viernes, 19 de junio de 2015

GHSP Journal, Volume 3, Issue 2 – Sharing Experiences and Results from the Global Health Community

USAID: From the American People
GHSP. GLOBAL HEALTH: SCIENCE AND PRACTICE. Dedicated to what works in global health programs. Photo of women at a clinic.
Photo: A BlueStar social franchisee provider in Senegal talks with prospective clients about service offerings on opening day. Global franchisors MSI and PSI have rapidly scaled their family planning social franchising programs in recent years. © 2012 Nils Elzenga/Marie Stopes International.

June 2015 | Volume 3 | Issue 2

Read the June 2015 issue of GHSP to find answers to these questions and more. View a list of all articles by article type below, or read and download the entire current issue.
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Social franchising has scaled up provision of voluntary family planning, especially long-acting reversible contraceptives, across Africa and Asia at a rapid and remarkable pace. The approach should be pursued vigorously, especially in countries with a significant private-sector presence, to advance the FP2020 goal of providing access to modern contraception to 120 million additional clients by 2020.
Global Health: Science and Practice
Advance preparation of oxytocin not only facilitates rapid administration after delivery to prevent postpartum hemorrhage but also could free health workers to provide immediate neonatal resuscitation to non-breathing newborns within the critical 1-minute time window.
Global Health: Science and Practice


Good knowledge is essential to prevent disease and improve health. Knowledge management (KM) provides a systematic process and tools to promote access to and use of knowledge among health and development practitioners to improve health and development outcomes. KM tools range from publications and resources (briefs, articles, job aids) and products and services (websites, eLearning courses, mobile applications) to training and events (workshops, webinars, meetings) and approaches and techniques (peer assists, coaching, after-action reviews, knowledge cafés).
Tara M Sullivan, Rupali J Limaye, Vanessa Mitchell, Margaret D'Adamo, Zachary Baquet
Building on expressed support from the Prime Minister to the Ministries of Health and Planning, the country's new family planning commitment grew out of: (1) recognition of the impact of family planning on maternal mortality and economic development; (2) knowledge sharing of best practices from other African countries; (3) participatory development of a national strategic plan; (4) strong collaboration between stakeholders; (5) effective advocacy by champions including country and international experts; and (6) increased donor support. The question becomes, will the favorable policy environment translate into effective local programming?
Thibaut Mukaba, Arsene Binanga, Sarah Fohl, Jane T Bertrand
An Institute of Medicine workshop on evaluation design drew on recent evaluations of four complex initiatives (U.S. President's Emergency Plan for AIDS Relief; the Global Fund to Fight AIDS, Tuberculosis and Malaria; the President's Malaria Initiative; and the Affordable Medicines Facility-malaria). Key components for good evaluations: (1) a robust theory of change to understand how and why programs should work; (2) use of multiple analytic methods; and (3) triangulation of evidence to validate and deepen understanding of results as well as synthesis of findings to identify lessons for scale-up or broader application.
Sangeeta Mookherji, Kate Meck


