy equipment, supplies are consistently in stock, and user fees are not prohibitive to accessing care.
- 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.
- 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.
- Building Support for Adolescent Sexuality and Reproductive Health Education and Responding to Resistance in Conservative Contexts: Cases From Pakistan
While there is no one-size-fits-all approach to building community support for such programs, key strategies in Pakistan included: (1) sensitizing and engaging key stakeholders, including religious groups, schools, health and education government officials, parents, and adolescents themselves; (2) tactfully designing and framing the curricula with careful consideration of context and sensitive topics; (3) institutionalizing the programs within the school system; (4) showcasing school programs to increase transparency; and (5) engaging the media to build positive public perceptions.
- Evolution and Resistance to Sexuality Education in Mexico
Mexico's efforts at sexuality education have progressively evolved, from a biological focus in the socialist era in the 1930s, to adding a demographically concerned family planning component in the 1970s and including a wider reproductive health perspective in the 1990s, and finally shifting to a broader sociological context in the early 21st century. Opposition to sexuality education rose steadily in the time period considered, with a growing range of more organized and well-financed actors. Despite this opposition, alliances between academic, government, civil society, and NGO champions have helped ensure sustainability.
- Using Program Data to Improve Access to Family Planning and Enhance the Method Mix in Conflict-Affected Areas of the Democratic Republic of the Congo
Analysis of program data and a formative assessment informed several program changes, including improved coaching and supportive supervision, introduction of postpartum IUDs and the levonorgestrel-releasing intrauterine system, and enhanced behavior change communication. These changes substantially increased family planning adoption, from a monthly average of 14 adopters per facility to 37 per facility. Implants continued to be the most popular method, but the percentage of adopters choosing the IUD increased from 2% in 2012 to 13% in 2016, and it was the most popular method among postabortion care clients.
- Liftoff: The Blossoming of Contraceptive Implant Use in Africa
Contraceptive implant use is rising rapidly, substantially, and equitably in many sub-Saharan African countries, across almost all sociodemographic categories. Gains in implant use have exceeded combined gains for IUDs, pills, and injectables. Key contributing factors include sizeable reductions in commodity cost, much-increased commodity supply, greater government commitment to expanded method choice, and wider adoption of high-impact service delivery practices that broaden access and better reach underserved populations. Continued progress in meeting women's reproductive intentions with implants calls for further investment in quality services for both insertion and removal, and for addressing issues of financing and sustainability.
- Effective Collaboration for Scaling Up Health Technologies: A Case Study of the Chlorhexidine for Umbilical Cord Care Experience
Facilitating factors for the Chlorhexidine Working Group: (1) strong, transparent leadership by a neutral broker, promoting shared ownership among all members; (2) reliable internal and external communication; (3) well-defined terms of reference building on common interest around a simple, effective health intervention; (4) clear benefits of participation, including access to evidence and technical assistance; and (5) adequate resources to support the secretariat functions.