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<title><![CDATA[Uganda Public Health Fellowship Program&#x2019;s Contributions to Malaria Control Programs 2015-2022: Strategies, Implementation Challenges, and Opportunities]]></title>
<link>http://ghspjournal.org/content/13/2/e2300257.short?rss=1</link>
<description><![CDATA[ABSTRACTThe Uganda Public Health Fellowship Program (UPHFP) is a 2-year, non-degree-granting field epidemiology training program. It enrolls only post-Master’s degree fellows, who are integrated during their training into key Ministry of Health (MOH) programs, such as the National Malaria Control Program, and supported technically and financially by the U.S. President’s Malaria Initiative (PMI) and U.S. Centers for Disease Control and Prevention. However, the nature and extent of the UPHFP contributions to the malaria control programs have not been systematically documented. We describe how the UPHFP strategies contributed to malaria control programs and share implementation challenges and opportunities to inform future programming. From 2015 to 2022, UPHFP led or supported 50 malaria projects, including 14 malaria surveillance projects, 11 malaria outbreak investigations, 7 epidemiological studies, 5 case studies, 6 malaria quality improvement projects, 3 policy briefs, and 4 training and mentorship projects. These projects have informed policy decisions and strengthened surveillance, coordination, and response to malaria outbreaks. A key challenge is single-source funding that makes the program more vulnerable to changes in donor priorities. Our documentation demonstrates the critical value of UPHFP to the country’s malaria control efforts by enhancing epidemiologic workforce capacity and strengthening epidemiological surveillance.]]></description>
<dc:creator><![CDATA[Alex R. Ario, Andrew Kwiringira, Richard Migisha, Benon Kwesiga, Lilian Bulage, Daniel Kadobera, Esther Kisaakye, Alice Asio, Maria&#x2019; G. Zalwango, Jane F. Zalwango, Damian Rutazaana, Jimmy Opigo, Julie R. Harris, Kyree Rollins, Mame Niang, Amy L. Boore, Lisa J. Nelson, Kassahun Belay]]></dc:creator>
<dc:date>2026-01-06T07:13:09-08:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-23-00257</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-23-00257</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:title><![CDATA[Uganda Public Health Fellowship Program&#x2019;s Contributions to Malaria Control Programs 2015-2022: Strategies, Implementation Challenges, and Opportunities]]></dc:title>
<prism:publicationDate>2025-12-31</prism:publicationDate>
<prism:section>ORIGINAL ARTICLE</prism:section>
<prism:volume>13</prism:volume>
<prism:number>2</prism:number>
<prism:issueIdentifier>2</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/13/2/e2300364.short?rss=1">
<title><![CDATA[Assessing the Generalizability of Client Experience Measurement Tools in Low- and Middle-Income Countries: A Narrative Review]]></title>
<link>http://ghspjournal.org/content/13/2/e2300364.short?rss=1</link>
<description><![CDATA[ABSTRACTIntroduction:The experiences of people who interact with a health system form a key component of overall quality of care in that system. Yet, client experience is rarely reflected in how health systems are designed and assessed. To make meaningful progress on delivering high-quality patient-centered care, health systems actors need valid measures of client experience of care. However, no cross-cutting measure of client experience of care exists at present that could facilitate measurement and benchmarking across multiple health service areas.Methods:We conducted a phased literature search using multiple scholarly databases to identify peer-reviewed articles detailing the development, validation, or adaptation of measures relating to the concept of client experience in sexual and reproductive health care, HIV, primary care, noncommunicable disease management, and health services management and marketing. Measure domains were thematically analyzed and mapped against domains of an existing client experience of care framework—effective communication, respect and dignity, and emotional support.Results:We identified 73 articles that met inclusion criteria and that recounted the development, validation, or adaptation of 61 different measures of health care quality and responsiveness. Numerous measures exhibited significant overlap with an existing conceptual framework for client experience, but few measures were used across health areas.Discussion:Content of many of the measures identified in this review mapped closely to domains that appear in an existing framework for client experience of care, including effective communication, respect and dignity, and emotional support. These findings support the notion that developing a generalizable measure of client experience of care could be technically feasible.]]></description>
<dc:creator><![CDATA[Andrew Corley, Susannah Gibbs, Nirali Chakraborty, Lara Fields, Giannina Chavez Ackermann, Jasmine Coulson, Yixin Zhang, Paul Bouanchaud]]></dc:creator>
<dc:date>2026-01-06T07:13:09-08:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-23-00364</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-23-00364</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:title><![CDATA[Assessing the Generalizability of Client Experience Measurement Tools in Low- and Middle-Income Countries: A Narrative Review]]></dc:title>
<prism:publicationDate>2025-12-31</prism:publicationDate>
<prism:section>REVIEW</prism:section>
<prism:volume>13</prism:volume>
<prism:number>2</prism:number>
<prism:issueIdentifier>2</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/13/2/e2300423.short?rss=1">
<title><![CDATA[Teleconsultation Support for Obstetric Emergencies During the COVID-19 Pandemic in Rural Nepal: Results and Lessons Learned From a Mixed-Methods Study]]></title>
<link>http://ghspjournal.org/content/13/2/e2300423.short?rss=1</link>
<description><![CDATA[ABSTRACTIn response to the 2020 COVID-19 pandemic, a nongovernmental organization in Nepal piloted a maternal and newborn health helpline program in partnership with the Government of Nepal and the Nepal Society of Obstetricians and Gynaecologists. The program connected service providers in remote areas with real-time clinical support during obstetric and neonatal emergencies via telephone consultations with clinical experts. 551 primary health care facilities across 14 districts of Nepal were included in the program and connected to a roster of 33 clinical expert volunteers from district or tertiary care hospitals. To assess the results of the program, we collected both quantitative and qualitative data, including monthly health facility record reviews from July 2020 to June 2021 and semi-structured interviews with clinical experts and service providers conducted in June 2021. Of the 551 health facilities included in the program, 160 facilities (29%) reported using the helpline during the study period, with 429 teleconsultation cases recorded. We found that 21% of these cases that otherwise would have been referred to a hospital were effectively managed by telephone on-site at rural health facilities, revealing the promising potential for impact using a low-tech solution. Of the health facilities that participated in the program, the helpline was predominantly used in remote facilities where access to higher-level referral centers for emergencies was limited. Feedback from both experts and service providers revealed that the program helped to improve clinical decision-making during emergencies, build confidence and skills of service providers, and improve referral efficiency. Implementation challenges included service providers’ underreporting of helpline utilization, a lack of essential drugs at primary health care facilities, unreliable phone signals, and a lack of financial incentives for clinical experts. The results and implementation experiences shared in this article provide a template for the design and implementation of similar support programs for service providers managing clinical emergencies in rural contexts.]]></description>
<dc:creator><![CDATA[Sajana Maharjan, Swaraj Rajbhandari, Liladhar Dhakal, Bhagawati Shrestha, Michaela Hayes, Punya Paudel, Anjana Karki, Binod Dangal, Surya Bhatta]]></dc:creator>
<dc:date>2026-01-06T07:13:09-08:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-23-00423</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-23-00423</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:title><![CDATA[Teleconsultation Support for Obstetric Emergencies During the COVID-19 Pandemic in Rural Nepal: Results and Lessons Learned From a Mixed-Methods Study]]></dc:title>
<prism:publicationDate>2025-12-31</prism:publicationDate>
<prism:section>PROGRAM CASE STUDY</prism:section>
<prism:volume>13</prism:volume>
<prism:number>2</prism:number>
<prism:issueIdentifier>2</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/13/2/e2400025.short?rss=1">
<title><![CDATA[Operationalizing Client-Centered Care: A Strategic Framework and Measurement Approach to Guide Sexual and Reproductive Health Programming]]></title>
<link>http://ghspjournal.org/content/13/2/e2400025.short?rss=1</link>
<description><![CDATA[ABSTRACTBackground:Promoting client-centered care (CCC) has been a long-standing goal for sexual and reproductive health (SRH) programs. MSI Reproductive Choices (MSI), a global SRH service delivery organization, set out to fully operationalize CCC delivery utilizing a new strategic framework and measurement approach.Development of the Approach:The framework was developed by a global technical group at MSI, based on a literature review, country pilots in Nepal and Zambia, and practical experience in service delivery and quality improvement. It is based on a socioecological model, recognizing that SRH client experience is determined by the behavior of the provider, the managerial support given to providers, and the broader organizational culture. The accompanying composite CCC metric assesses performance across these 3 levels annually using program monitoring tools. A digital results dashboard links to a suite of guidance and tools to support CCC improvement.Lessons Learned:SRH programs in 28 countries have been monitoring their progress on CCC since 2021, and a majority have made improvements in their CCC performance since then. Using the annual CCC results, global support staff and country managers have selected interventions based on local needs, including CCC training, client feedback systems, and client experience checklists. Implementation of a global staff engagement survey has been instrumental in CCC measurement, complementing preexisting client exit interview and quality audit processes. A global CCC monitoring process allows sharing of successes and positive practice, and staff have supported and championed CCC.Conclusion:Recognizing the critical influences of provider support and engagement as well as broader organizational culture has been pivotal in scaled operationalization of CCC within SRH programs. The simple framework and accompanying metric can be adapted to fit available tools and data systems in other institutions to support attainment of the highest standards of quality care and respect for client rights.]]></description>
<dc:creator><![CDATA[Kathryn Church, Georgina Page, Sarindi Aryasinghe, Raman Shrestha, Inonge Wina Chinyama, Mary Morris, Kate Austen, Angela Argenziano]]></dc:creator>
<dc:date>2026-01-06T07:13:09-08:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-24-00025</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-24-00025</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:title><![CDATA[Operationalizing Client-Centered Care: A Strategic Framework and Measurement Approach to Guide Sexual and Reproductive Health Programming]]></dc:title>
<prism:publicationDate>2025-12-31</prism:publicationDate>
<prism:section>PROGRAM CASE STUDY</prism:section>
<prism:volume>13</prism:volume>
<prism:number>2</prism:number>
<prism:issueIdentifier>2</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/13/2/e2400077.short?rss=1">
<title><![CDATA[Anemia Mukt Bharat Index: Methodology and State Rankings of Iron and Folic Acid Supplementation Coverage in India, 2018-2019 to 2022-2023]]></title>
<link>http://ghspjournal.org/content/13/2/e2400077.short?rss=1</link>
<description><![CDATA[ABSTRACTIn 2018, the Government of India launched the Anemia Mukt Bharat (AMB) program to accelerate reductions in the prevalence of anemia among children aged 6–59 months, children aged 5–9 years, adolescents aged 10–19 years, pregnant women, and lactating mothers through 6 programmatic interventions and 6 institutional mechanisms. We describe the process of computing the AMB index, aimed at providing timely and systematic information on iron and folic acid (IFA) supplementation coverage across these groups to aid in evaluating the effectiveness of the program. This study presents data from fiscal year 2018–2019 to 2022–2023 on IFA supplementation coverage among these 5 groups. We calculated the AMB index that provides an average for IFA supplementation coverage for target groups. Data on the target groups were acquired from the AMB dashboard, and information on IFA supplementation coverage was sourced from the health management information system. The AMB index confirmed that between 2018-2019 and 2022–2023 IFA supplementation coverage increased overall in India by 22.1 percentage points, from 35.5% to 57.6%. During this period, IFA supplementation coverage increased for all target groups including pregnant women, children aged 6–59 months, children 5–9 years, adolescents aged 10–19 years, and lactating mothers. The supply chain management and reporting of the data on the portal were among the key factors that substantially impacted the IFA supplementation coverage. The IFA supplementation coverage will significantly increase if the IFA supply chain and reporting standards improve. We discuss the policy implications and suggestions to improve the overall IFA supplementation coverage across India.]]></description>
<dc:creator><![CDATA[Zoya Ali Rizvi, Jitendra Singh, Preetu Mishra, Abhishek Kumar, Avi Saini, Narendra Patel, Neha Agarwal, Kapil Yadav, William Joe]]></dc:creator>
<dc:date>2026-01-06T07:13:09-08:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-24-00077</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-24-00077</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:title><![CDATA[Anemia Mukt Bharat Index: Methodology and State Rankings of Iron and Folic Acid Supplementation Coverage in India, 2018-2019 to 2022-2023]]></dc:title>
<prism:publicationDate>2025-12-31</prism:publicationDate>
<prism:section>PROGRAM CASE STUDY</prism:section>
<prism:volume>13</prism:volume>
<prism:number>2</prism:number>
<prism:issueIdentifier>2</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/13/2/e2400130.short?rss=1">
<title><![CDATA[A Comprehensive Strategy to Mitigate Institutional Maternal Mortality: Lessons From a Quality Improvement Initiative in Brazilian Maternity Hospitals]]></title>
<link>http://ghspjournal.org/content/13/2/e2400130.short?rss=1</link>
