Global Health: Science and Practice最新文献

{"title":"Do No Harm: A Review of Social Harms Associated with HIV Partner Notification.","authors":"Dawn Greensides, Kristina Bishop, Liz Manfredini, Vincent Wong","doi":"10.9745/GHSP-D-23-00189","DOIUrl":"10.9745/GHSP-D-23-00189","url":null,"abstract":"<p><strong>Introduction: </strong>HIV partner notification services (PNS) are highly effective in identifying people living with HIV, but the complex risks and repercussions associated with HIV testing and disclosure must be examined. The benefits of assisting people to learn their HIV status and link with treatment or prevention based on their results must be considered alongside the risks of adverse events or social harms.</p><p><strong>Methods: </strong>The study team systematically searched the PubMed, EBSCO, and Web of Science electronic databases (2015-2021), as well as abstracts from the International AIDS Society Conference (2016-2020) and the Conference on Retroviruses and Opportunistic Infections (2015-2020). Fifteen studies and 1 conference abstract met the inclusion criteria for this narrative review.</p><p><strong>Results and discussion: </strong>Incidence of social harms across studies ranged from 0%-6.3%, with the higher range occurring among women with a previous history of intimate partner violence (IPV). The majority of the studies (69%) reported that less than or equal to 1% of participants experienced social harms as a result of PNS. Social harms included relationship dissolution, IPV, and loss of financial support.</p><p><strong>Conclusions: </strong>Evidence from a limited set of studies suggests that although social harms associated with HIV partner notification do occur, they are rare. Considering the rapid global scale-up of PNS, additional research and oversight are needed to provide countries with recommended minimum standards to support providers, clients, and their partners with safe partner notification.</p>","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10749648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138884827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strengthening the Diagnosis and Treatment of Malnutrition Through Increased Nurse Involvement: A Quality Improvement Project From Pediatric Wards in Mozambique.","authors":"Delfina Moçambique, Andreas Schindele, Osvaldo Loquiha, Sónia Martins, Monica Sequene, Amir Seni, Eugénia Macassa, Lara Samuel, Custódio Mondlane, Alex Vilanculo, Matias Epifanio, W Chris Buck","doi":"10.9745/GHSP-D-23-00094","DOIUrl":"10.9745/GHSP-D-23-00094","url":null,"abstract":"<p><strong>Background: </strong>Childhood acute malnutrition continues to be a serious health problem in many low-resource settings in Africa. On pediatric wards in Mozambique, missed opportunities for timely diagnosis and treatment of malnutrition may lead to poor health outcomes. To improve inpatient nutritional care, a quality improvement (QI) project was implemented that aimed to engage pediatric nurses in inpatient malnutrition diagnosis and treatment.</p><p><strong>Methods: </strong>In 2 Mozambican referral hospitals, for 6 months, the Plan-Do-Study-Act framework for QI was implemented to identify key drivers of the following measures: having complete anthropometric evaluation documented at admission, 3 or more weight measurements per hospitalization week, documentation of nutritional therapy for eligible patients, and documentation of referral for outpatient nutritional rehabilitation after discharge. Clinical data were abstracted from hospital charts and entered into an EpiInfo database, including a 3-month observation period after the project, and analyzed retrospectively.</p><p><strong>Results: </strong>A total of 2,208 children from wards other than malnutrition were included in the analysis. Complete anthropometric evaluation at admission improved from 24.4% 2 months before the QI project to 80.1% during and 75.2% in the 3 months after the project (<i>P</i><.001). The percentage of patients with 3 or more weight measurements per hospitalization week rose from 22.3% to 82.8% during and 75.0% after the project (<i>P</i><.001). Documentation of nutritional therapy increased from 58.8% before to 67.1% during and 70.6% after the project (<i>P</i>=.54), and documentation of referral for outpatient nutritional rehabilitation after discharge decreased from 55.9% to 54.9% during and increased to 70.6% after the project, (<i>P</i><.001).</p><p><strong>Conclusion: </strong>Nurse engagement may lead to important advancements in the diagnosis and treatment of acute malnutrition in pediatric wards other than malnutrition in Mozambique. Task-sharing, particularly nurse engagement, in combination with QI methodology, may be considered for wards in similar settings with a high burden of malnutrition.