Health Workers
- The Quality of Postabortion Care in Tanzania: Service Provider Perspectives and Results From a Service Readiness Assessment
Of the approximately 2,000 postabortion care (PAC) clients treated over 6 months in 2016, 55% chose a contraceptive method before discharge. Gaps in PAC availability and quality spanned multiple domains including human resource capacity and availability of supplies and contraceptives. While PAC providers generally expressed commitment to providing high-quality care, several facility and systems factors constrained their efforts, including limited training and facility space, lack of time, and supply chain challenges.
- Successfully Engaging Private Providers to Improve Diagnosis, Notification, and Treatment of TB and Drug-Resistant TB: The EQUIP Public-Private Model in Chennai, India
Based on a participatory program design that addressed the self-described needs of private providers, a local NGO offered the providers access to rapid diagnostics and support for notification and patient treatment including free anti-TB drugs. The model resulted in high provider participation, contributing more than 10% of the overall TB case notifications, and an 89% treatment success rate for drug-sensitive TB.
- Strengthening and Institutionalizing the Leadership and Management Role of Frontline Nurses to Advance Universal Health Coverage in Zambia
Through a 12-month blended learning program, nurses and nurse-midwives leading low-resource health facilities at the community level improved their capacity to engage community members, increased their ability to lead frontline teams, strengthened their skills and confidence in technology use, and optimized investments in the community health system to achieve high-quality services.
- Adaptation of the Training Resource Package to Strengthen Preservice Family Planning Training for Nurses and Midwives in Tanzania and Uganda
Lessons learned when adapting the evidence-based global family planning training resource package included the need to: (1) engage key nursing and midwifery educators for buy-in; (2) update the technical skills of educators in contraceptive technology and competency-based training methods; and (3) adapt to the local context including condensing the global content for the time-limited preservice education context.
- Effectiveness of SMS Technology on Timely Community Health Worker Follow-Up for Childhood Malnutrition: A Retrospective Cohort Study in sub-Saharan Africa
In Ghana, Rwanda, Senegal, and Uganda, we found positive association between community health workers (CHWs) using SMS data entry with reminder alerts and timely follow-up for childhood malnutrition screening visits compared with paper forms. This association was strongest when CHWs used SMS data entry consecutively over multiple visits than when they switched between SMS and paper forms.
- Improving Contraceptive Access, Use, and Method Mix by Task Sharing Implanon Insertion to Frontline Health Workers: The Experience of the Integrated Family Health Program in Ethiopia
Between 2009 and 2015, 1.2 million women received Implanon implants from trained Health Extension Workers. Of the approximately 7,000 implant service visits made during the first 6 months, 25% were among women who had never used contraception before.
- An NGO-Implemented Community–Clinic Health Worker Approach to Providing Long-Term Care for Hypertension in a Remote Region of Southern India
Paid community health workers screened for hypertension in the community, referred cases to the clinic for diagnosis and initial treatment by a physician, and then monitored patients who had well-controlled blood pressure including dispensing maintenance medications prescribed by the physician. Blood pressure control was successful in the majority of such patients.
- Using Data to Improve Programs: Assessment of a Data Quality and Use Intervention Package for Integrated Community Case Management in Malawi
Use of simple wall charts by community and facility health workers to collect and visualize data helped inform data-based decision making for community health education activities, tracking stock-outs, staffing decisions, and other programming issues. Since intervention scale-up, however, use of the wall chart has dropped, demonstrating need for continued investment in supportive supervision.
- Large-Scale Evaluation of Quality of Care in 6 Countries of Eastern Europe and Central Asia Using Clinical Performance and Value Vignettes
When providers in 6 different countries were asked how they would care for the same patient, there was wide variation within and between countries. Nevertheless, 11% of the physicians scored over 80%, suggesting good quality of care is possible even with resource constraints. Use of validated clinical vignettes, which can be applied affordably at scale, could help improve quality of services in low- and middle-income countries.
- A Mobile-Based Community Health Management Information System for Community Health Workers and Their Supervisors in 2 Districts of Zambia
Using simple-feature mobile phones, CHWs sent weekly reports on disease caseloads and commodities consumed, ordered drugs and supplies, and sent pre-referral notices to health centers. Supervisors provided feedback to CHWs on referred patient outcomes and received monthly SMS reminders to set up mentoring sessions with the CHWs. Scale-up limitations include: (1) staff shortages at health centers to supervise the CHWs, (2) need for ongoing technical support to troubleshoot challenges with mobile phones and software, and (3) recurring costs for data bundles.