Health Workers
- Implementation of a Pediatric Early Warning Score to Improve Communication and Nursing Empowerment in a Rural District Hospital in Rwanda
Implementation of the Pediatric Early Warning Score for Resource-Limited Settings tool improved nurses’ competency and confidence in their triage capabilities. This tool has the potential to improve patient outcomes. However, staff turnover and limited physician buy-in were barriers to sustainability of the tool in low-resource settings.
- Counseling Is a Relationship Not Just a Skill: Re-conceptualizing Health Behavior Change Communication by India’s Accredited Social Health Activists
The capacity for India’s community health workers—accredited social health activists (ASHAs)—to promote healthy behaviors must be understood within the health system and community context. Their ability to influence health behaviors depends on the strength of their relationships with families and support they receive from the health system.
- Bringing Greater Precision to Interactions Between Community Health Workers and Households to Improve Maternal and Newborn Health Outcomes in India
We identified how the quantity and quality of actions taken by community health workers can be refined to move from a one-size-fits-all model to a precision approach that stands to benefit the health of the mothers and newborns they support.
- Practical Implications of Policy Guidelines: A GIS Model of the Deployment of Community Health Volunteers in Madagascar
Geographic information systems can be used to support informed decisions about practical issues related to implementing community health worker (CHW) programs. Demands placed on CHWs regarding expected population and surface area coverage and travel time to facilities need to be carefully considered to ensure they are rational and realistic.
- Private Providers’ Experiences Implementing a Package of Interventions to Improve Quality of Care in Kenya: Findings From a Qualitative Evaluation
Although private providers felt that social franchising, quality improvement interventions, and accreditation helped them to increase the quantity and quality of services in their facilities, the quality improvement process was viewed as prohibitively expensive, and the accreditation process often was complex and difficult to navigate without outside assistance.
- Using Patient-Reported Outcome Measures to Promote Patient-Centered Practice: Building Capacity Among Pediatric Physiotherapists in Rwanda
Tracking outcomes is integral to assessing effectiveness of health systems. Multimodal training was offered in the use of a contextually appropriate, patient-centered outcome measure in a low-resource setting. Results offer insights for designing future capacity-building programs.
- Insights Into Provider Bias in Family Planning from a Novel Shared Decision Making Based Counseling Initiative in Rural, Indigenous Guatemala
Race, ethnicity, and indigenous status should be considered as potential drivers of provider bias in family planning services globally. Efforts to confront provider bias in family planning counseling should include concrete strategies that promote provider recognition of biases and longitudinal curriculums that allow for sustained feedback and self-reflection.
- Provider-Initiated Family Planning Within HIV Services in Malawi: Did Policy Make It Into Practice?
Four years after Malawi embraced a policy of provider-initiated family planning (PIFP) within its HIV Clinical Guidelines, this policy remained largely unimplemented at the health facility level. Strengthening PIFP in Malawi’s public and private health facilities will require targeted and comprehensive systems changes.
- Provider Bias in Family Planning Services: A Review of Its Meaning and Manifestations
Provider bias, including bias regarding client age, parity, and marital status, persists as an important barrier to contraceptive choice and access. Newer approaches to mitigate bias that have moved beyond training and guideline development to more fundamental behavior change show promise.
- Three Waves of Data Use Among Health Workers: The Experience of the Better Immunization Data Initiative in Tanzania and Zambia
Data quality and use rollout in Tanzania's and Zambia's immunization programs progressed along 3 phases—from strengthening data collection, to improving data quality, to increasing data use for programmatic decision making cultivating a culture of data use.