</p>","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10749644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138884830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Skeletal Fluorosis in Northern Tanzania: A Follow-Up Study.","authors":"Anna Foat, Claire Stevens, Grace George, John Massawe, Ally Mhina, William K Gray, Blandina T Mmbaga, Deogratias S Rwakatema, Paul Sallis, Helen Jarvis, Irene Haule, Daniel Benedict, Richard Walker","doi":"10.9745/GHSP-D-22-00342","DOIUrl":"10.9745/GHSP-D-22-00342","url":null,"abstract":"<p><strong>Objectives: </strong>Skeletal fluorosis is a metabolic bone disease caused by excessive exposure to fluoride, predominantly through contamination of drinking water. This study aimed to identify all cases of skeletal fluorosis in Tindigani village situated in Northern Tanzania. This was done following changes in drinking water sources after a previous prevalence study in 2009 in this population.</p><p><strong>Methods: </strong>In a door-to-door cross-sectional study of Tindigani village, a sample of residents was assessed for skeletal fluorosis and dental fluorosis. Diagnosis of skeletal fluorosis was based on pre-defined angles of deformity of the lower limbs. Dental fluorosis was diagnosed and graded using the Thylstrup and Fejerskov Index. Samples from current drinking water sources underwent fluoride analysis.</p><p><strong>Results: </strong>Tindigani village had a population of 1,944 individuals. Of the 1,532 individuals who were screened, 45 had skeletal fluorosis, giving a prevalence of 3.3% (95% CI=2.4, 4.3). Dental fluorosis was present in 82.5% of those examined (95% CI=79.8, 85.3). Dental fluorosis was present in all individuals with skeletal fluorosis and at higher grades than in the rest of the population. Drinking water samples were collected from 28 sources. These included piped, surface, well, and borehole water sources. Fluoride concentrations ranged from 0.45-38.59 mg/L of fluoride.</p><p><strong>Conclusions: </strong>Skeletal fluorosis is an ongoing but preventable health problem in the current population. The delivery of sustainable low fluoride piped water to this community would be of clear health benefit. This has been addressed at a local level.</p>","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10749641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138884828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advocacy as a Tool for Advancing Family Planning in the Democratic Republic of the Congo: A Case Study.","authors":"Arsene Binanga, Grace Matawa, Jennifer Racher, Protais Musindo, Jane T Bertrand","doi":"10.9745/GHSP-D-23-00021","DOIUrl":"10.9745/GHSP-D-23-00021","url":null,"abstract":"<p><p>The national strategic plan for family planning (FP) in the Democratic Republic of the Congo (DRC) calls for an increase in modern contraceptive prevalence in 2025. The DRC's size and weak health infrastructure pose significant challenges to programming in all areas of primary health care, including FP. Notwithstanding, in the past decade, a group of advocates organized to undertake a series of activities to improve the policy environment for FP in the DRC. We outline the 4 major accomplishments to date: revitalizing a multisectoral FP stakeholder group at the national and provincial levels, obtaining the repeal of the Law of 1920 in the form of a new Public Health Law passed in 2018, soliciting public statements favorable to FP from political figures including 2 presidents, and securing the disbursement of government funds for the purchase of contraceptives. We reveal the work behind the scenes needed to obtain these advocacy wins. Given that the field of advocacy does not lend itself to rigorous evaluation using randomized trials or quasi-experimental design, it is important to document and analyze how such advocacy wins can be attained.</p>","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10749657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138884812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the Mechanisms of Change in the Supportive and Respectful Maternity Care Intervention in Sindh, Pakistan: Provider Perspectives.","authors":"Bilal Iqbal Avan, Waqas Hameed, Bushra Khan, Muhammad Asim, Sarah Saleem, Sameen Siddiqi","doi":"10.9745/GHSP-D-23-00216","DOIUrl":"10.9745/GHSP-D-23-00216","url":null,"abstract":"<p><strong>Introduction: </strong>We conducted this qualitative investigation to explore the mechanisms of change in providing respectful care resulting from the supportive and respectful maternity care intervention (S-RMC) in Sindh, Pakistan.</p><p><strong>Methods: </strong>We applied the principles of realist evaluation methodology with a descriptive explanatory research design. We conducted in-depth interviews with 36 maternity care providers at secondary-level public health facilities where S-RMC was implemented for 6 months. The S-RMC broad components included capacity-building of maternity teams and systemic changes for improvements in governance and accountability within public health facilities. Data were analyzed using a deductive content analysis approach.