Health Topics
- Limits of “Skills And Drills” Interventions to Improving Obstetric and Newborn Emergency Response: What More Do We Need to Learn?
A “skills and drills” intervention in 4 hospitals in Karnataka, India, produced modest improvement in provider knowledge and skills but not in actual response to obstetric and newborn emergencies. We explore possible explanations, which include (1) the need for a more intensive intervention; (2) other weaknesses in the health system; and (3) behavioral or organizational barriers related to hierarchical structures, roles, and team formation.
- Indoor Residual Spraying Delivery Models to Prevent Malaria: Comparison of Community- and District-Based Approaches in Ethiopia
Integrating indoor residual spraying into the institutionalized community-based health system in 5 districts was more efficient than the district-based model and did not compromise quality or compliance with environmental standards.
- Pilot Research as Advocacy: The Case of Sayana Press in Kinshasa, Democratic Republic of the Congo
The pilot study obtained Ministry of Health approval to allow medical and nursing students to provide the injectable contraceptive Sayana Press and other methods in the community, paving the way for other task-shifting pilots including self-injection of Sayana Press with supervision by the students as well as injection by community health workers.
- Strengthening Government Leadership in Family Planning Programming in Senegal: From Proof of Concept to Proof of Implementation in 2 Districts
Based on a previous pilot experience, in a next proof-of-implementation phase, district authorities enthusiastically assumed leadership and mobilized local resources to implement a simplified package of family planning interventions, with outside technical support. Comparing a 6-month baseline period with a 6-month implementation period, couple-years of protection increased from about 2,000 to about 4,000 (82% increase) in one district, and from nearly 6,000 to about 9,000 (56% increase) in the second. Longer implementation periods could further support institutionalization and sustainability.
- Limited Effectiveness of a Skills and Drills Intervention to Improve Emergency Obstetric and Newborn Care in Karnataka, India: A Proof-of-Concept Study
Skills refresher training combined with emergency drills improved knowledge, skills, and confidence of providers but was not sufficient to improve diagnosis and management of maternal and newborn complications. Systems-level changes, including consistent availability of equipment and supplies, adequate human resource staffing, and supportive supervision, are likely needed to improve maternal and newborn outcomes.
- Key Role of Drug Shops and Pharmacies for Family Planning in Urban Nigeria and Kenya
Pharmacies and drug shops provide a rich opportunity for expanding family planning access to urban women, especially unmarried and younger women. In urban Nigeria and Kenya, drug shops and pharmacies were the major sources for most short-acting methods, including oral contraceptive pills, emergency contraceptives, and condoms.
- Referral Systems to Integrate Health and Economic Strengthening Services for People with HIV: A Qualitative Assessment in Malawi
Two types of referral systems were implemented in this low-resource context: (1) a simple paper-based system connecting clinical HIV and nutrition support to village savings and loans services, and (2) a complex mHealth-based system with more than 20 types of health, economic strengthening, livelihoods, and food security services. Clients reported the referrals improved their health and nutrition and ability to save money in both models but more with the simple model. Providers had difficulty using the mobile app under the mHealth system, even after repeated trainings, considerable ongoing technical assistance, and multiple rounds of revisions to the interface.
- Social Mobilization and Community Engagement Central to the Ebola Response in West Africa: Lessons for Future Public Health Emergencies
Key lessons for the crucial components of social mobilization and community engagement in this context:
Invest in trusted local community members to facilitate community entrance and engagement.
Use key communication networks and channels with wide reach and relevance to the community, such as radio in low-resource settings or faith-based organizations.
Invest in strategic partnerships to tap relevant capacities and resources.
Support a network of communication professionals who can deploy rapidly for lengthy periods.
Balance centralized mechanisms to promote consistency and quality with decentralized programming for flexibility and adaptation to local needs.
Evolve communication approaches and messaging over time with the changing outbreak patterns, e.g., from halting disease transmission to integration and support of survivors.
Establish clear communication indicators and analyze and share data in real time.
- A Review of 10 Years of Vasectomy Programming and Research in Low-Resource Settings
Reviewed areas included misconceptions and lack of knowledge among men, women, and providers; approaches to demand generation including community-based and mass media communications; service delivery innovations consisting of the no-scalpel vasectomy technique, whole-site training, cascade training, task shifting, and mobile outreach; and engagement of religious and community leaders to create an enabling environment.
- Mobile-Based Nutrition and Child Health Monitoring to Inform Program Development: An Experience From Liberia
Monitoring behavior using mobile phones at food distribution points allowed managers to rapidly adapt project activities. Self-reported breastfeeding, complementary feeding, and use of insecticide-treated nets improved. Applying the same methodology at the household level proved unsuccessful.