Family-planning social franchising has succeeded in countries with an active private sector serving low- and middle-income clients, with services provided mostly by mid-level providers, such as nurses and midwives. Key support for social franchising includes: clinical training and supportive supervision, help building sustainable businesses, marketing and demand creation, and mechanisms to make services affordable for clients. The forward agenda includes selectively introducing other priority health services, improving cost-effectiveness of the model, and promoting sustainability and health systems integration.
Sarah Thurston, Nirali M Chakraborty, Brendan Hayes, Anna Mackay, Pierre Moon
In just 7 years, Marie Stopes International has scaled up social franchising across Africa and Asia, from 7 countries to 17, cumulatively reaching an estimated 3.75 million clients, including young adults and the poor. In 2014, 68 percent of clients chose long-acting reversible contraceptives, and many clients had not been using modern contraception in the last 3 months. Service quality and efficiency (couple-years of protection delivered per outlet) also improved significantly.
Erik Munroe, Brendan Hayes, Julia Taft
Using an analytical framework to design and implement voluntary medical male circumcision (VMMC) programs can lead to more effective interventions, especially when insights are incorporated from disciplines such as behavioral science and commercial market research. Promising VMMC behavior change practices: (1) address individual, interpersonal, and environmental barriers and facilitators; (2) tailor messages to men's behavior change stage and focus on other benefits besides HIV prevention, such as hygiene and sexual pleasure; (3) include women as a key target audience; (4) engage traditional and religious leaders; (5) use media to promote positive social norms; and (6) deploy community mobilizers to address individual concerns.
Sema K Sgaier, James Baer, Daniel C Rutz, Emmanuel Njeuhmeli, Kim Seifert-Ahanda, Paulin Basinga, Rosie Parkyn, Catharine Laube
Training public-sector providers to treat diarrhea in children with low-osmolarity oral rehydration salts and zinc appeared to be effective. Among private providers, drug-detailing visits by pharmaceutical representatives seemed less effective, particularly in improving knowledge of the correct dosage and duration of zinc treatment. Consistent supplies and sufficient attention to training all health care cadres, especially community health workers who may be new to diarrhea treatment and informal-sector providers who are typically excluded from formal training, are critical to improving knowledge and prescribing behaviors.
Christa L Fischer Walker, Sunita Taneja, Amnesty LeFevre, Robert E Black, Sarmila Mazumder
Community members and health workers recognized the value of spacing and limiting births, but a variety of traditional and gender norms constrain their use of contraception. Limited method choice, persistent side effects, transportation fees, stock-outs, long wait times, and hidden service costs also inhibit contraceptive use.
Didi Bertrand Farmer, Leslie Berman, Grace Ryan, Lameck Habumugisha, Paulin Basinga, Cameron Nutt, Francois Kamali, Elias Ngizwenayo, Jacklin St Fleur, Peter Niyigena, Fidele Ngabo, Paul E Farmer, Michael L Rich
Only about 35 percent of sample households reported receiving immunization, food supplements, pregnancy care information, or nutrition information. Monetary incentives for such product-oriented services as immunization improved performance and may have spillover effects for information-oriented services. Immunization day events and good frontline worker recordkeeping also improved service delivery.
Katrina Kosec, Rasmi Avula, Brian Holtemeyer, Parul Tyagi, Stephanie Hausladen, Purnima Menon
Six key steps for effective transition: (1) develop a roadmap; (2) involve stakeholders; (3) communicate the plan; (4) support midterm evaluations; (5) strengthen financial, technical, and management capacity; and (6) support ongoing monitoring and evaluation. The Eastern Caribbean will need to identify HIV champions, strengthen leadership and management, improve policies to protect key populations, engage the private sector and civil society more, integrate HIV programs into primary care, improve supply chain capacity, and address health worker shortages.
Abigail Vogus, Kylie Graff


Action-oriented research in nutrition, vital to guiding effective policies and programs at scale, is greatly underrepresented in public health journals and, even more so, in nutrition journals.
Judy Pham, David Pelletier


Advance preparation and bedside availability of oxytocin before childbirth was significantly and robustly associated with rapid administration of the utertonic, as recommended to prevent postpartum hemorrhage.
Corrina Moucheraud, Jonathon Gass, Stuart Lipsitz, Jonathan Spector, Priya Agrawal, Lisa R Hirschhorn, Atul Gawande, Bhala Kodkany
Health workers' knowledge of contraceptive side effects increased substantially after the refresher training. The mobile phone approach was convenient and flexible and did not disrupt routine service delivery. Clear limitations of the medium are participants can't practice clinical skills or have interactive discussions. Also, some participants had trouble with network reception.
Abdoulaye Diedhiou, Kate E Gilroy, Carie Muntifering Cox, Luke Duncan, Djimadoum Koumtingue, Sara Pacqué-Margolis, Alfredo Fort, Dykki Settle, Rebecca Bailey

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