Health Topics
- Prevalence and Incidence of Traumatic Experiences Among Orphans in Institutional and Family-Based Settings in 5 Low- and Middle-Income Countries: A Longitudinal Study
Contrary to some conventional wisdom, in this large study that randomly sampled orphans and separated children from 5 countries, prevalence of reported traumatic events was no worse among those institutionalized than among those in family-based care. Reported incidence of physical or sexual abuse was actually higher for those in family-based care. Understanding the specific context, and elements contributing to potential harm and benefits in both family-based and institutional care, are essential to promoting the best interest of the child.
- Empirically Derived Dehydration Scoring and Decision Tree Models for Children With Diarrhea: Assessment and Internal Validation in a Prospective Cohort Study in Dhaka, Bangladesh
The DHAKA Dehydration Score and the DHAKA Dehydration Tree are the first empirically derived and internally validated diagnostic models for assessing dehydration in children with acute diarrhea for use by general practice nurses in a resource-limited setting. Frontline providers can use these new tools to better classify and manage dehydration in children.
- Improved Reproductive Health Equity Between the Poor and the Rich: An Analysis of Trends in 46 Low- and Middle-Income Countries
In light of advocacy efforts to reach the poorest with better health services, an examination of recent history reveals that overall the poor-rich gap in contraceptive use is already narrowing substantially, and more so where family planning programs are stronger. For most of 18 other reproductive health indicators, the gap is also narrowing. However, contraceptive use gaps in many sub-Saharan African countries have not diminished, calling for strong family planning program efforts to improve equity.
- Regulatory Monitoring of Fortified Foods: Identifying Barriers and Good Practices
Food fortification with micronutrients often is not compliant with relevant standards, in large part because poor regulatory monitoring does not sufficiently identify and hold producers accountable for underfortified products. We propose these reinforcing approaches: clear legislation, government leadership, strong enforcement of regulations, improved financial and human capacity at the regulatory agency and industry levels, civil society engagement, simplified monitoring processes, and relationship building between industry and government.
- Estimating Contraceptive Prevalence Using Logistics Data for Short-Acting Methods: Analysis Across 30 Countries
Three models showed strong correlation between public-sector logistics data for injectables, oral contraceptives, and condoms and their prevalence rates, demonstrating that current logistics data can provide useful prevalence estimates when timely survey data are unavailable.
- Covering the Last Kilometer: Using GIS to Scale-Up Voluntary Medical Male Circumcision Services in Iringa and Njombe Regions, Tanzania
Interactive GIS maps created by overlapping facility data including roads and infrastructure with population and service delivery data permitted strategic deployment of mobile voluntary medical male circumcision (VMMC) services to underserved rural communities. The percentage of VMMCs performed in rural areas jumped from 48% in 2011 to 93% in 2014.
- Remote Sensing of Vital Signs: A Wearable, Wireless “Band-Aid” Sensor With Personalized Analytics for Improved Ebola Patient Care and Worker Safety
This wireless sensor technology, currently being field-tested in an Ebola Treatment Unit in Sierra Leone, monitors multiple vital signs continuously and remotely. When connected with enhanced analytics software, it can discern changes in patients’ status much more quickly and intelligently than conventional periodic monitoring, thus saving critical health care worker time and reducing exposure to pathogens.
- Social Franchising: A Blockbuster to Address Unmet Need for Family Planning and to Advance Toward the FP2020 Goal
Social franchising has scaled-up provision of voluntary family planning, especially long-acting reversible contraceptives, across Africa and Asia at a rapid and remarkable pace. The approach should be pursued vigorously, especially in countries with a significant private-sector presence, to advance the FP2020 goal of providing access to modern contraception to 120 million additional clients by 2020.
- Benefits of Advance Oxytocin Preparation Could Extend to the Newborn
Advance preparation of oxytocin not only facilitates rapid administration after delivery to prevent postpartum hemorrhage but also could free health workers to provide immediate neonatal resuscitation to non-breathing newborns within the critical 1-minute time window.
- Family Planning Policy Environment in the Democratic Republic of the Congo: Levers of Positive Change and Prospects for Sustainability
Building on expressed support from the Prime Minister to the Ministries of Health and Planning, the country’s new family planning commitment grew out of: (1) recognition of the impact of family planning on maternal mortality and economic development; (2) knowledge sharing of best practices from other African countries; (3) participatory development of a national strategic plan; (4) strong collaboration between stakeholders; (5) effective advocacy by champions including country and international experts; and (6) increased donor support. The question becomes: Will the favorable policy environment translate into effective local programming?