<description><![CDATA[ABSTRACTIntroduction: Many pregnancy-related deaths can be avoided if health care workers reliably provide prompt, evidence-based care during the final stages of pregnancy and delivery. We report the impact on the institutional maternal mortality ratio (iMMR) of a quality improvement (QI) initiative that focused on establishing timely and reliable obstetric care in public Brazilian hospitals for the primary causes of maternal deaths.Methods: The QI initiative used a quasi-experimental time-series design implemented in 19 Brazilian maternity hospitals comparing 3 periods: baseline (January 2018 to November 2019), implementation (December 2019 to March 2021), and post-implementation (April 2021 to September 2021). We used a sequential approach, referred to as the “4Rs” (Recognize, Rescue, Reassess, and Refer), with the Modified Early Obstetric Warning Score (MEOWS) as a key tool, to identify clinical deterioration and implement care bundles directed at the management of 3 principal life-threatening conditions around the time of birth: postpartum hemorrhage, sepsis, and hypertensive disorders of pregnancy (HDPs). Clinical staff received tailored training and support within a structured learning system that brought multiple teams together to rapidly test and implement evidence-based changes.Results: Comparing the baseline with the implementation period, run charts detected an overall reduction of 34.2% in all causes of maternal deaths (from 83.7 to 55 deaths per 100,000 live births). Additionally, the iMMR due to the 3 analyzed life-threatening conditions decreased by 60.9% between baseline and the combined implementation and post-implementation periods (from 44.1 to 17.2 deaths per 100,000 live births); postpartum hemorrhage-related deaths were reduced by 72.9% (from 11.7 to 3.17 deaths per 100,000 live births) and sepsis-related deaths were reduced by 100% (from 20.4 to 0 deaths per 100,000 liv births). No changes by HDP-related deaths were observed. There was a 178% increase in iMMR by all causes (mainly attributed to COVID-19) during the post-implementation period, but deaths related to life-threatening conditions either remained stable or decreased even further.Conclusion: Optimization of the steps in a care sequence and reliable implementation of care bundles directed at the principal life-threatening conditions around the time of birth, using QI, tailored training, and the MEOWS tool, seem to be feasible and promising approaches for reducing iMMR.]]></description>
<dc:creator><![CDATA[Paulo Borem, Andrea Keiko Fu&#x0237;inami Gushken, Ana Paula Gushken, Rodolfo de Carvalho Pacagnella, Ademir Jose Petenate, Paula Tuma, Livia Sanches Pedrilio, Santiago Narino, Pierre Barker, Claudia Garcia de Barros, Sebastian Vernal]]></dc:creator>
<dc:date>2026-01-06T07:13:09-08:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-24-00130</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-24-00130</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:title><![CDATA[A Comprehensive Strategy to Mitigate Institutional Maternal Mortality: Lessons From a Quality Improvement Initiative in Brazilian Maternity Hospitals]]></dc:title>
<prism:publicationDate>2025-12-31</prism:publicationDate>
<prism:section>ORIGINAL ARTICLE</prism:section>
<prism:volume>13</prism:volume>
<prism:number>2</prism:number>
<prism:issueIdentifier>2</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/13/2/e2400174.short?rss=1">
<title><![CDATA[Research and Learning Priorities for a Surgical Obstetrics and Family Planning Project Implementing in Low- and Middle-Income Countries: Results of an Expert Consultation]]></title>
<link>http://ghspjournal.org/content/13/2/e2400174.short?rss=1</link>
<description><![CDATA[ABSTRACTIntroduction: Cesarean delivery, peripartum hysterectomy, female genital fistula treatment, and long-acting and permanent contraceptive method provision comprise an important set of surgical procedures in reproductive and maternal health. The volume of these procedures is growing in low- and middle-income countries (LMICs). Establishing research priorities in a learning agenda for surgical obstetrics and family planning represents a key step in generating and using evidence to improve health outcomes associated with these surgeries.Methods: Between January and February 2022, a safe surgery project addressing family planning and obstetrics used a 2-stage rating and ranking consultation process to prioritize topics in its learning agenda, focusing on LMIC needs. A list of research and learning topics spanning the project’s technical areas, consisting of surgical obstetric care (cesarean delivery and peripartum hysterectomy), fistula prevention and treatment, family planning, and cross-cutting safe surgery, was curated by searching the literature, conducting project-related surveys of experts and partners, and soliciting an expert panel via virtual consultation. Through an online survey, the experts rated the 63 topics on a 5-point scale based on 4 criteria—feasibility, technical importance, level of saturation, and potential for impact—and average ratings were calculated for each criterion and topic. The expert panel then reconvened virtually to rank and refine highly rated topics.Results: A total of 39 people participated in the expert panel, representing multilateral, academic, and funding organizations, implementing partners, and professional associations active in LMICs. Fifteen topics were prioritized across the 4 technical areas. Prioritized topics covered themes of prevention (e.g., intrapartum/midwifery practices to prevent unnecessary cesarean delivery), care-seeking (e.g., social and behavior change strategies for fistula prevention), perioperative care (e.g., use of quality improvement tools including checklists and audits), and postoperative care (e.g., effective measurement approaches for monitoring outcomes).Conclusion: This agenda guides clinical and programmatic learning across the safe surgery ecosystem. Collaborative action across program initiatives and clinical and community settings may contribute to significant evidence building in these priority topics.]]></description>
<dc:creator><![CDATA[Farhad A. Khan, Karen Levin, Renae Stafford, Vandana Tripathi]]></dc:creator>
<dc:date>2026-01-06T07:13:09-08:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-24-00174</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-24-00174</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:title><![CDATA[Research and Learning Priorities for a Surgical Obstetrics and Family Planning Project Implementing in Low- and Middle-Income Countries: Results of an Expert Consultation]]></dc:title>
<prism:publicationDate>2025-12-31</prism:publicationDate>
<prism:section>ORIGINAL ARTICLE</prism:section>
<prism:volume>13</prism:volume>
<prism:number>2</prism:number>
<prism:issueIdentifier>2</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/13/2/e2400186.short?rss=1">
<title><![CDATA[Preventing Disruptions in HIV Service Delivery to Key Populations During Project Transition From an International to a Local Implementing Partner: A Case Study From Zambia]]></title>
<link>http://ghspjournal.org/content/13/2/e2400186.short?rss=1</link>
<description><![CDATA[ABSTRACTIn the management of chronic conditions like HIV, the continuity of service delivery is necessary to achieve desired outcomes, such as HIV viral load suppression, behavioral change, improved health, and client satisfaction. The transition phase—when a project closes and another starts—is a potential period of service delivery disruption. Active management of this transition period is important to prevent disruptions, especially for key populations who may be stigmatized and have limited options for accessing HIV services. We analyzed this transition period between July and December 2022 between 2 projects that provided HIV prevention services, management of sexually transmitted infections, and linkage to HIV treatment and other complementary services to key populations in Zambia. To ensure a smooth project transition, we implemented a set of interventions, including joint planning for project transition, strategic leadership, trust-building initiatives, active community and stakeholder engagement, repeated stakeholder reassurance, open communication, and transparent data sharing. After transitioning to the new project, we noted that all 3 service types of interest experienced at least a 20% increase over the levels achieved in the last month of the closing project. This increase contrasts with the assumption that all service types delivered through project structures would decline to zero persons reached within 2 months of project closing if the next project did not commence seamlessly. The decrease in service delivery was averted with the intentional transition interventions. Additionally, we recorded operational gains, such as stakeholder satisfaction, adequate assets transfer, stability in project service delivery location, and reduced personnel anxiety. We conclude that active multipartite management of the transition phase for projects is essential for ensuring uninterrupted service delivery and sustaining good outcomes for clients. Donors, health system managers, and program managers should actively require and design sound transition management plans as part of their program designs. In the aftermath of recent abrupt cuts in US Government development sector funding that allowed no planned transitions, it is important that surviving programs carefully imbibe lessons shared in this paper to protect years—and sometimes decades—of program gains.]]></description>
<dc:creator><![CDATA[Edward Adekola Oladele, Maurice Musheke, Florence Mulenga, Alick Samona, Ihoghosa Iyamu, Arlene Phiri, Ngaitila Phiri, Otto N. Chabikuli]]></dc:creator>
<dc:date>2026-01-06T07:13:09-08:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-24-00186</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-24-00186</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:title><![CDATA[Preventing Disruptions in HIV Service Delivery to Key Populations During Project Transition From an International to a Local Implementing Partner: A Case Study From Zambia]]></dc:title>
<prism:publicationDate>2025-12-31</prism:publicationDate>
<prism:section>PROGRAM CASE STUDY</prism:section>
<prism:volume>13</prism:volume>
<prism:number>2</prism:number>
<prism:issueIdentifier>2</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/13/2/e2400281.short?rss=1">
<title><![CDATA[Progressive Development of a New Tool for Rapid Thematic Analysis of Community Perceptions and Concerns During Health Emergencies]]></title>
<link>http://ghspjournal.org/content/13/2/e2400281.short?rss=1</link>
<description><![CDATA[ABSTRACTBackground:Rapid analysis of community needs, perspectives, and concerns during global health emergencies is essential but technically challenging. In the past, emergency responders have struggled to listen to and engage affected communities because of perceptions about anticipated costs and time delays in receiving actionable results.Tool Development:The U.S. Centers for Disease Control and Prevention Excel Tool for Thematic Analysis was developed over 5 years of assisting with emergency responses for Ebola, COVID-19, Sudan Ebolavirus, mpox, and the Ukraine crisis. Beginning with a simple Excel spreadsheet for coding Ebola-related community feedback, we continued to add new features as needs arose, such as preloaded epidemic and health emergency coding schemes, preprogrammed results tables, step-by-step thematic analysis instruction, YouTube training videos, and planning and communication tools for effective use of the results.Implementation:The tool is a customized Excel workbook for qualitative text coding and thematic analysis that enables the user to code and derive key themes from texts, such as interview and focus group transcripts, notes, surveys with open-ended questions, and social media comments. We review the 10 programmed worksheets for planning, cataloguing, coding, and thematically analyzing any kind of text data.Conclusion:The strategies for rapid community feedback analysis during health emergencies are a special application of qualitative analysis methodology to the health emergency setting, enabling a deep reading and transparent and defensible interpretation of the text. Skills learned while using the tool are easily transferable to analyses using licensed software or fully manual methods. The tool offers a step-by-step guide for anyone to analyze text data to answer a relevant question in or outside the context of emergencies.]]></description>
<dc:creator><![CDATA[Giulia Earle-Richardson, Ciara Nestor, Christine E. Prue]]></dc:creator>
<dc:date>2026-01-06T07:13:09-08:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-24-00281</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-24-00281</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:title><![CDATA[Progressive Development of a New Tool for Rapid Thematic Analysis of Community Perceptions and Concerns During Health Emergencies]]></dc:title>
<prism:publicationDate>2025-12-31</prism:publicationDate>
<prism:section>METHODOLOGY</prism:section>
<prism:volume>13</prism:volume>
<prism:number>2</prism:number>
<prism:issueIdentifier>2</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/13/2/e2500050.short?rss=1">
<title><![CDATA[Navigating Change, Sustaining Impact: GHSP&#x2019;s Mission in a Transformed Landscape]]></title>
<link>http://ghspjournal.org/content/13/2/e2500050.short?rss=1</link>
<description><![CDATA[]]></description>
<dc:creator><![CDATA[Stephen Hodgins, Ruwaida M. Salem,  on behalf of the GHSP Editorial Team]]></dc:creator>
<dc:date>2026-01-06T07:13:09-08:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-25-00050</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-25-00050</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:title><![CDATA[Navigating Change, Sustaining Impact: GHSP&#x2019;s Mission in a Transformed Landscape]]></dc:title>
<prism:publicationDate>2025-12-31</prism:publicationDate>
<prism:section>EDITORIAL</prism:section>
<prism:volume>13</prism:volume>
<prism:number>2</prism:number>
<prism:issueIdentifier>2</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/13/1/e2200507.short?rss=1">
<title><![CDATA[Building Public Health Quantitative Methods Capacity and Networks in sub-Saharan Africa: An Evaluation of a Faculty Training Program]]></title>
<link>http://ghspjournal.org/content/13/1/e2200507.short?rss=1</link>
<description><![CDATA[ABSTRACTIntroduction:There is a shortage of individuals trained in using quantitative methods in biomedical research in sub-Saharan Africa (SSA). Improving public health in SSA requires new ways to promote quantitative knowledge and skills among faculty in biomedical research and better-integrated network systems of support.Methods:We describe the development, implementation, and evaluation of an innovative faculty training and support program in SSA from December 2017–June 2020, using courses in monitoring and evaluation, data management, and complex surveys as prototypical examples. Indicators were selected to follow the 4 levels outlined in the Kirkpatrick evaluation model: reaction, learning, behavior, and results. We used survey data from faculty fellows and students and reported median change and interquartile ranges (IQR).Results:The training program created an international community of 26 faculty members working collaboratively to lead the training of 3 quantitative methods courses. The program increased faculty members’ knowledge of the course content (median increase 17 percentage points [IQR: 0, 20]). Faculty members, in turn, trained 380 students at institutions of higher education in 8 SSA countries (Botswana, Ethiopia, Ghana, Nigeria, Rwanda, South Africa, Tanzania, and Uganda).Conclusion:The program relied on collaborative funding from participating institutions and focused on individual capacity-strengthening. In the future, the program will be scaled to include other emerging areas, such as data science, will integrate institutional support and feedback, and will move some of the training and mentoring activities to an online platform. Finally, to ensure that faculty have both improved confidence and improvement in competence, in future iterations, the program will include competency evaluation at the start and end and pair fellows who need additional training with those who excelled to co-teach.]]></description>
<dc:creator><![CDATA[Oleosi Ntshebe, Sarah Anoke, Jesca M. Batidzirai, Chris Guure, Beatrice Muganda, Marcello Pagano, Muhammed Semakula, Elysia Larson]]></dc:creator>
<dc:date>2025-08-14T13:53:01-07:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-22-00507</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-22-00507</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:title><![CDATA[Building Public Health Quantitative Methods Capacity and Networks in sub-Saharan Africa: An Evaluation of a Faculty Training Program]]></dc:title>
