viernes, 5 de enero de 2018

GHSP Journal, Volume 5, Issue 4

GHSP Journal, Volume 5, Issue 4

USAID: From the American People

GHSP. GLOBAL HEALTH: SCIENCE AND PRACTICE. Dedicated to what works in global health programs. Photo: A woman checks the blood pressure of a man

December 2017 | Volume 5 | Number 4

Read the December issue of GHSP to find answers to these questions and more. View a list of all articles by article type below or online.
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While modeling approaches seek to draw on the best available evidence to project health impact of improved coverage of specific interventions, uncertainty around the outputs often remains. When the modeling estimates are used for advocacy, these uncertainties should be communicated to policy makers clearly and openly to ensure they understand the model's limits and to maintain their confidence in the process.
Steve Hodgins


Recently published evidence from 2 large studies find that the duration of effectiveness of the etonorgestrel-releasing contraceptive implant to be at least 5 years (compared with the current 3-year label), and for the 20 μg levonorgestrel-releasing intrauterine system at least 7 years (compared with the current 5-year label).
Moazzam Ali, Luis Bahamondes, Sihem Bent Landoulsi
To develop guidance for women at high risk of HIV, WHO carefully considered the risks of maternal morbidity and mortality from unintended pregnancy against possible increased risk of HIV acquisition with injectable use. Among the many challenges: (1) balancing timeliness of changing the guidance against the potential impact of it; (2) engaging a range of stakeholders; (3) translating complex research and policy messages to clients; (4) needing additional research; and (5) monitoring and evaluating successes and challenges with implementing new guidelines.
Leo Han, Eva Patil, Nancy Kidula, Mary Lyn Gaffield, Petrus S. Steyn


Evidence shows that effective prevention of rapid repeat pregnancy among adolescents links adolescent-friendly clinical contraceptive services with non-clinical interventions that contribute to positive youth development.
Maureen Norton, Venkatraman Chandra-Mouli, Cate Lane


MANDATE is a mathematical model designed to estimate the relative impact of different interventions on maternal, fetal, and neonatal lives saved in sub-Saharan Africa and India. A key advantage is that it allows users to explore the contribution of preventive interventions, diagnostics, treatments, and transfers to higher levels of care to mortality reductions, and at different levels of penetration, utilization, and efficacy.
Bonnie Jones-Hepler, Katelin Moran, Jennifer Griffin, Elizabeth M McClure, Doris Rouse, Carolina Barbosa, Emily MacGuire, Elizabeth Robbins, Robert L Goldenberg
Our model suggests that removing progestin-only injectables in Africa would have a net negative effect on maternal health, life expectancy, and mortality under a variety of scenarios.
Maria Isabel Rodriguez, Mary E Gaffield, Leo Han, Aaron B Caughey
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.
Yewondwossen Tilahun, Candace Lew, Bekele Belayihun, Kidest Lulu Hagos, Mengistu Asnake
Promotion of gender policies led to increased hiring of women in supervisory roles in a large indoor residual spraying (IRS) program with no meaningful differences in IRS output between men and women spray operators.
Abigail Donner, Allison Belemvire, Ben Johns, Keith Mangam, Elana Fiekowsky, Jayleen Gunn, Mary Hayden, Kacey Ernst
Jordan's limited method mix, which has shifted toward less effective methods such as withdrawal and condoms, is a likely contributor to the plateau, coupled with social and cultural norms that discourage contraceptive use, such as preference for large family size and pressure to have a child immediately after marriage. Greater investment in social and behavior change and advocacy for stronger programming efforts are warranted.
Esther Spindler, Nisreen Bitar, Julie Solo, Elizabeth Menstell, Dominick Shattuck
A farmer field school program in food-insecure areas had positive impacts on household food security but not child nutritional status. Similar agricultural interventions may benefit food security, but the more difficult-to achieve improvements in child nutrition status may require more focused and integrated programming approaches.
Shannon Doocy, Sarah Cohen, Jillian Emerson, Joseph Menakuntuala, the Jenga Jamaa II Study Team, Jozimo Santos Rocha
Across the 10 countries, 77% of 921,918 women left with a contraceptive method after receiving abortion care. While contraceptive uptake was high among all age groups, adolescents ages 15–19 were less likely to choose a method than women 25 years or older.
Janie Benson, Kathryn Andersen, Joan Healy, Dalia Brahmi


Five models estimate the impact of family planning on health outcomes, but the estimates previously have diverged because the models used different assumptions, inputs, and algorithms. After a collective harmonization process, the models now produce more similar estimates although they retain some minimal differences. These models assist in planning, resource allocation, and evaluation.
Ian Askew, Michelle Weinberger, Aisha Dasgupta, Jacqueline Darroch, Ellen Smith, John Stover, Melanie Yahner
Paid CHWs 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.
Sujatha Sankaran, Prema S Ravi, Yichen Ethel Wu, Sharan Shanabogue, Sangeetha Ashok, Kaylan Agnew, Margaret C Fang, Raman A Khanna, Madhavi Dandu, James D Harrison
Bar codes can help track and trace health products in the supply chain. But to do so efficiently, they should be based on global standards rather than a proprietary system, and the captured data should be integrated into national health information systems to achieve end-to-end data visibility.
Liuichi Hara, Ramy Guirguis, Keith Hummel, Monica Villanueva


A variety of microcephaly case definitions detect high background prevalence in rural Guatemala, which complicates congenital Zika screening efforts. In addition, gestational age is needed for most screening tools but is usually unknown in low-resource settings. Fenton growth curves, originally designed for use in preterm infants, offer a standardized approach to adjust for unknown gestational age and may improve screening efforts.
Anne-Marie Rick, Gretchen Domek, Maureen Cunningham, Daniel Olson, Molly M Lamb, Andrea Jimenez-Zambrano, Gretchen Heinrichs, Stephen Berman, Edwin J Asturias
Helen Smith, Charles Ameh, Pamela Godia, Judith Maua, Kigen Bartilol, Patrick Amoth, Matthews Mathai, Nynke van den Broek


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