Image: A family planning provider in Tanzania counsels a client of mobile outreach services on IUDs. © 2015 Sala Lewis/EngenderHealth
Global Health: Science and Practice (GHSP), a no-fee, peer-reviewed, open-access journal, is targeted to global health professionals, particularly program implementers, to validate their experiences and program results by peer reviewers and to share them with the greater global health community.
September 2018 | Volume 6 | Number 3
- How can countries end preventable maternal mortality?
- Which single question can help you gain insight into the client experience in sexual and reproductive health clinics?
- Can caregivers and CHWs correctly use mid-upper arm circumference to detect severe acute malnutrition?
- What lessons emerged from implementation of a national school-based HPV vaccination campaign in South Africa?
- Can trained nonphysicians safely and effectively perform tubal occlusion by minilaparotomy?
- How did Bangladesh successfully shift management of drug-resistant TB from hospitals to the community?
Read the September 2018 issue of GHSP to find answers to these questions and more. View a list of all articles by article type below or online.
Visit the GHSP website to read and comment on the articles, and subscribe to receive alerts when new articles and issues are published.
TABLE OF CONTENTS
EDITORIALS
The revised Helping Babies Breathe training package now emphasizes the need for regular practice and quality improvement—an important improvement since more is needed than one-off training to have substantial impact on asphyxia-related newborn mortality.
Carbetocin is more heat stable than oxytocin with at least equivalent efficacy for preventing postpartum hemorrhage. It will certainly be helpful if the supplier can make it available in low-income country settings at a price comparable to oxytocin. But even so, programs will still need oxytocin and other uterotonic medications.
COMMENTARIES
Many countries will need to double, or more than double, their current annual rate of reduction of maternal mortality to ensure sufficient progress toward national targets and the global Sustainable Development Goals. Dedication to the principles and actions of quality, equity, dignity, social justice, and human rights are key.
ORIGINAL ARTICLES
The NPS measures a customer’s likeliness to recommend a company to a friend or colleague on a 0-to-10 scale. Pilot testing in 4 countries suggests the NPS can also be successfully used in nonprofit clinics and among low-literacy populations. Combining the NPS with client demographic and service-use data can provide a powerful tool for identifying populations for whom the client experience can be improved.
Evaluation of the campaign confirmed its feasibility in this setting: it achieved high coverage, few adverse events, and mostly positive media coverage. However, challenges occurred in data and cold chain management. Future implementation requires improved partnerships between government ministries, simplified informed consent, and closer monitoring of social media messaging.
In all 3 countries, nearly all women obtained their method of choice, with more mobile outreach and special family planning day clients having a preexisting preference for implants than static service clients. Clients of all service modalities in all countries reported experiencing most elements of full, free, and informed choice, but there is room for improvement with some aspects, such as counseling about potential side effects and giving clients the opportunity to ask questions.
The combined intervention of free contraceptives plus a set of quality inputs for family planning during the extended perinatal period, including provision of long-acting methods immediately postpartum, had the strongest effect on use of modern contraceptives, especially long-acting methods.
In the 10 countries surveyed, the availability of oral contraceptives, injectables, and condoms varied greatly, and the availability of basic items indicating service readiness, such as guidelines, trained staff, equipment, and certain commodities, was low.
Trained clinical officers—nonphysicians with 3 years of specialized training—conducted the procedure safely and effectively compared with procedures performed by more advanced assistant medical officers. This evidence supports policy change allowing properly trained and supported clinical officers to perform minilaparotomy.
Exposure to family planning messages from religious leaders was significantly associated with higher modern contraceptive use, after accounting for background characteristics and other variables such as myths and misconceptions. Engaging religious leaders to support positive social norms is an important strategy to improving voluntary contraceptive use in Nigeria.
In this pilot introduction setting, trained providers reported higher acceptance and preference for the dedicated inserter compared with the conventional postpartum insertion with forceps, suggesting potential for the dedicated inserter to expand access to postpartum IUDs.
The scale, designed to measure students’ self-assessment of their confidence in 11 competency domains before and after participating in global placements, was found to be reliable and correlated well with an earlier validated scale.
The revised neonatal resuscitation curriculum updates not only the science of resuscitation but also the educational and implementation approaches needed to further enhance neonatal survival, including promoting ongoing practice to retain skills and linkages with quality improvement initiatives.
REVIEWS
Limited studies suggest that with robust program inputs caregivers and CHWs can correctly use mid-upper arm circumference to detect severe acute malnutrition (SAM) and that properly trained and supported CHWs can treat uncomplicated SAM in communities.
SHORT REPORTS
In the 10 hospitals studied, we found that hospital policies, protocols, and interventions only partially align with WHO early newborn care recommendations, and that many hospitals still use outdated and non-medically sound practices.
Local suppliers reported that after doing business with PEPFAR’s global procurement and distribution project for essential HIV/AIDS medicines and supplies, they achieved revenue and asset growth, improved their quality standards, acquired new contracts with other businesses, and hired more employees.
FIELD ACTION REPORTS
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.
Shifting from hospital- to community-based management of drug-resistant TB, increased treatment enrollment, reduced treatment initiation delays, improved follow-up and adherence, and lowered treatment failure, and was associated with higher cure rates and lower mortality.
INNOVATIONS
A new family planning counseling tool uses the simple mnemonic device “NORMAL” to help family planning counselors and providers communicate to their clients key messages about menstrual bleeding changes associated with use of hormonal contraception and the copper IUD
UPDATES
Update of: Marks et al., Review of Grain Fortification Legislation, Standards, and Monitoring Documents
.png)
No hay comentarios:
Publicar un comentario