<prism:publicationDate>2025-08-14</prism:publicationDate>
<prism:section>SHORT REPORT</prism:section>
<prism:volume>13</prism:volume>
<prism:number>1</prism:number>
<prism:issueIdentifier>1</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/13/1/e2300370.short?rss=1">
<title><![CDATA[A Novel Approach to Assessing the Potential of Electronic Decision Support Systems to Improve the Quality of Antenatal Care in Nepal]]></title>
<link>http://ghspjournal.org/content/13/1/e2300370.short?rss=1</link>
<description><![CDATA[ABSTRACTIntroduction:Electronic decision-support systems (EDSSs) aim to improve the quality of antenatal care (ANC) through adherence to evidence-based guidelines. We assessed the potential of the mHealth integrated model of hypertension, diabetes, and ANC EDSS and the World Health Organization EDSS to improve the quality of ANC in primary-level health care facilities in Nepal.Methods:From December 2021 to January 2023, we conducted a mixed-methods evaluation in 19 primary-level ANC facilities in Bagmati Province, Nepal. Implementation was from March 2022 to August 2022. We conducted a health facility survey, ANC clinical observations, longitudinal case studies and validation workshop, in-depth interviews, monitoring visits, research team debriefing meetings, health care provider attitude survey, and stakeholder engagement and feedback meetings. Results were integrated using concurrent triangulation to develop explanations about the EDSS implementation process and the effects observed.Results:We identified 9 themes on implementation challenges that hindered the EDSS from generating the desired improvements to ANC quality. Facility readiness and provider confidence in using the EDSS were mixed. It was not always used or used as intended, and the approach to ANC provision did not change. EDSS inflexibility did not reflect how staff made decisions about pregnant women’s needs or ensure that tests were done at the right time. There was mixed evidence that ANC staff believed that the EDSS benefited their work. The EDSS did not become fully integrated into existing health systems. Engagement of essential stakeholders fell short.Conclusion:Different understandings of and inconsistent use of the EDSS highlighted the need for increased training and support periods, greater stakeholder engagement, and further integration into existing health systems. Our novel approach to integrating findings from multiple substudies offers uniquely valuable insights into the many factors needed for the successful implementation of an EDSS to improve the quality of ANC in Nepal.]]></description>
<dc:creator><![CDATA[Biraj Man Karmacharya, Seema Das, Abha Shrestha, , Sulata Karki, Rajani Shakya, Emma Radovich, Loveday Penn-Kekana, Clara Calvert, Oona M.R. Campell, Ona L. McCarthy]]></dc:creator>
<dc:date>2025-08-14T13:53:01-07:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-23-00370</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-23-00370</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:title><![CDATA[A Novel Approach to Assessing the Potential of Electronic Decision Support Systems to Improve the Quality of Antenatal Care in Nepal]]></dc:title>
<prism:publicationDate>2025-08-14</prism:publicationDate>
<prism:section>ORIGINAL ARTICLE</prism:section>
<prism:volume>13</prism:volume>
<prism:number>1</prism:number>
<prism:issueIdentifier>1</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/13/1/e2300398.short?rss=1">
<title><![CDATA[Disinfection of Neonatal Resuscitation Equipment in Resource-Limited Settings: Lessons From a Mixed-Methods Implementation Experience in Kenya]]></title>
<link>http://ghspjournal.org/content/13/1/e2300398.short?rss=1</link>
<description><![CDATA[ABSTRACTBackground:The majority of neonatal deaths occur in low- and middle-income countries, most often due to perinatal events, prematurity, and/or infection. Reprocessing of neonatal resuscitation equipment is vital for ensuring the availability of clean equipment and preventing transmission of infection to a newborn. Staff at Tenwek Hospital, a tertiary referral hospital in rural Kenya, identified reprocessing medical equipment as a gap in improving neonatal care. We sought to implement steam-based high-level disinfection (HLD) for reprocessing neonatal resuscitation equipment in the labor and delivery ward of Tenwek Hospital.Needs Assessment:Before implementation, a needs assessment was conducted to identify existing facilitators and barriers to reprocessing through semistructured interviews with key stakeholders at the hospital (N=12) and identify gaps in the hospital’s existing reprocessing procedures. A chemical, chlorine-based method of disinfection was used for neonatal resuscitation equipment in the ward. We conducted baseline bacterial burden of neonatal resuscitation equipment before clinical use, after clinical use, and after reprocessing. There was not a significant decrease in bacterial burden after reprocessing.Implementation:After implementing a new steam-based HLD process, we conducted bacterial burden testing, which showed a reduction. However, staff preferences and implementation challenges compelled us to modify our original plan and instead implement optimized chemical HLD using chlorine. Although testing showed improved bacterial burden from baseline, in our small number of samples, bacterial burden testing after implementing the optimized chemical HLD process did not differ significantly compared to steam-based HLD.Conclusions:Optimal chemical HLD was felt to be feasible and sustainable in the local setting. Reprocessing methods should be designed for unique challenges in low-resource settings.]]></description>
<dc:creator><![CDATA[Anne M. White, Dominic Mutai, Allison Parsons, David Cheruiyot, Beena D. Kamath-Rayne, Joshua K. Schaffzin, Joel E. Mortensen, Amy R.L. Rule]]></dc:creator>
<dc:date>2025-08-14T13:53:01-07:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-23-00398</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-23-00398</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:title><![CDATA[Disinfection of Neonatal Resuscitation Equipment in Resource-Limited Settings: Lessons From a Mixed-Methods Implementation Experience in Kenya]]></dc:title>
<prism:publicationDate>2025-08-14</prism:publicationDate>
<prism:section>FIELD ACTION REPORT</prism:section>
<prism:volume>13</prism:volume>
<prism:number>1</prism:number>
<prism:issueIdentifier>1</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/13/1/e2400017.short?rss=1">
<title><![CDATA[Enhancing Antiretroviral Therapy Initiation for Hospitalized and Recently Discharged People Living With HIV in Johannesburg, South Africa]]></title>
<link>http://ghspjournal.org/content/13/1/e2400017.short?rss=1</link>
<description><![CDATA[ABSTRACTBackground:Despite increased antiretroviral therapy (ART) access in South Africa, HIV testing and ART initiation are suboptimal in hospital settings. Key gaps include in-hospital case finding, ART initiation support, and primary health care (PHC) facility linkage after discharge.Intervention Development and Description:We identified weaknesses in hospital processes by comparing them with PHC HIV services and developed a quality improvement model for implementation in 5 Johannesburg hospitals. We introduced dedicated teams of HIV testing counselors for structured case finding and ART-trained nurses and linkage officers to provide in-hospital or post-discharge ART initiation and support to strengthen PHC facility linkage. Monitoring data (May 2020–March 2021) was used to measure initiation rates.Lessons Learned:Over 11 months, despite COVID-19 pandemic-related disruptions, our model achieved 74% (5,201/7,025) ART linkage within 28 days post-discharge and 87% (6,087/7,025) overall, including all initiations (i.e., all newly diagnosed, known not on ART and reinitiating individuals). The 2 highest-performing hospitals achieved 97% (2,096/2,170) linkage overall, demonstrating the potential of implementing this quality improvement model with fidelity. Over half (58%, 4,092/7,025) of patients initiated ART within 7 days, with 39% (2,748) initiating on the same day. Women and men achieved similar initiation rates (3,010/4,015, 75%; 2,186/3,003, 73%, respectively). Combining rapid (<7 days) in-hospital ART initiation with 28-day post-discharge follow-up supported high ART initiation rates. Using the model mitigated initiation gaps for men and older people, engaging stakeholders supported implementation, and using a team-based approach founded on clear roles and responsibilities improved service delivery.Conclusion:This model achieved above-average ART linkage rates in a large hospitalized population. We recommend considering introducing this model or adaptations of it to hospitals across South Africa and similar settings where hospital-to-PHC ART service gaps are identified to optimize case finding, ART initiation, and post-discharge linkage support.]]></description>
<dc:creator><![CDATA[Natasha Davies, Melanie Bisnauth, Kate Rees]]></dc:creator>
<dc:date>2025-08-14T13:53:01-07:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-24-00017</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-24-00017</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:title><![CDATA[Enhancing Antiretroviral Therapy Initiation for Hospitalized and Recently Discharged People Living With HIV in Johannesburg, South Africa]]></dc:title>
<prism:publicationDate>2025-08-14</prism:publicationDate>
<prism:section>PROGRAM CASE STUDY</prism:section>
<prism:volume>13</prism:volume>
<prism:number>1</prism:number>
<prism:issueIdentifier>1</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/13/1/e2400125.short?rss=1">
<title><![CDATA[A Missed Opportunity: Prioritizing the Development of a Healthy Market Ecosystem for Equitable Menstrual Health Within the International Conference on Population and Development Programme of Action]]></title>
<link>http://ghspjournal.org/content/13/1/e2400125.short?rss=1</link>
<description><![CDATA[]]></description>
<dc:creator><![CDATA[Sarah Webb, Tanya Mahajan]]></dc:creator>
<dc:date>2025-08-14T13:53:01-07:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-24-00125</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-24-00125</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:title><![CDATA[A Missed Opportunity: Prioritizing the Development of a Healthy Market Ecosystem for Equitable Menstrual Health Within the International Conference on Population and Development Programme of Action]]></dc:title>
<prism:publicationDate>2025-08-14</prism:publicationDate>
<prism:section>VIEWPOINT</prism:section>
<prism:volume>13</prism:volume>
<prism:number>1</prism:number>
<prism:issueIdentifier>1</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/13/1/e2400164.short?rss=1">
<title><![CDATA[Narrative Review of Human-Centered Design in Public Health Interventions in Low- and Middle-Income Countries: Recommendations for Practice, Research, and Reporting]]></title>
<link>http://ghspjournal.org/content/13/1/e2400164.short?rss=1</link>
<description><![CDATA[ABSTRACTThe application of human-centered design (HCD) is growing in global health, given its potential to generate innovative solutions to entrenched health problems by prioritizing human perspectives, needs, and desires. To address gaps in consolidated evidence on prior programs, we conducted a review of studies that applied a comprehensive HCD approach in low- and middle-income countries. A total of 535 articles were initially identified. Based on the inclusion and exclusion criteria, 22 articles were included. Most studies were conducted in sub-Saharan Africa and used qualitative or mixed methods throughout the HCD work. In the “discover and define” phase, user personas, journey maps, and interviews were commonly used to empathize with end users and key stakeholders. Studies used various strategies in the “ideation” phase, including idea generation based on feasibility and resource constraints. In the “testing” phase, low-fidelity prototypes were tested to obtain feedback from end users and stakeholders, enabling quick and cost-effective refinements. Prototype iterations occurred twice in most studies, but information about when iterations ceased was limited. Evaluations of design outcomes and health impacts were lacking. Studies cited multidisciplinary approaches, flexible methodology, and a sense of ownership among users and communities as strengths of HCD. Contrastingly, challenges in consistent participant engagement and limited scientific rigor were reported as weaknesses. Elements that enhanced program reporting included clear descriptions of HCD as cyclical, stakeholder maps (empathy tools), visual materials on design activities and prototypes, and transparency in failures. We recommend strengthening capacity among those applying HCD to optimize the effectiveness of the approach for global health. Although HCD is not inherently intended to serve as a rigorous research method, data triangulation and proper evaluations may ensure its usability as evidence in health research when appropriate. Also, a thorough reporting of design phases and providing detailed rationale behind design decisions can advance future HCD literature.]]></description>
<dc:creator><![CDATA[Bee-Ah Kang, Manvi Poddar, Aditi Luitel, Rajiv N. Rimal, Biruk Melaku, Danielle Piccinini Black]]></dc:creator>
<dc:date>2025-08-14T13:53:01-07:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-24-00164</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-24-00164</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:title><![CDATA[Narrative Review of Human-Centered Design in Public Health Interventions in Low- and Middle-Income Countries: Recommendations for Practice, Research, and Reporting]]></dc:title>
<prism:publicationDate>2025-08-14</prism:publicationDate>
<prism:section>REVIEW</prism:section>
<prism:volume>13</prism:volume>
<prism:number>1</prism:number>
<prism:issueIdentifier>1</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/13/1/e2400177.short?rss=1">
<title><![CDATA[Integrating Gender-Based Violence Services Into HIV Care: Insights From Malawi]]></title>
<link>http://ghspjournal.org/content/13/1/e2400177.short?rss=1</link>
<description><![CDATA[ABSTRACTIntroduction:Gender-based violence (GBV) not only poses significant public health and human rights challenges but is also closely associated with HIV. GBV acts as a barrier to HIV prevention, testing, and treatment adherence, and fear of GBV inhibits disclosure of HIV status to sexual partners. In Malawi, where both GBV and HIV prevalence is high, integrating GBV services into HIV care is crucial. We describe the integration of GBV services into Lighthouse Trust’s HIV testing and treatment clinics in Malawi, including screening, documentation, intervention implementation, outcomes, and lessons learned.Methods:We conducted a retrospective analysis from January 2020 to June 2024. Data on cases identified, post-GBV services, and perpetrator demographics were collected from the GBV register. We used descriptive statistics to describe the intervention outcomes.Results:We documented 9,045 reported GBV cases among males and females from January 2020 to June 2024. Adolescent girls aged 10–19 years constituted a significant proportion of survivors. Psychosocial services were the most common type of service that was offered to GBV survivors (25%), followed by HIV testing (19%) and sexually transmitted infection screening (18%). Perpetrators were mostly known to survivors.Conclusion:We successfully integrated GBV services into the Lighthouse Trust HIV clinics in close collaboration with the one-stop centers in Malawi. Training health care providers enhanced support for GBV survivors, with a focus on increasing awareness, especially for children and adolescents. Recommended actions include improving access to GBV services, enhancing documentation, and promoting multi-sectoral collaboration to ensure comprehensive care aimed at creating a safer, more dignified health care environment for all, particularly GBV survivors.]]></description>