</p><p><strong>Results: </strong>We identified mechanisms of change, categorized by the S-RMC components: (1) S-RMC training: insight into women's feelings and rights, realization of the value that nonclinical staff can play, understanding of team coordination, orientation in psychosocial components of maternity care; (2) assessment of women's psychosocial vulnerabilities: identification of women's differential needs beyond routine care to provide woman-centered care; (3) psychosocial support: effective engagement with women and within maternity teams and the customization of woman- and companion-focused care; (4) care coordination: improved coordination among clinical and nonclinical staff to provide personalized care and psychosocial support and proper handover to ensure continuity of care; (5) assessment of quality of care: identification of service gaps from women's feedback; and (6) performance review and accountability: monthly performance review meetings to establish team member communication, systematic awareness of the maternity team's performance and challenges, and implementation of collective corrective actions.</p><p><strong>Conclusion: </strong>Our findings pointed to S-RMC working along multiple pathways-and concertedly with various health system components-to enable positive processes and behavioral change in maternity teams.</p>","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10749650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138482288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lessons Learned From the Implementation of a School-Based Sexual Health Education Program for Adolescent Girls in Cape Town, South Africa.","authors":"Carey Pike, Chelsea Coakley, Devyn Lee, Derek Daniels, Nadia Ahmed, Miriam Hartmann, Nancy Padian, Linda-Gail Bekker","doi":"10.9745/GHSP-D-23-00026","DOIUrl":"10.9745/GHSP-D-23-00026","url":null,"abstract":"<p><p>Comprehensive sexual education (CSE) is an important approach for health promotion dissemination in schools, particularly when delivered in participatory ways that are sport based, peer or near-peer led, and include concepts of gender and power dynamics. Sufficient attendance at CSE sessions is critical to ensure content exposure and build potential for impact. This article details implementation lessons from the delivery of an after-school, near-peer-led CSE program called SKILLZ during a cluster randomized controlled trial among 40 secondary schools in Cape Town, South Africa. SKILLZ is an evidence-based program previously implemented in similar contexts. Attendance in this study was suboptimal (less than 50%) despite qualitative indications of high acceptability and extensive efforts to adapt implementation and boost attendance. Qualitative and quantitative data gathered during anonymous surveys, in-depth interviews, and focus group discussions with participants with high and low attendance records, near-peer coaches, and school staff from both cohorts indicated that poor attendance could be attributed to several factors. Program adaptations, such as delivering difficult-to-access health services before participants attended the SKILLZ program rather than after, may have reduced the incentive for young people to attend the program. Practical barriers to attendance were identified, including security concerns, competing priorities, and unfamiliarity with after-school programming culture in this setting. Community engagement and acceptability of sexual education programs for adolescents alone may be insufficient to ensure program uptake and engagement.</p>","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10749656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138829278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research to Help Projects Operate Successfully.","authors":"Robert Hornik","doi":"10.9745/GHSP-D-23-00433","DOIUrl":"10.9745/GHSP-D-23-00433","url":null,"abstract":"","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10727460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138801318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving State Government's Responsiveness to Family Planning Interventions in Nigeria Using an Innovative Reflection and Action Tool.","authors":"Lekan Ajijola, Victor Igharo, Nneoma Anieto, Lisa Mwaikambo","doi":"10.9745/GHSP-D-22-00189","DOIUrl":"10.9745/GHSP-D-22-00189","url":null,"abstract":"<p><strong>Background: </strong>The Challenge Initiative (TCI) works with state governments in Nigeria to scale high-impact family planning and reproductive health (FP/RH) interventions rapidly and sustainably. The Reflection and Action to Improve Self-reliance and Effectiveness (RAISE) tool is an innovative responsive feedback (RF) mechanism developed by TCI to periodically monitor governments' readiness to sustain implementation of their FP/RH interventions.</p><p><strong>Raise description: </strong>The RAISE tool-a facilitated, self-administered tool used quarterly to track program improvements, identify gaps, and provide feedback-contains FP/RH progress indicators across 4 pillars: political and financial commitment, government capacity, institutionalization, and sustained demand. As a maturity matrix that helps state governments to understand the extent of their self-reliance in leadership and program management, the tool measures the stages of capacity: \"beginning\" (54% and below), \"developing\" (55-69%), \"expanding\" (70-84%), and \"mature\" (85% and above). Participants self-administer the tool with a trained government facilitator, develop a remediation plan with timelines and responsible persons assigned to address identified gaps, and communicate the plan to the broader FP/RH program team.