<dc:creator><![CDATA[Christine Kiruthu-Kamamia, Evelyn Viola, Odala Sande, Tapiwa Kumwenda, Joseph Lungu, Joseph Diele, Ellen MacLachlan, Agnes Thawani]]></dc:creator>
<dc:date>2025-08-14T13:53:01-07:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-24-00177</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-24-00177</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:title><![CDATA[Integrating Gender-Based Violence Services Into HIV Care: Insights From Malawi]]></dc:title>
<prism:publicationDate>2025-08-14</prism:publicationDate>
<prism:section>FIELD ACTION REPORT</prism:section>
<prism:volume>13</prism:volume>
<prism:number>1</prism:number>
<prism:issueIdentifier>1</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/13/1/e2400282.short?rss=1">
<title><![CDATA[Development of a Cervical Cancer Screening Program in Rural Guatemala]]></title>
<link>http://ghspjournal.org/content/13/1/e2400282.short?rss=1</link>
<description><![CDATA[ABSTRACTBackground:In San Lucas Tolimán (SLT), Guatemala, a rural municipality with a large Indigenous population, women seeking cervical cancer screening face many barriers. We describe the process from design to implementation of a culturally appropriate and accessible cervical cancer screening and treatment pilot program for women aged 30–49 years.Methods:After conducting a community needs assessment, we trained community health workers (CHWs) on basic cervical cancer pathophysiology and human papillomavirus (HPV) self-swab kit use. CHWs provided educational seminars and enrolled interested, eligible women in a mobile health application. Women collected samples at home and returned completed kits to CHWs, who sent the kits to a partner lab. Women who were positive for HPV received follow-up care at the local hospital, where physicians had received training in visual inspection with acetic acid (VIA) with same-day cryotherapy or thermocoagulation. Women with advanced lesions received access to care from gynecologists free of cost.Results:Between February and November 2023, of the 230 women eligible to participate in the program, 132 completed HPV self-swabs and received results, and 34 received positive HPV tests (25.76% prevalence). Sixty-seven women had VIA exams as their first screening. Women who received VIA exams had an overall positivity rate of 24.47% (23/94). Twenty-three women received treatment: cryotherapy (n=8), thermocoagulation (n=7), or loop electrosurgical excision procedure (n=8). SLT had higher HPV-positivity rates than nearby Escuintla (21.6%; P=.29) and significantly higher than Santiago Atitlán (17.4% HPV+; P=.02).Conclusion:Our screening program found significantly higher HPV-positivity rates in SLT than in previous Guatemalan studies. Our research reinforces that adequately treating cervical cancer in Guatemala requires accompaniment during care and economic support to make care affordable or free. Based on our pilot program, organizations worldwide can further invest in culturally sensitive cervical cancer screening and treatment.]]></description>
<dc:creator><![CDATA[Taryn McGinn Valley, Elizabeth White, Alli Foreman, Ale&#x0237;andro Chavez, Tana Chongsuwat, Linda Foxworthy, Madhuri Reddy, Cecilia Arroyave, Kevin Wyne, Rafael Tun, Yoselin Emelina Letona Lopez, Dominga Pic Salazar, Cesia Castro Chuta, Sean Duffy]]></dc:creator>
<dc:date>2025-08-14T13:53:01-07:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-24-00282</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-24-00282</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:title><![CDATA[Development of a Cervical Cancer Screening Program in Rural Guatemala]]></dc:title>
<prism:publicationDate>2025-08-14</prism:publicationDate>
<prism:section>ORIGINAL ARTICLE</prism:section>
<prism:volume>13</prism:volume>
<prism:number>1</prism:number>
<prism:issueIdentifier>1</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/13/1/e2400608.short?rss=1">
<title><![CDATA[&#x201C;Community Over Commercialization&#x201D;: Help Us Keep GHSP Open]]></title>
<link>http://ghspjournal.org/content/13/1/e2400608.short?rss=1</link>
<description><![CDATA[]]></description>
<dc:creator><![CDATA[Sonia Abraham, Natalie Culbertson, Stephen Hodgins, Ruwaida M. Salem]]></dc:creator>
<dc:date>2025-08-14T13:53:01-07:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-24-00608</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-24-00608</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:title><![CDATA[&#x201C;Community Over Commercialization&#x201D;: Help Us Keep GHSP Open]]></dc:title>
<prism:publicationDate>2025-08-14</prism:publicationDate>
<prism:section>EDITORIAL</prism:section>
<prism:volume>13</prism:volume>
<prism:number>1</prism:number>
<prism:issueIdentifier>1</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/13/Supplement_1/e2300062.short?rss=1">
<title><![CDATA[Applying a Theory of Change for Human Resources Development in Public Health Supply Chains in Rwanda]]></title>
<link>http://ghspjournal.org/content/13/Supplement_1/e2300062.short?rss=1</link>
<description><![CDATA[ABSTRACTBackground:The health supply chain (SC) system in Rwanda experienced a number of workforce-related challenges, including insufficient skilled supply chain management (SCM) professionals with the necessary competencies. The Human Resources for Supply Chain Management (HR4SCM) Theory of Change (TOC) provides a methodology to assess human resources (HR) management systems by explaining the preconditions required to achieve optimized workforce performance. We applied this model to design interventions to strengthen the Rwanda health SC workforce.Methods:We compared conditions in the health SC HR system in Rwanda with the 60 outcomes described as necessary for optimized workforce performance in the HR4SCM TOC model. We used a survey and participatory workshop at the central level, followed by structured interviews (N=35) with SC professionals in health centers, hospitals, and regional warehouses (N=20) in Southern Province and Kigali City to identify which outcomes already existed in the Rwandan HR system and which outcomes required strengthening through targeted interventions. We used focus groups (N=2) to refine interventions.Findings:We identified that 31 of the 60 outcomes were not sufficiently in place in the Rwandan health SC HR system. SCM workers had gaps in the technical and managerial competencies and did not have access to adequate training and professional development opportunities for certain required competencies. An SCM career path did not exist, and education was not available for all required SCM qualifications. Fourteen of these outcomes were prioritized for strengthening. We designed 20 workforce interventions with the Ministry of Health to address these deficiencies and selected indicators to monitor the interventions.Conclusion:Applying this HR TOC model enabled a systematic process to identify gaps, develop and prioritize interventions, and select indicators. Practitioners designing and evaluating SC workforce interventions should consider applying this methodology to design more effective, theory-driven interventions to improve SC workforce performance.]]></description>
<dc:creator><![CDATA[Erin Meier, Andrew N. Brown, Bridget McHenry, Joseph Kabatende, Ines K. Gege Buki, Joyce Icyimpaye]]></dc:creator>
<dc:date>2025-05-09T09:19:44-07:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-23-00062</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-23-00062</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:title><![CDATA[Applying a Theory of Change for Human Resources Development in Public Health Supply Chains in Rwanda]]></dc:title>
<prism:publicationDate>2025-05-09</prism:publicationDate>
<prism:section>ORIGINAL ARTICLE</prism:section>
<prism:volume>13</prism:volume>
<prism:number>Supplement 1</prism:number>
<prism:issueIdentifier>Supplement_1</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/13/Supplement_1/e2300119.short?rss=1">
<title><![CDATA[Presenting a Framework to Professionalize Health Supply Chain Management]]></title>
<link>http://ghspjournal.org/content/13/Supplement_1/e2300119.short?rss=1</link>
<description><![CDATA[ABSTRACTIntroduction:Many countries have an insufficient supply of adequately skilled supply chain workers to manage health commodities, and no global standards in education or experience exist for the supply chain management (SCM) workforce managing health products. We present a professionalization framework for the health SCM workforce that provides a systematic process that countries can use to standardize and elevate the health SCM profession.Methods:In 2019, semistructured interviews were conducted with individuals from 10 leading organizations supporting in-country public health supply chains to explore approaches for an SCM professionalization framework. Interview data were analyzed using direct thematic analysis. Findings were then validated through a validation workshop with 11 individuals from 8 leading SCM organizations.Results:Four associated components of this framework were developed: (1) The Library of Competencies and Designations contains management competencies grouped in 7 domains and supply chain technical competencies assigned to 5 professional designations; (2) The Collection of Roles and Job Descriptions contains 96 sample job descriptions; (3) The Mapping of Education displays the education offerings relevant to each competency across the 5 professional designations; and (4) The Implementation Approach for Health Supply Chains leads project teams to systematically apply these 3 tools in the supply chain context of a country.Conclusion:The SCM Professionalisation Framework provides a valuable tool to increase the supply of and demand for health SCM workers, increasing the recognition and use of SCM professionals within national health systems. Its utilization is a critical step in addressing the current workforce gap, particularly in low- and middle-income countries, and ensuring that the health SCM workforce possesses the right competencies, skills, and qualifications to fulfill its roles. The comprehensive framework can be used by governments, employers, and education institutions to define and align SCM professional standards, competencies, and curricula with job requirements.]]></description>
<dc:creator><![CDATA[Andrew N. Brown, Barry Chovitz, Richard dos Santos, Michael Egharevba, Bridget McHenry, Erin Meier, Dominique Zwinkels]]></dc:creator>
<dc:date>2025-05-09T09:19:44-07:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-23-00119</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-23-00119</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:title><![CDATA[Presenting a Framework to Professionalize Health Supply Chain Management]]></dc:title>
<prism:publicationDate>2025-05-09</prism:publicationDate>
<prism:section>ORIGINAL ARTICLE</prism:section>
<prism:volume>13</prism:volume>
<prism:number>Supplement 1</prism:number>
<prism:issueIdentifier>Supplement_1</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/13/Supplement_1/e2300208.short?rss=1">
<title><![CDATA[Promising Practices in Capacity Development for Health Supply Chains in Resource-Constrained Countries]]></title>
<link>http://ghspjournal.org/content/13/Supplement_1/e2300208.short?rss=1</link>
<description><![CDATA[AbstractPerformance gaps in health supply chains in low- and middle-income countries contribute significantly to inefficiencies and underperformance of their health systems. Some significant factors hindering the performance of supply chains in low and middle-income countries include low human resource capacity and capability, weak structures for monitoring supply chain performance, weak in-service and pre-service training programs, chronic underfunding, lack of transparency and an overdependence on obsolete methods, like manual data gathering, record-keeping, and analyses. Although proven health supply chain strengthening techniques exist, the level of adoption of these practices has varied across countries, resulting in multiple capacity gaps and underperforming supply chains. The resulting challenges require complementary and needs-based practices to address the gaps. While it is recognized that there is no “one-size-fits-all” solution to these issues, we demonstrate that real benefits can be achieved by using “promising practices”—that is, using targeted, innovative interventions. To demonstrate the potential of using promising practices in the health supply chain in Africa and the breadth of possible solutions available, we present 3 case studies from different contexts and with different objectives.]]></description>
<dc:creator><![CDATA[Mahama Duwiejua, Pamela Steele, Paul Lalvani, Dorothy Leab, Lloyd Matowe, Jonathan Moody]]></dc:creator>
<dc:date>2025-05-09T09:19:44-07:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-23-00208</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-23-00208</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:title><![CDATA[Promising Practices in Capacity Development for Health Supply Chains in Resource-Constrained Countries]]></dc:title>
<prism:publicationDate>2025-05-09</prism:publicationDate>
<prism:section>PROGRAMMATIC REVIEW AND ANALYSIS</prism:section>
<prism:volume>13</prism:volume>
<prism:number>Supplement 1</prism:number>
<prism:issueIdentifier>Supplement_1</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/13/Supplement_1/e2300320.short?rss=1">
<title><![CDATA[Creating a Career Development Path for Young Supply Chain Professionals: Three Case Studies in Benin, Kenya, and South Africa]]></title>
<link>http://ghspjournal.org/content/13/Supplement_1/e2300320.short?rss=1</link>
<description><![CDATA[ABSTRACTLow and middle-income countries (LMICs) continue to have a limited supply of skilled supply chain (SC) management professionals in the public sector. In addition, the SC workforce lacks the competencies demanded by new technologies and markets. Young people may be an untapped resource for the procurement and SC management workforce. We present 3 use cases in which career development paths were created for young SC professionals in Benin, Kenya, and South Africa. In Benin, with advocacy from L’Association des Logisticiens Béninois, the professional body of logisticians, career development opportunities were made through creating specific programs like the Young Logisticians Professionals Program. SAPICS, the professional body for SC management in South Africa, has been providing opportunities for career development by giving students and young professionals access to subject matter experts, conferences, site visits, and various industry-specific training and networking opportunities, as well as general “job readiness” training through coaching and mentorship programs. In Kenya, the Girls on the Move program focuses on introducing SC management as a career path to girls through internships, skills training, and mentorship, all aimed at equipping them for successful work placements. The COVID-19 pandemic underscored the critical importance of SC management and highlighted vulnerabilities that demand greater responsiveness and resilience. In the post-COVID era, it is imperative for the public SC sector to build an agile and skilled workforce capable of addressing immediate needs and supporting long-term pandemic preparedness. The cases presented show how opportunities for training, mentorship, and work experience were made available to young professionals and highlight some of the positive outcomes of these initiatives. The cases also illustrate innovative approaches to developing career pathways for youth in LMICs that aim to expand the pool of skilled professionals who can strengthen public SCs and enhance their capacity to respond to future challenges.]]></description>
<dc:creator><![CDATA[Rachel Msimuko, Ricardo Sedomedji Missihoun, Chloe Peebles, Jenny Froome, Lloyd Matowe, Pamela Steele]]></dc:creator>
<dc:date>2025-05-09T09:19:44-07:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-23-00320</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-23-00320</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:title><![CDATA[Creating a Career Development Path for Young Supply Chain Professionals: Three Case Studies in Benin, Kenya, and South Africa]]></dc:title>
<prism:publicationDate>2025-05-09</prism:publicationDate>
<prism:section>PROGRAM CASE STUDY</prism:section>
<prism:volume>13</prism:volume>
<prism:number>Supplement 1</prism:number>
<prism:issueIdentifier>Supplement_1</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/13/Supplement_1/e2300365.short?rss=1">
<title><![CDATA[Strategic Training Executive Program 2.0: A Leadership and Change Management Program for Health Supply Chains in Low- and Middle-Income Countries]]></title>
<link>http://ghspjournal.org/content/13/Supplement_1/e2300365.short?rss=1</link>
<description><![CDATA[ABSTRACTPeople that Deliver’s vision is “a world where health supply chain workforces are empowered and equipped to optimize health outcomes by improving access to health commodities.” However, health supply chain management (HSCM) is not a recognized profession in many low- and middle-income countries (LMICs). HSCM professionalization efforts are essential if health outcomes are to be significantly improved in these countries; this means transforming supply chain management into a recognized profession of the highest integrity.The Strategic Training Executive Program (STEP) was created in 2016 to address prevailing leadership style gaps. Since then, STEP has undergone rigorous revisions to improve its applicability, scalability, and usefulness in LMICs. To date, STEP—in all its forms—has been delivered to 30 countries and contributed to building the supply chain capacities of more than 600 health supply chain professionals.This case study discusses the evolution journey of designing and sustaining the second generation of STEP (STEP 2.0). This journey is an innovative illustration of how diverse yet motivated organizations collaborated during a global lockdown and health emergency to reimagine a program recognized by all as essential for post-pandemic supply chain systems.]]></description>
<dc:creator><![CDATA[Patricia Bobo, George Bray, Kevin Etter, Namrata Singh]]></dc:creator>
<dc:date>2025-05-09T09:19:44-07:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-23-00365</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-23-00365</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:title><![CDATA[Strategic Training Executive Program 2.0: A Leadership and Change Management Program for Health Supply Chains in Low- and Middle-Income Countries]]></dc:title>
<prism:publicationDate>2025-05-09</prism:publicationDate>
<prism:section>PROGRAM CASE STUDY</prism:section>
<prism:volume>13</prism:volume>
<prism:number>Supplement 1</prism:number>
<prism:issueIdentifier>Supplement_1</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/13/Supplement_1/e2300366.short?rss=1">
<title><![CDATA[People that Deliver: Established to Address the Health Supply Chain Workforce Gap]]></title>
<link>http://ghspjournal.org/content/13/Supplement_1/e2300366.short?rss=1</link>
<description><![CDATA[]]></description>
<dc:creator><![CDATA[Dominique Zwinkels, Andrew Brown, Francis Aboagye-Nyame]]></dc:creator>
<dc:date>2025-05-09T09:19:44-07:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-23-00366</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-23-00366</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:title><![CDATA[People that Deliver: Established to Address the Health Supply Chain Workforce Gap]]></dc:title>
<prism:publicationDate>2025-05-09</prism:publicationDate>
<prism:section>COMMENTARY</prism:section>
<prism:volume>13</prism:volume>
<prism:number>Supplement 1</prism:number>
<prism:issueIdentifier>Supplement_1</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/13/Supplement_1/e2300467.short?rss=1">
<title><![CDATA[People that Deliver Theory of Change for Building Human Resources for Supply Chain Management: Applications in sub-Saharan Africa and Southeast Asia]]></title>
<link>http://ghspjournal.org/content/13/Supplement_1/e2300467.short?rss=1</link>
<description><![CDATA[The Theory of Change for Building Human Resources for Supply Chain Management (TOC) offers a practical framework outlining 4 interdependent pathways—staffing, skills, working conditions, and motivation—to manage the workforce quantity and capability necessary to operate health supply chains effectively. We conducted a desk review of project reports on applications of the TOC as a diagnostic and analytical framework for health supply chains in Cameroon, Ethiopia, Malawi, Rwanda, and the Philippines. We compared approaches to program development, project management, and implementation to reach conclusions and make recommendations based on experience in each country. The TOC can be applied in multiple country contexts, is useful in highlighting supply workforce challenges, and provides a framework that allows governments and technical partners to readdress them.]]></description>
<dc:creator><![CDATA[Pamela Steele, Hilary Claire Frazer, Gashaw Mekonnen]]></dc:creator>
<dc:date>2025-05-09T09:19:44-07:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-23-00467</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-23-00467</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:title><![CDATA[People that Deliver Theory of Change for Building Human Resources for Supply Chain Management: Applications in sub-Saharan Africa and Southeast Asia]]></dc:title>
<prism:publicationDate>2025-05-09</prism:publicationDate>
<prism:section>ORIGINAL ARTICLE</prism:section>
<prism:volume>13</prism:volume>
<prism:number>Supplement 1</prism:number>
<prism:issueIdentifier>Supplement_1</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/13/Supplement_1/e2400232.short?rss=1">
<title><![CDATA[Exploring the Role of Gender in the Public Health Supply Chain Workforce in Low- and Middle-Income Countries]]></title>
<link>http://ghspjournal.org/content/13/Supplement_1/e2400232.short?rss=1</link>
<description><![CDATA[ABSTRACTThis article describes exploratory research conducted to understand pathways to entering the public health supply chain (PHSC) workforce in low- and middle-income countries (LMICs) to identify potential barriers for women working in this field and gather suggestions on how to improve gender equity in the PHSC workforce. Key informant interviews were conducted in the Democratic Republic of Congo and Malawi with health sciences students, health science education professionals, individuals currently working in the PHSC workforce, and global stakeholders. An online survey was conducted with responses from PHSC professionals across 26 countries. The survey and interviews revealed that respondents perceived that there were gender imbalances and inequities at all levels of the PHSC workforce. Respondents reported on barriers for women to receive the education, training, mentorship, and leadership opportunities needed to advance in this profession, barriers to traveling for work due to cultural norms and safety concerns, and a lack of policy and structural support for women to feel safe and supported at work. To improve gender equity in the PHSC workforce, we recommend strengthening career pathways for women; fostering mentorship opportunities among women; making recruitment practices more gender sensitive; implementing gender-sensitive policies; improving access to financial, physical, and technological resources; collecting and using gender-disaggregated data; and increasing the number of women in leadership positions.]]></description>
<dc:creator><![CDATA[Susan Truog, Katie Reynolds, Rebecca Alban, Louis Tshituka, Tafwirapo Chihana, Mariam Zameer, Amanda Pain, Bvudzai P. Magadzire, Sierra Petrosky]]></dc:creator>
<dc:date>2025-05-09T09:19:44-07:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-24-00232</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-24-00232</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:title><![CDATA[Exploring the Role of Gender in the Public Health Supply Chain Workforce in Low- and Middle-Income Countries]]></dc:title>
<prism:publicationDate>2025-05-09</prism:publicationDate>
<prism:section>ORIGINAL ARTICLE</prism:section>
<prism:volume>13</prism:volume>
<prism:number>Supplement 1</prism:number>
<prism:issueIdentifier>Supplement_1</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/13/Supplement_1/e2400444.short?rss=1">
<title><![CDATA[The Supply Chain Workforce: The Foundation of Health Supply Chains]]></title>
<link>http://ghspjournal.org/content/13/Supplement_1/e2400444.short?rss=1</link>
<description><![CDATA[]]></description>
<dc:creator><![CDATA[Dominique Zwinkels, Lloyd Matowe, Domina Asingizwe, Andrew N. Brown, Jonathan Moody]]></dc:creator>
<dc:date>2025-05-09T09:19:44-07:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-24-00444</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-24-00444</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:title><![CDATA[The Supply Chain Workforce: The Foundation of Health Supply Chains]]></dc:title>
<prism:publicationDate>2025-05-09</prism:publicationDate>
<prism:section>EDITORIAL</prism:section>
<prism:volume>13</prism:volume>
<prism:number>Supplement 1</prism:number>
<prism:issueIdentifier>Supplement_1</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/12/6/e2300381.short?rss=1">
<title><![CDATA[Self-Reflection as a Starting Point: Observations in Global Health Research]]></title>
<link>http://ghspjournal.org/content/12/6/e2300381.short?rss=1</link>
<description><![CDATA[]]></description>
<dc:creator><![CDATA[Wouter Bakker, Thomas van den Akker, Jelle Stekelenburg]]></dc:creator>
<dc:date>2024-12-20T06:39:28-08:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-23-00381</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-23-00381</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:title><![CDATA[Self-Reflection as a Starting Point: Observations in Global Health Research]]></dc:title>
<prism:publicationDate>2024-12-20</prism:publicationDate>
<prism:section>VIEWPOINT</prism:section>
<prism:volume>12</prism:volume>
<prism:number>6</prism:number>
<prism:issueIdentifier>6</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/12/6/e2300463.short?rss=1">
<title><![CDATA[The Case for Parent-Implemented Programs to Mitigate Musculoskeletal Complications in Children With Severe Cerebral Palsy in Resource-Limited Settings]]></title>
<link>http://ghspjournal.org/content/12/6/e2300463.short?rss=1</link>
<description><![CDATA[]]></description>
<dc:creator><![CDATA[Shayne R. van Aswegen, Mark T. Richards, Brenda M. Morrow]]></dc:creator>
<dc:date>2024-12-20T06:39:28-08:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-23-00463</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-23-00463</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:subject><![CDATA[Maternal, Newborn, and Child Health]]></dc:subject>
<dc:title><![CDATA[The Case for Parent-Implemented Programs to Mitigate Musculoskeletal Complications in Children With Severe Cerebral Palsy in Resource-Limited Settings]]></dc:title>
<prism:publicationDate>2024-12-20</prism:publicationDate>
<prism:section>COMMENTARY</prism:section>
<prism:volume>12</prism:volume>
<prism:number>6</prism:number>
<prism:issueIdentifier>6</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/12/6/e2300483.short?rss=1">
<title><![CDATA[Process Evaluation of Teaching Critical Thinking About Health Using the Informed Health Choices Intervention in Rwanda: A Mixed Methods Study]]></title>
<link>http://ghspjournal.org/content/12/6/e2300483.short?rss=1</link>
<description><![CDATA[ABSTRACTIntroduction:We evaluated the Informed Health Choices secondary school intervention in a cluster randomized trial in Rwanda. The intervention was effective in helping students to think critically about health. In parallel to the trial, we conducted a process evaluation to assess factors affecting the implementation, impacts, and scale-up of the intervention.Methods:We used a mixed methods approach that included quantitative and qualitative methods. We collected quantitative data from teachers to evaluate the teacher training and each lesson. We conducted focus group discussions with students (n=10) and their parents/guardians (n=5). We conducted lesson observations (n=16) and key informant interviews with teachers (n=10) and school administrators (n=10) from intervention schools and policymakers (n=2). We analyzed the quantitative data using descriptive statistics. We used framework analysis and thematic content analysis to analyze the qualitative data.Results:Teachers noted that the teacher training supported their delivery of the intervention and that they made only small adaptations to fit student, teacher, or contextual needs. Students reported obtaining important skills, including recognizing health claims, understanding the need for research, and “thinking twice” before deciding. Participants saw the design of the intervention, students’ and teachers’ motivation, and school and home support as key facilitators for the implementation and impact of the intervention. Implementation barriers identified included the content of the lessons not being included in national examinations, competing priorities, and time constraints. Participants identified several factors that could facilitate intervention scale-up, including the need for the skills taught in the lessons and compatibility of the intervention with the national curriculum.Conclusion:We found that it was feasible to implement the intervention in Rwandan secondary schools and that students benefited from the intervention. Scaling up the intervention will likely require addressing the barriers identified in this study.]]></description>
<dc:creator><![CDATA[Michael Mugisha, Andrew D. Oxman, Laetitia Nyirazinyoye, Anne Marie Uwitonze, Clarisse Marie Claudine Simbi, Faith Chesire, Ronald Ssenyonga, Matt Oxman, Allen Nsangi, Daniel Semakula, Margaret Kaseje, Nelson K. Sewankambo, Sarah Rosenbaum, Simon Lewin]]></dc:creator>
<dc:date>2024-12-20T06:39:28-08:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-23-00483</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-23-00483</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:subject><![CDATA[Behavior Change Communication, Adolescents and Youth]]></dc:subject>
<dc:title><![CDATA[Process Evaluation of Teaching Critical Thinking About Health Using the Informed Health Choices Intervention in Rwanda: A Mixed Methods Study]]></dc:title>
<prism:publicationDate>2024-12-20</prism:publicationDate>
<prism:section>ORIGINAL ARTICLE</prism:section>
<prism:volume>12</prism:volume>
<prism:number>6</prism:number>
<prism:issueIdentifier>6</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/12/6/e2300484.short?rss=1">
<title><![CDATA[Process Evaluation of Teaching Critical Thinking About Health Using the Informed Health Choices Intervention in Uganda: A Mixed Methods Study]]></title>
<link>http://ghspjournal.org/content/12/6/e2300484.short?rss=1</link>