</p><p><strong>Assessment results: </strong>Thirteen supported states have completed 5 rounds of assessments between June 2020 and September 2022. Baseline results revealed that 4 states were at the developing stage, 8 were at the expanding stage, and 1 had a mature program. The most recent assessment revealed mature capacity for 9 states while the 4 others are in the expanding stage. Consequently, all the states demonstrated improved government self-reliance over the course of the year.</p><p><strong>Conclusion: </strong>To ensure objectivity, RAISE participants, who include government policymakers, program managers, and implementers, use available government data sources to complement assessment findings. As an RF mechanism, the RAISE tool contributed to governments' enhanced leadership and management of their FP/RH programs, with current considerations for modifications to serve other primary health care programs.</p>","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10727459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80788084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Getting Rigor Right: A Framework for Methodological Choice in Adaptive Monitoring and Evaluation.","authors":"Christina Synowiec, Erin Fletcher, Luke Heinkel, Taylor Salisbury","doi":"10.9745/GHSP-D-22-00243","DOIUrl":"10.9745/GHSP-D-22-00243","url":null,"abstract":"<p><p>The field of global development has embraced the idea that programs require agile, adaptive approaches to monitoring, evaluation, and learning. But considerable debate still exists around which methods are most appropriate for adaptive learning. Researchers have a range of proven and novel tools to promote a culture of adaptation and learning. These tools include lean testing, rapid prototyping, formative research, and structured experimentation, all of which can be utilized to generate responsive feedback (RF) to improve social change programs. With such an extensive toolkit, how should one decide which methods to employ? In our experience, the level of rigor used should be responsive to the team's level of certainty about the program design being investigated-how certain-or confident-are we that a program design will produce its intended results? With less certainty, less rigor is needed; with more certainty, more rigor is needed. In this article, we present a framework for getting rigor right and illustrate its use in 3 case studies. For each example, we describe the feedback methods used and why, how the approach was implemented (including how we conducted cocreation and ensured buy-in), and the results of each engagement. We conclude with lessons learned from these examples and how to use the right kind of RF mechanism to improve social change programs.</p>","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10727457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90562967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Codeveloping an Adolescent Health Program in India During the COVID-19 Pandemic: A Case Study of a Community-Partnered Responsive Feedback Approach.","authors":"Ricky Sharma, Mohammed Danish, Yasmin Khajenoori, Daniya Shaikh, Yasmeen Chaudary, Hiba Khan, Neha Bhat, Avani Doshi, Samruddhi Nalawade, Pawan Rajput, Snigdha Shahi, Priya Shankar","doi":"10.9745/GHSP-D-22-00224","DOIUrl":"10.9745/GHSP-D-22-00224","url":null,"abstract":"<p><p>We describe the responsive feedback (RF) approach experience of a nongovernmental organization, Girls Health Champions (now known as Adolescent Health Champions [AHC]), that undertakes peer education interventions in Mumbai, India, schools to improve gender equality and health outcomes for adolescents aged 13-19 years. AHC used the RF approach at the onset of the COVID-19 pandemic in light of uncertainties stemming from school closures and the negative impact of the lockdown on adolescents' physical and mental health. Using an RF approach, AHC was able to: (1) understand pandemic-specific challenges faced by adolescents; (2) overhaul its theory of change; (3) pilot new modes of intervention delivery; (4) design a curriculum for parents/guardians and a COVID-19 module; (5) design an AHC mobile app; (6) develop a new, more gender-inclusive name and visual identity; (7) change the overall structure, adolescent-friendly nature, and agility of the organization; (8) and help clarify future directions taken by the organization. Overall, use of the RF approach had significant positive impacts on AHC as an organization, such as changes in organizational culture, deeper stakeholder engagement, and innovation, and was instrumental in AHC's growth, development, and pandemic response. This article outlines the steps of the process, from initial informal stakeholder consultations to the eventual formalization of the RF approach into the everyday working of AHC through the creation of a youth advisory board. We discuss challenges, such as time and resource constraints encountered; strategies for dealing with such challenges; and general key findings and learnings from this experience that could be beneficial to other youth- and community-serving organizations.</p>","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10727469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138801251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}