<description><![CDATA[ABSTRACTIntroduction:We designed the Informed Health Choices (IHC) secondary school intervention and evaluated whether it improves students’ ability to assess the trustworthiness of claims about treatment effects in Uganda. We conducted a process evaluation alongside a randomized trial to identify factors that may affect the implementation, fidelity, and scaling up of the intervention in Uganda. We also explored the potential adverse and beneficial effects of the intervention.Methods:We used mixed methods to collect, triangulate, and report data from a variety of sources. We observed at least 1 lesson in all 40 intervention schools. One teacher from each of these schools completed a teacher training evaluation form and lesson evaluation questionnaires after each lesson. We purposively selected 10 schools where we conducted a total of 10 focus group discussions with students and 1 with parents. We also conducted key informant interviews with policymakers (N=9), teachers (N=10), head teachers (N=4), and parents (N=3). We used a framework analysis approach to analyze the data.Findings:All participants in the process evaluation felt that the IHC intervention was needed, important, and timely. Students were motivated to attend class and learn the content because it spoke to their daily life experiences and their own challenges to decide what to do or believe when faced with health claims. The training workshop gave teachers the confidence to teach the lessons. The participating students demonstrated a clear understanding of the content and use of what was learned. The content improved both students’ and teachers’ appreciation of the critical thinking, communication, and problem-solving competencies in the lower secondary school curriculum.Conclusion:The findings of this process evaluation are consistent with the findings of the trial, which showed that the intervention improved the students’ critical thinking skills. The IHC resources enabled teachers to teach this competency.]]></description>
<dc:creator><![CDATA[Ronald Ssenyonga, Simon Lewin, Esther Nakyejwe, Faith Chelagat, Michael Mugisha, Matt Oxman, Allen Nsangi, Daniel Semakula, Sarah E. Rosenbaum, Jenny Moberg, Andrew D. Oxman, Heather Munthe-Kaas, Christine Holst, Margaret Kaseje, Laetitia Nyirazinyoye, Nelson Sewankambo]]></dc:creator>
<dc:date>2024-12-20T06:39:28-08:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-23-00484</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-23-00484</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:subject><![CDATA[Behavior Change Communication, Adolescents and Youth]]></dc:subject>
<dc:title><![CDATA[Process Evaluation of Teaching Critical Thinking About Health Using the Informed Health Choices Intervention in Uganda: A Mixed Methods Study]]></dc:title>
<prism:publicationDate>2024-12-20</prism:publicationDate>
<prism:section>ORIGINAL ARTICLE</prism:section>
<prism:volume>12</prism:volume>
<prism:number>6</prism:number>
<prism:issueIdentifier>6</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/12/6/e2300485.short?rss=1">
<title><![CDATA[Process Evaluation of Teaching Critical Thinking About Health Using the Informed Health Choices Intervention in Kenya: A Mixed Methods Study]]></title>
<link>http://ghspjournal.org/content/12/6/e2300485.short?rss=1</link>
<description><![CDATA[ABSTRACTIntroduction:We evaluated the Informed Health Choices secondary school intervention to help students in Kenya think critically about health choices. We conducted this process evaluation to explore if the intervention was implemented as planned, identify factors that facilitated or hindered implementation, potential benefits of the intervention, and how to scale up the intervention beyond the trial.Methods:This was a mixed methods process evaluation nested in a cluster-randomized trial of the Informed Health Choices intervention. We analyzed quantitative data from teacher training evaluation forms completed by 39 teachers, 10 lesson evaluation forms completed by 40 teachers allocated to the intervention, and 72 structured classroom observation forms. We conducted a framework analysis of qualitative data from 14 group interviews (with 96 students, 23 teachers, and 18 parents) and 22 individual interviews (with 8 teachers, 5 school principals, 6 curriculum developers, and 3 policymakers). We assessed confidence in our findings from the qualitative analysis using a modified version of Confidence in the Evidence from Reviews of Qualitative Research.Results:Lesson objectives were achieved with minimal adaptations. Factors that might have facilitated the implementation of the intervention include teacher training; perceived value of the intervention by students, teachers, and policymakers; and support from school administration. Time constraints, teachers’ heavy workloads, and the lessons not being included in the curriculum or national examination are factors that might have impeded implementation. Both students and teachers demonstrated the ability to apply key concepts that were taught to health choices and other choices. However, they experienced difficulties with 2 of the lessons.Conclusion:Scale-up of this intervention in Kenyan schools is feasible but may depend on adjusting the time allocated to teaching the lessons, modifying the 2 lessons that teachers and students found difficult, and including the lesson objectives and assessment in the national curriculum.]]></description>
<dc:creator><![CDATA[Faith Chesire, Andrew D. Oxman, Margaret Kaseje, Violet Gisore, Michael Mugisha, Ronald Ssenyonga, Matt Oxman, Allen Nsangi, Daniel Semakula, Laetitia Nyirazinyoye, Nelson K. Sewankambo, Heather Munthe-Kaas, Christine Holst, Sarah Rosenbaum, Simon Lewin]]></dc:creator>
<dc:date>2024-12-20T06:39:28-08:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-23-00485</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-23-00485</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:subject><![CDATA[Behavior Change Communication, Adolescents and Youth]]></dc:subject>
<dc:title><![CDATA[Process Evaluation of Teaching Critical Thinking About Health Using the Informed Health Choices Intervention in Kenya: A Mixed Methods Study]]></dc:title>
<prism:publicationDate>2024-12-20</prism:publicationDate>
<prism:section>ORIGINAL ARTICLE</prism:section>
<prism:volume>12</prism:volume>
<prism:number>6</prism:number>
<prism:issueIdentifier>6</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/12/6/e2300509.short?rss=1">
<title><![CDATA[Understanding Integrated Community Case Management Institutionalization Processes Within National Health Systems in Malawi, Mali, and Rwanda: A Qualitative Study]]></title>
<link>http://ghspjournal.org/content/12/6/e2300509.short?rss=1</link>
<description><![CDATA[ABSTRACTIntroduction:Since 2012, the World Health Organization (WHO) and UNICEF have recommended integrated Community Case Management (iCCM) of childhood illnesses as an intervention delivered by community health workers (CHWs) in areas with limited access to health facilities to increase access to lifesaving interventions for children younger than 5 years with malaria, pneumonia, or diarrhea. In recent years, the importance of institutionalizing iCCM and community health more broadly within national health systems has become increasingly recognized.Methods:This qualitative study sought to identify and describe processes of iCCM institutionalization from the perspectives of health system actors. A total of 51 semistructured interviews were conducted with purposefully selected key informants in 3 countries: Malawi, Mali, and Rwanda. Thematic analysis of coded interview data was conducted, and country documentation was reviewed to provide contextual background for qualitative interpretation. The study was informed by a newly developed iCCM Institutionalization Framework, which conceptualizes the process of institutionalization through a maturity model of phases (i.e., awareness, experimentation, expansion, consolidation, and maturity) with 4 drivers: core values, leadership, resources, and policy.Results:According to key informant narrative descriptions, processes of iCCM institutionalization reflected a progression of maturity phases, which were iterative rather than linear in progression. All 4 drivers of institutionalization as conceptualized within the iCCM Institutionalization Framework were described by key informants as contributing to the advancement of iCCM institutionalization within their countries. Key informants emphasized the need to continually strengthen or reinforce iCCM institutionalization for it to be sustained within the context of wider health system dynamics.Conclusion:Overall, key informants viewed government ownership and integration within national systems to define the status of iCCM institutionalization. Further development of the iCCM Institutionalization Framework and other practical sensemaking models could assist health system actors in advancing institutionalization of iCCM and other health interventions.]]></description>
<dc:creator><![CDATA[Alyssa L. Davis, Erica Felker-Kantor, Jehan Ahmed, Zachariah Jezman, Beh Kamate, John Munthali, Noella Umulisa, Oumar Yattara]]></dc:creator>
<dc:date>2024-12-20T06:39:28-08:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-23-00509</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-23-00509</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:title><![CDATA[Understanding Integrated Community Case Management Institutionalization Processes Within National Health Systems in Malawi, Mali, and Rwanda: A Qualitative Study]]></dc:title>
<prism:publicationDate>2024-12-20</prism:publicationDate>
<prism:section>ORIGINAL ARTICLE</prism:section>
<prism:volume>12</prism:volume>
<prism:number>6</prism:number>
<prism:issueIdentifier>6</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/12/6/e2300513.short?rss=1">
<title><![CDATA[Early Effects of Information Revolution Interventions on Health Information System Performance in Ethiopia]]></title>
<link>http://ghspjournal.org/content/12/6/e2300513.short?rss=1</link>
<description><![CDATA[ABSTRACTHealth information systems (HISs) are essential to a country’s health system as they provide critical support to health policymaking, management, financing, and service delivery. A well-functioning HIS should produce timely and reliable data that are available and easily accessible to decision-makers throughout the health system. Ethiopia has transitioned from a fragmented, paper-based health management information system (HMIS) to a harmonized, digital system used at points of collection and service delivery.In 2016, the Federal Ministry of Health (MOH) launched the Information Revolution (IR), a transformative agenda aimed at enhancing the culture of data use, scaling priority HIS tools and systems, and strengthening HIS governance. Between 2016 and 2022, the MOH, Data Use Partnership, and other partners implemented a series of IR interventions that supported this agenda. These interventions included deploying and harmonizing digital HIS systems; strengthening HIS leadership, coordination, and governance; implementing the IR pathway strategy; enhancing capacity through supportive supervision, mentorship, and training; and improving performance monitoring teams. This article aims to synthesize the key HIS interventions implemented in Ethiopia as part of the IR and document the effects of these interventions on HIS performance.Early studies indicate promising improvements in HIS performance across health facilities in Ethiopia. However, challenges remain. To ensure sustainable progress, it is essential to continue addressing key challenges, such as system interoperability, HIS workforce, and capacity for data use at all levels. By building on the successes of the first Health Sector Transformation Plan and addressing these gaps, Ethiopia can advance its vision of a robust, data-driven health system capable of improving health outcomes and driving evidence-based decision-making.]]></description>
<dc:creator><![CDATA[Barbara Knittel, Heather M. Marlow, Afrah Mohammedsanni, Abebaw Gebeyehu, Hiwot Belay, Wubshet Denboba]]></dc:creator>
<dc:date>2024-12-20T06:39:28-08:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-23-00513</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-23-00513</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:subject><![CDATA[Health Systems]]></dc:subject>
<dc:title><![CDATA[Early Effects of Information Revolution Interventions on Health Information System Performance in Ethiopia]]></dc:title>
<prism:publicationDate>2024-12-20</prism:publicationDate>
<prism:section>FIELD ACTION REPORT</prism:section>
<prism:volume>12</prism:volume>
<prism:number>6</prism:number>
<prism:issueIdentifier>6</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/12/6/e2300517.short?rss=1">
<title><![CDATA[Early Outcomes of Mental Health Screening Integrated Into Routine HIV Care in Malawi]]></title>
<link>http://ghspjournal.org/content/12/6/e2300517.short?rss=1</link>
<description><![CDATA[ABSTRACTMental health (MH) disorders are highly prevalent among people living with HIV and can have a negative impact on antiretroviral therapy (ART) outcomes. Malawi’s Ministry of Health introduced MH screening in national HIV management guidelines in 2022. We describe early experience with integrated MH screening at ART clinics that have scarce human resources and limited capacity of specialist MH units. ART staff in 15 facilities were trained to use the Patient Health Questionnaire-9 (depression) and the Alcohol Use Disorders Identification Test (harmful alcohol use) screening instruments, MH registers were developed for tracking screening results and referrals, and existing MH referral units were engaged. Based on screening results, ART clients received counseling by lay cadre staff (for mild symptoms) or intensive counseling by trained psychosocial counselors and referrals to specialist MH units (for moderate to severe symptoms). From October 2022 through July 2023, 9,826 ART clients were screened from the following priority groups: returning to care after an interruption in treatment (50%), newly diagnosed (38%), and viral load ≥1,000 copies/mL (12%). Of those screened, 59% were female and 14% were aged 12–19 years. Screening coverage was 85% (9,826/11,553) among the 3 priority groups. All of the individuals who screened positive for moderate/severe depression (1.1%; n=106) or high risk for harmful alcohol use (2.3%; n=227) were referred to specialist MH units. In conclusion, thorough preparation led to high MH screening coverage among ART priority groups, and the number of referrals to specialist MH units was low. MH screening was feasible at Malawi ART clinics. Next steps include studying the clinical impact of integrated MH screening on MH outcomes and ART outcomes (retention in care and viral suppression) and scaling up integrated MH screening to all ART clinics.]]></description>
<dc:creator><![CDATA[Elijah Chikuse, Christine Hagstrom, Deanna Smith, Thokozire Banda, Harrison Chimbaka, Zinaumaleka Nkhoma, Martin Samuko, John Lichenya, Risa Hoffman, Joseph Njala, Sam Phiri, Khumbo Phiri, Joep J. van Oosterhout]]></dc:creator>
<dc:date>2024-12-20T06:39:28-08:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-23-00517</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-23-00517</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:subject><![CDATA[HIV/AIDS, Mental Health]]></dc:subject>
<dc:title><![CDATA[Early Outcomes of Mental Health Screening Integrated Into Routine HIV Care in Malawi]]></dc:title>
<prism:publicationDate>2024-12-20</prism:publicationDate>
<prism:section>FIELD ACTION REPORT</prism:section>
<prism:volume>12</prism:volume>
<prism:number>6</prism:number>
<prism:issueIdentifier>6</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/12/6/e2400062.short?rss=1">
<title><![CDATA[mHealth and Digital Innovations as Catalysts for Transforming Mental Health Care in Ghana]]></title>
<link>http://ghspjournal.org/content/12/6/e2400062.short?rss=1</link>
<description><![CDATA[]]></description>
<dc:creator><![CDATA[Enoch Sackey, Angela Ofori-Atta, Sammy Ohene, Kwadwo Obeng, Dror Ben-Zeev]]></dc:creator>
<dc:date>2024-12-20T06:39:28-08:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-24-00062</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-24-00062</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:subject><![CDATA[Digital Health, Mental Health]]></dc:subject>
<dc:title><![CDATA[mHealth and Digital Innovations as Catalysts for Transforming Mental Health Care in Ghana]]></dc:title>
<prism:publicationDate>2024-12-20</prism:publicationDate>
<prism:section>COMMENTARY</prism:section>
<prism:volume>12</prism:volume>
<prism:number>6</prism:number>
<prism:issueIdentifier>6</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/12/6/e2400124.short?rss=1">
<title><![CDATA[No Matter When or Where: Addressing the Need for Continuous Family Planning Services During Shocks and Stressors]]></title>
<link>http://ghspjournal.org/content/12/6/e2400124.short?rss=1</link>
<description><![CDATA[]]></description>
<dc:creator><![CDATA[Sarah Rich, Lily Jacobi, Nesrine Talbi, Ashley Wolfington, Kelly McDonald]]></dc:creator>
<dc:date>2024-12-20T06:39:28-08:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-24-00124</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-24-00124</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:subject><![CDATA[Family Planning and Reproductive Health, Health Systems]]></dc:subject>
<dc:title><![CDATA[No Matter When or Where: Addressing the Need for Continuous Family Planning Services During Shocks and Stressors]]></dc:title>
<prism:publicationDate>2024-12-20</prism:publicationDate>
<prism:section>COMMENTARY</prism:section>
<prism:volume>12</prism:volume>
<prism:number>6</prism:number>
<prism:issueIdentifier>6</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/12/6/2400145.short?rss=1">
<title><![CDATA[The Impact of Health Information System Interventions on Maternal and Child Health Service Utilizations in Ethiopia: A Quasi-Experimental Study]]></title>
<link>http://ghspjournal.org/content/12/6/2400145.short?rss=1</link>
<description><![CDATA[ABSTRACTBackground:Health information systems (HIS) are vital in supporting all aspects of managing health systems, financing, policymaking, and service delivery. A package of priority HIS interventions was piloted in selected woredas across all regions in Ethiopia. This study examined the impact of HIS interventions on maternal and child health (MCH) service utilization.Methods:A 2-arm quasi-experimental study was implemented in intervention and control woredas. Baseline and endline household and health facility surveys were conducted for both arms in 2020 and 2022, respectively. At baseline, 3,016 mothers and 167 health facilities were surveyed. At endline, 3,076 mothers and 160 health facilities were surveyed. The study used modified Performance of Routine Information System Management tools for the facility survey and a structured questionnaire for the household survey. Difference-in-difference (DID) analysis using mixed effect modeling was employed to measure changes and to account for clustering and control for likely confounders.Results:Intervention sites showed greater improvements in 75% of key HIS performance indicators. The changes in 90% of the MCH service utilization indicators were higher in the intervention sites. Significant (DID: P<.05) changes were observed in indicators including quality of antenatal care, skilled birth attendance, delivery at a health facility, family planning met need and unmet need, measles and second dose of rotavirus vaccination, and Vitamin A supplementation. BCG vaccination showed significantly higher improvement in the control sites. Other key indicators did not show significant changes.Conclusions:In many of the MCH service utilization indicators, the changes in the intervention sites were significantly higher compared to the control sites, but it was not universal. Scale-up of performance monitoring teams is crucial because it is one of the key pathways that links HIS performance with MCH service utilization. Outcome indicators that showed no or lower improvement require in-depth investigation.]]></description>
<dc:creator><![CDATA[Abebaw Gebeyehu Worku, Wubshet Denboba Midekssa, Hibret Alemu Tilahun, Hiwot Tadesse Belay, Zeleke Abebaw, Afrah Mohammedsanni, Naod Wendrad, Mesoud Mohammed, Shemsedin Omer Mohammed, Amanuel Biru, Benti Ejeta Futassa]]></dc:creator>
<dc:date>2024-12-20T06:39:28-08:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-24-00145</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-24-00145</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:subject><![CDATA[Maternal, Newborn, and Child Health, Health Systems]]></dc:subject>
<dc:title><![CDATA[The Impact of Health Information System Interventions on Maternal and Child Health Service Utilizations in Ethiopia: A Quasi-Experimental Study]]></dc:title>
<prism:publicationDate>2024-12-20</prism:publicationDate>
<prism:section>ORIGINAL ARTICLE</prism:section>
<prism:volume>12</prism:volume>
<prism:number>6</prism:number>
<prism:issueIdentifier>6</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/12/6/e2400156.short?rss=1">
<title><![CDATA[Towards Ending AIDS: The Additional Role of HIV Self-Testing in Thailand]]></title>
<link>http://ghspjournal.org/content/12/6/e2400156.short?rss=1</link>
<description><![CDATA[Background:In 2022, 10% of an estimated 560,000 people living with HIV in Thailand were unaware of their HIV status. A well-established HIV program is a solid platform for integrating HIV self-testing (HST) as part of efforts to end AIDS. We analyzed how HST was integrated into the national HIV program and became a benefit package.Policy Adoption of HST:In 2015, the National AIDS Prevention and Alleviation Committee included HST as a strategy to end HIV/AIDS by 2030. This led to collaboration between the Department of Disease Control (DDC), Food and Drug Administration (FDA), and partner networks, including civil society organizations, to amend policy regulations, allowing HIV testing outside health care facilities and facilitating HST registration. By 2024, 4 HST commercial products were registered by the Thai FDA.Program Pilots:In 2020, the DDC launched pilot programs distributing HST kits through private pharmacies in Bangkok and online platforms. Preliminary findings showed feasibility in reaching key populations and adolescents. In 2023, HST was included in the Universal Health Coverage benefit package, providing free access to all citizens. Guidelines, e-learning, public awareness campaigns, and a reimbursement system of HST were developed and implemented. By September 2024, over 166,000 users had received HST kits.Lessons Learned:Leadership, scientific evidence, feasibility testing through pilots, regulatory adjustments, licensing, price negotiations by the National Health Security Office, and stakeholder and community engagement were key to the program’s success. A nationwide distribution network through public and private health care facilities, including pharmacies, was a key enabling factor for HST delivery.Conclusions:HST is an additional intervention to increase awareness of HIV status and a key component in Thailand’s effort to end HIV/AIDS.]]></description>
<dc:creator><![CDATA[Cheewanan Lertpiriyasuwat, Patsaya Mookleemas, Naparat Pattarapayoon, Darinda Rosa, Viroj Tangcharoensathien]]></dc:creator>
<dc:date>2024-12-20T06:39:28-08:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-24-00156</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-24-00156</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:subject><![CDATA[HIV/AIDS]]></dc:subject>
<dc:title><![CDATA[Towards Ending AIDS: The Additional Role of HIV Self-Testing in Thailand]]></dc:title>
<prism:publicationDate>2024-12-20</prism:publicationDate>
<prism:section>PROGRAM CASE STUDY</prism:section>
<prism:volume>12</prism:volume>
<prism:number>6</prism:number>
<prism:issueIdentifier>6</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/12/6/e2400158.short?rss=1">
<title><![CDATA[Recommendations for Using Health Service Coverage Cascades to Measure Effective Coverage for Maternal, Newborn, Child, and Adolescent Health Services or Interventions]]></title>
<link>http://ghspjournal.org/content/12/6/e2400158.short?rss=1</link>
<description><![CDATA[]]></description>
<dc:creator><![CDATA[Kathleen Strong, Georgia Konstantinou, Ambrose Agweyu, Theresa Diaz, Debra Jackson, Minjoon Kim, Shogo Kubota, Hannah Leslie, Marzia Lazzerini, Tanya Marchant, Melinda Munos, Moise Muzigaba, Alicia Quach, Ashley Sheffel, Nuhu Yaqub, Jr.,  for the Life Stages Quality of Care Metrics Technical Working Group for Maternal, Newborn, Child and Adolescent Health and Ageing]]></dc:creator>
<dc:date>2024-12-20T06:39:28-08:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-24-00158</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-24-00158</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:subject><![CDATA[Maternal, Newborn, and Child Health, Adolescents and Youth]]></dc:subject>
<dc:title><![CDATA[Recommendations for Using Health Service Coverage Cascades to Measure Effective Coverage for Maternal, Newborn, Child, and Adolescent Health Services or Interventions]]></dc:title>
<prism:publicationDate>2024-12-20</prism:publicationDate>
<prism:section>VIEWPOINT</prism:section>
<prism:volume>12</prism:volume>
<prism:number>6</prism:number>
<prism:issueIdentifier>6</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/12/6/e2400166.short?rss=1">
<title><![CDATA[Health System Factors Influencing the Integration of Pre-Exposure Prophylaxis into Antenatal and Postnatal Clinic Services in Cape Town, South Africa]]></title>
<link>http://ghspjournal.org/content/12/6/e2400166.short?rss=1</link>
<description><![CDATA[ABSTRACTIntroduction:Oral pre-exposure prophylaxis (PrEP) is an effective and safe option to prevent HIV acquisition and vertical HIV transmission in pregnant and breastfeeding women. Understanding health system factors influencing the integration of PrEP into care for pregnant and breastfeeding women is key to increasing access. We explored managers’ and health care workers’ (HCWs) experiences with integrating PrEP into antenatal care and postnatal care services in primary health care clinics in Cape Town, South Africa.Methods:This exploratory qualitative study used codebook thematic analysis, where HCWs were purposively, heterogeneously sampled from an implementation science study. Semistructured individual interviews were conducted with 9 managerial-level staff, and 3 focus group discussions were conducted with HCWs (nurses, midwives, and HIV counselors) providing PrEP (6–7 HCWs per group) between November 2022 and January 2023 (N=28). Interview guides covered health system facilitators, barriers, and recommendations. The Health Systems Dynamics framework guided data analysis and presentation of results.Results:PrEP integration into antenatal care services was described as acceptable and feasible; however, changes to HIV testing policy and indicators in breastfeeding women are needed to integrate PrEP into postnatal clinics, together with identification of mother and baby as a dyad in visits. Results showed that supportive policies facilitated wider, simplified PrEP provision. The availability and accessibility of prescribing nurses and lay HIV counselors, PrEP (both within facilities and in communities), and information about PrEP for implementers and pregnant and breastfeeding women will be pivotal to facilitating integration.Conclusion:Facilitators for PrEP integration include task-shifting PrEP education and identification of women for PrEP initiation to HIV counselors, changes to national guidelines defining who can prescribe PrEP, revision and integration of PrEP training for HCWs, community-level interventions for PrEP demand creation and stigma reduction, and provision of differentiated PrEP delivery options.]]></description>
<dc:creator><![CDATA[Lara Court, Aurelie Nelson, Reghana Taliep, Sarah Schoetz Dean, Rufaro Mvududu, Lucia Knight, Kathryn Dovel, Thomas Coates, Landon Myer, Dvora L. Joseph Davey]]></dc:creator>
<dc:date>2024-12-20T06:39:28-08:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-24-00166</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-24-00166</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:subject><![CDATA[HIV/AIDS, Maternal, Newborn, and Child Health, Health Systems]]></dc:subject>
<dc:title><![CDATA[Health System Factors Influencing the Integration of Pre-Exposure Prophylaxis into Antenatal and Postnatal Clinic Services in Cape Town, South Africa]]></dc:title>
<prism:publicationDate>2024-12-20</prism:publicationDate>
<prism:section>ORIGINAL ARTICLE</prism:section>
<prism:volume>12</prism:volume>
<prism:number>6</prism:number>
<prism:issueIdentifier>6</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/12/6/e2400187.short?rss=1">
<title><![CDATA[Simulation-Based Education of Health Workers in Low- and Middle-Income Countries: A Systematic Review]]></title>
<link>http://ghspjournal.org/content/12/6/e2400187.short?rss=1</link>
<description><![CDATA[ABSTRACTIntroduction:Simulation-based education (SBE) is increasingly used to improve clinician competency and patient care and has been identified as a priority by the World Health Organization for low- and middle-income countries (LMICs). The primary aim of this review was to investigate the global distribution and effectiveness of SBE for health workers in LMICs. The secondary aim was to determine the learning focus, simulation modalities, and additional evaluation conducted in included studies.Methods:A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta Analysis guidelines, searching Ovid (Medline, Embase, and Emcare) and the Cochrane Library from January 1, 2002, to March 14, 2022. Primary research studies reporting evaluation at Level 4 of The Kirkpatrick model were included. Studies on simulation-based assessment and validation were excluded. Quality and risk-of-bias assessments were conducted using appropriate tools. Narrative synthesis and descriptive statistics were used to present the results.Results:A total of 97 studies were included. Of these, 54 were in sub-Saharan Africa (56%). Forty-seven studies focused on neonatology (48%), 29 on obstetrics (30%), and 16 on acute care (16%). Forty-nine used mannequins (51%), 46 used scenario-based simulation (47%), and 21 used synthetic part-task trainers (22%), with some studies using more than 1 modality. Sixty studies focused on educational programs (62%), while 37 used SBE as an adjunct to broader interventions and quality improvement initiatives (38%). Most studies that assessed for statistical significance demonstrated at least partial improvement in Level 4 outcomes (75%, n=81).Conclusion:SBE has been widely applied to improve outcomes in a variety of contexts across LMICs. Modalities of simulation are typically low-technology versions. However, there is a lack of standardized reporting of educational activities, particularly relating to essential features of SBE. Further research is required to determine which approaches are effective in specific contexts.]]></description>
<dc:creator><![CDATA[Samuel J.A. Robinson, Angus M.A. Ritchie, Maurizio Pacilli, Debra Nestel, Elizabeth McLeod, Ramesh Mark Nataraja]]></dc:creator>
<dc:date>2024-12-20T06:39:28-08:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-24-00187</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-24-00187</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:subject><![CDATA[Health Workers]]></dc:subject>
<dc:title><![CDATA[Simulation-Based Education of Health Workers in Low- and Middle-Income Countries: A Systematic Review]]></dc:title>
<prism:publicationDate>2024-12-20</prism:publicationDate>
<prism:section>REVIEW</prism:section>
<prism:volume>12</prism:volume>
<prism:number>6</prism:number>
<prism:issueIdentifier>6</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/12/6/e2400207.short?rss=1">
<title><![CDATA[Advocating for Lesbian, Gay, Bisexual, and Transgender Youth Sexual and Reproductive Health and Rights in Central Asia]]></title>
<link>http://ghspjournal.org/content/12/6/e2400207.short?rss=1</link>
<description><![CDATA[]]></description>
<dc:creator><![CDATA[Ulukbek Batyrgaliev]]></dc:creator>
<dc:date>2024-12-20T06:39:28-08:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-24-00207</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-24-00207</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:subject><![CDATA[Family Planning and Reproductive Health]]></dc:subject>
<dc:title><![CDATA[Advocating for Lesbian, Gay, Bisexual, and Transgender Youth Sexual and Reproductive Health and Rights in Central Asia]]></dc:title>
<prism:publicationDate>2024-12-20</prism:publicationDate>
<prism:section>VIEWPOINT</prism:section>
<prism:volume>12</prism:volume>
<prism:number>6</prism:number>
<prism:issueIdentifier>6</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/12/6/e2400208.short?rss=1">
<title><![CDATA[Service Delivery Redesign for Noncommunicable Disease Management: Assessment of Needs and Solutions Through a Co-Creation Process in Argentina]]></title>
<link>http://ghspjournal.org/content/12/6/e2400208.short?rss=1</link>
<description><![CDATA[ABSTRACTIntroduction:In Argentina, the implementation of a national strategy to reduce the prevalence of noncommunicable diseases (NCDs) has been hampered by challenges at the provincial level. We aimed to design a new model of care for NCDs at the primary care level by conducting a multimodal system assessment and co-design of potential solutions in the province of Mendoza.Methods:We carried out a mixed-methods study with 7 components: evaluation of patterns of care, patient focus groups, cross-sectional standardized population-based phone survey, an electronic cohort follow-up of patients with type 2 diabetes, in-depth interviews with stakeholders, a knowledge test for health care providers on chronic condition management, and a Delphi consensus to provide recommendations from stakeholders.Results:Focus group and in-depth interviews revealed access to primary health care for NCDs was associated with problems with long waiting times and time-consuming procedures for referral to laboratory tests, hospital care, and provision of medication. Mental health care services were particularly limited. Survey respondents (N=1,190) were predominantly covered through public (41%) or social security sectors (54%); 41% fell in the lowest income group. Contact with the health system was high (5.7 annual visits), but 19.7% reported unmet health care needs. Public sector providers perceived they provided high-quality care despite insufficient material and human resources. Within the social security sector, the main challenge was insufficient staff, particularly affecting mental health care. Health care providers showed a higher percentage of correct answers to depression-related questions, but worse results were seen in hypertension and diabetes care. Actions supported by evidence and expert agreement were identified for implementation to guide future system changes.Conclusion:Our research highlights the potential for Argentina’s primary care system to initiate transformative, system-level changes aimed at improving health outcomes. We propose an innovative methodological assessment and co-design for improving primary care.]]></description>
<dc:creator><![CDATA[Agustina Mazzoni, Javier Roberti, Marina Guglielmino, Ana Maria Nadal, Yanina Mazzaresi, Andrea Falaschi, Patricia J. Garcia, Laura Espinoza&ndash;Pa&#x0237;uelo, Jesus Medina&ndash;Ranilla, Hannah H. Leslie, Juan Manuel Gomez Portillo, Maria Gabriela Masier, Ezequiel Garcia&ndash;Elorrio]]></dc:creator>
<dc:date>2024-12-20T06:39:28-08:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-24-00208</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-24-00208</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:subject><![CDATA[Noncommunicable Diseases, Primary Health Care]]></dc:subject>
<dc:title><![CDATA[Service Delivery Redesign for Noncommunicable Disease Management: Assessment of Needs and Solutions Through a Co-Creation Process in Argentina]]></dc:title>
<prism:publicationDate>2024-12-20</prism:publicationDate>
<prism:section>ORIGINAL ARTICLE</prism:section>
<prism:volume>12</prism:volume>
<prism:number>6</prism:number>
<prism:issueIdentifier>6</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/12/6/e2400210.short?rss=1">
<title><![CDATA[Using the 5C Vaccine Hesitancy Framework to Elucidate and Measure Contraceptive Acceptability in sub-Saharan Africa]]></title>
<link>http://ghspjournal.org/content/12/6/e2400210.short?rss=1</link>
<description><![CDATA[]]></description>
<dc:creator><![CDATA[Lotus McDougal, Caroline Deignan, Peter Kisaakye, Courtney McLarnon, Rebecka Lundgren, Shannon Pryor, Madeleine Short Fabic]]></dc:creator>
<dc:date>2024-12-20T06:39:28-08:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-24-00210</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-24-00210</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:subject><![CDATA[Family Planning and Reproductive Health]]></dc:subject>
<dc:title><![CDATA[Using the 5C Vaccine Hesitancy Framework to Elucidate and Measure Contraceptive Acceptability in sub-Saharan Africa]]></dc:title>
<prism:publicationDate>2024-12-20</prism:publicationDate>
<prism:section>COMMENTARY</prism:section>
<prism:volume>12</prism:volume>
<prism:number>6</prism:number>
<prism:issueIdentifier>6</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/12/6/e2400220.short?rss=1">
<title><![CDATA[Recognizing and Addressing the Contraceptive Hesitancy-Acceptability Continuum: Adopting Lessons Learned From the Immunization Field]]></title>
<link>http://ghspjournal.org/content/12/6/e2400220.short?rss=1</link>
<description><![CDATA[]]></description>
<dc:creator><![CDATA[Madeleine Short Fabic, Amy Ong Tsui]]></dc:creator>
<dc:date>2024-12-20T06:39:28-08:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-24-00220</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-24-00220</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:subject><![CDATA[Family Planning and Reproductive Health]]></dc:subject>
<dc:title><![CDATA[Recognizing and Addressing the Contraceptive Hesitancy-Acceptability Continuum: Adopting Lessons Learned From the Immunization Field]]></dc:title>
<prism:publicationDate>2024-12-20</prism:publicationDate>
<prism:section>COMMENTARY</prism:section>
<prism:volume>12</prism:volume>
<prism:number>6</prism:number>
<prism:issueIdentifier>6</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/12/6/e2400228.short?rss=1">
<title><![CDATA[Accelerating Progress in Women&#x2019;s Sexual and Reproductive Health and Rights Decision-Making: Trends in 32 Low- and Middle-Income Countries and Future Perspectives]]></title>
<link>http://ghspjournal.org/content/12/6/e2400228.short?rss=1</link>
<description><![CDATA[ABSTRACTIntroduction:In 1994, the International Conference on Population and Development (ICPD) Programme of Action established the empowerment and autonomy of women as fundamental to achieving sustainable economic and social progress. Three decades later, significant strides have been made in enhancing sexual and reproductive health and rights (SRHR). However, deep-rooted gender inequality continues to impede substantial progress for many. We assess the advancements made under the Sustainable Development Goals, specifically through indicator 5.6.1, which measures women’s SRHR decision-making.Methods:Using data from 76 Demographic and Health Surveys and 1 Multiple Indicator Cluster Survey in 32 low- and middle-income countries from 2006 to 2022, the study analyzed trends in women’s SRHR decision-making and its subcomponents of autonomy on reproductive health care, contraceptive use, and sexual relations—among married or in-union women aged 15–49 years currently using contraception. The analysis also examined trends in decision-making disparities related to household wealth quintiles, women’s education levels, and area of residence, using disaggregated population-weighted percentages.Results:Analysis revealed a generally positive trend in women’s SRHR decision-making, with gains observed in Eastern and Southern Africa and notable declines in West and Central Africa. Subindicator disparities showed variations in autonomy across health care, contraception, and the ability to refuse sex. An inequality analysis highlighted that while some countries saw a narrowing wealth gap in decision-making, others faced growing disparities. Educational and urban-rural divides also shifted, reflecting a complex landscape of progress and challenges in improving women’s SRHR decision-making.Conclusion:The analysis underscores a patchwork of progress in women’s SRHR decision-making while also exposing deep disparities. These data suggest a critical need for interventions tailored to cultural and socioeconomic contexts, particularly in countries and subnational areas lagging behind. Forward-thinking strategies must prioritize enhancing women’s reproductive agency, ensuring interventions are informed by community-tailored priorities and global human rights standards.]]></description>
<dc:creator><![CDATA[Mengjia Liang, Lindsay Katz, Emilie Filmer-Wilson, Priscilla Idele]]></dc:creator>
<dc:date>2024-12-20T06:39:28-08:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-24-00228</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-24-00228</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:subject><![CDATA[Family Planning and Reproductive Health]]></dc:subject>
<dc:title><![CDATA[Accelerating Progress in Women&#x2019;s Sexual and Reproductive Health and Rights Decision-Making: Trends in 32 Low- and Middle-Income Countries and Future Perspectives]]></dc:title>
<prism:publicationDate>2024-12-20</prism:publicationDate>
<prism:section>SHORT REPORT</prism:section>
<prism:volume>12</prism:volume>
<prism:number>6</prism:number>
<prism:issueIdentifier>6</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/12/6/e2400242.short?rss=1">
<title><![CDATA[Emergency Obstetric Care Access Dynamics in Kampala City, Uganda: Analysis of Women&#x2019;s Self-Reported Care-Seeking Pathways]]></title>
<link>http://ghspjournal.org/content/12/6/e2400242.short?rss=1</link>
<description><![CDATA[ABSTRACTIntroduction:Timely access to emergency obstetric care (EmOC) remains a challenge in sub-Saharan Africa, influenced by poor health care utilization and rapid urbanization. Studies show poor maternal health outcomes in African cities, reflecting weak health systems. Understanding care-seeking pathways is key to improving service delivery and health outcomes. We examined self-reported care-seeking pathways among women with obstetric complications in Kampala City, Uganda.Methods:In this cross-sectional survey, we collected sequential data from 433 women (15–49 years) from 9 health facilities in Kampala City. We developed typologies of common pathways to EmOC and descriptively analyzed key attributes, including median time spent at each step, comparing pathways across complications and participant characteristics. Provider utilization and service delivery performance issues were also assessed.Results:Participants’ average age was 26 years (standard deviation=6), with 55% (237/433) living outside Kampala. We identified 4 common pathways based on number and location of steps: pathways with 1 step, directly to a facility that provided required care (42%, 183/433); 2 steps, mostly including direct facility referrals (40%, 171/433); 3 steps (14%, 62/433); and 4 or more steps (4%, 17/433). Comprehensive EmOC facilities referred elsewhere 43% (79/184) of women who initially sought care in these facilities. Peripheral facilities referred 65% of women directly to the national referral hospital. A majority (60%, 34/57) of referred women returned home before reaching the final care facility.Conclusions:Our findings suggest that care pathways of women with obstetric complications in Kampala often involve at least 2 formal providers and reflect possible inefficiencies in the referral process, including potential delays and unnecessary steps. Efforts to strengthen urban health and referral systems should adopt multidisciplinary and integrated approaches, supported by clear policies and structures that facilitate effective interfacility and interdistrict care coordination. This should include streamlined care/referral pathways and equitable emergency transportation systems.]]></description>
<dc:creator><![CDATA[Catherine Birabwa, Lenka Be&#x0148;ova, Josefien van Olmen, Aline Semaan, Peter Waiswa, Aduragbemi Banke&ndash;Thomas]]></dc:creator>
<dc:date>2024-12-20T06:39:28-08:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-24-00242</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-24-00242</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:subject><![CDATA[Maternal, Newborn, and Child Health, Health Systems]]></dc:subject>
<dc:title><![CDATA[Emergency Obstetric Care Access Dynamics in Kampala City, Uganda: Analysis of Women&#x2019;s Self-Reported Care-Seeking Pathways]]></dc:title>
<prism:publicationDate>2024-12-20</prism:publicationDate>
<prism:section>ORIGINAL ARTICLE</prism:section>
<prism:volume>12</prism:volume>
<prism:number>6</prism:number>
<prism:issueIdentifier>6</prism:issueIdentifier>
</item>
<item rdf:about="http://ghspjournal.org/content/12/6/e2400254.short?rss=1">
<title><![CDATA[Hybrid Mentorship of Medical Laboratories to Achieve ISO 15189:2012 Accreditation in Malawi: The University of Maryland Malawi Experience]]></title>
<link>http://ghspjournal.org/content/12/6/e2400254.short?rss=1</link>
<description><![CDATA[ABSTRACTIntroduction:As part of a laboratory strengthening program in Malawi to achieve and maintain International Organization for Standardization (ISO) 15189 accreditation, we intended to mentor selected HIV molecular laboratories to achieve this accreditation. Due to the COVID-19 pandemic, mentorship pivoted to a hybrid model using an Internet-based approach and on-site mentorships. We describe the implementation of this strategy, successes, and challenges.Methods:We conducted weekly, 1-hour virtual mentorship sessions for the 5 initial laboratories (cohort 1) selected based on their Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) performance score of 3 or more stars. Laboratories presented updates and supporting documents electronically, and trainings were conducted virtually. In September 2020, when travel restrictions were relaxed, we initiated hybrid mentorships and audits for cohort 1 laboratories. The same hybrid approach was used to mentor 4 additional laboratories in cohort 2. We performed descriptive analysis, and the Wilcoxon signed-rank test was used to compare the training pre-and post-test scores.Results:Between March 2020 and May 2023, the team completed a total of 54 virtual mentorship sessions and 20 on-site visits across 9 laboratories. Overall, the team conducted 8 training sessions for 35 laboratory quality officers. Median score improvement (pre-test vs. post-test scores) was observed across individual trainings and across cohorts (P<.01). At the end of cohort 1, 4 of 5 (80%) laboratories were accredited. One laboratory that did not reach accreditation joined cohort 2. At the end of the mentoring period, all 5 cohort 2 laboratories were accredited.Conclusions:We demonstrated that using a hybrid mentorship model for accreditation was a successful strategy during the COVID-19 pandemic. For the first time in Malawi, this strategy resulted in accrediting 9 of the 10 HIV molecular laboratories in 3 years at a reduced cost. Continuous mentorship is key in the maintenance of accreditation.]]></description>
<dc:creator><![CDATA[Hannaniah Moyo, Sophia Osawe, Charles Nyangulu, Philemon Ndhlovu, Visopo Harawa, Oscar Divala, Malango Msukwa, Talishiea Croxton, Natalia Blanco, Dyson Mwandama, Memory Mkandawire, Elizabeth Kampira, Muluken Kaba, Alice Maida, Andrew F. Auld, Lindsay Kim, Reuben Mwenda, Howard Kress, James Kandulu, Thresa Sumani, Joseph Bitilinyu, Thokozani Kalua, Alash&#x2019;le Abimiku]]></dc:creator>
<dc:date>2024-12-20T06:39:28-08:00</dc:date>
<dc:identifier>info:doi/10.9745/GHSP-D-24-00254</dc:identifier>
<dc:identifier>hwp:master-id:ghsp;GHSP-D-24-00254</dc:identifier>
<dc:publisher>Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs</dc:publisher>
<dc:subject><![CDATA[HIV/AIDS]]></dc:subject>
<dc:title><![CDATA[Hybrid Mentorship of Medical Laboratories to Achieve ISO 15189:2012 Accreditation in Malawi: The University of Maryland Malawi Experience]]></dc:title>
<prism:publicationDate>2024-12-20</prism:publicationDate>
<prism:section>ORIGINAL ARTICLE</prism:section>
<prism:volume>12</prism:volume>
<prism:number>6</prism:number>
<prism:issueIdentifier>6</prism:issueIdentifier>
</item>
</rdf:RDF>