Global Health: Science and Practice最新文献

{"title":"The Challenge Initiative: Lessons on Rapid Scale-Up of Family Planning and Adolescent and Youth Sexual and Reproductive Health Services.","authors":"Clea Finkle, Yacine Bai, Venkatraman Chandra-Mouli, Samuel O'Keefe, Moses Tetui, Suzanne Fischer, Kojo Lokko, Lisa Mwaikambo, Saori Ohkubo","doi":"10.9745/GHSP-D-24-00153","DOIUrl":"10.9745/GHSP-D-24-00153","url":null,"abstract":"","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":"12 Suppl 2","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11111109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141075608","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":"Implementing Quality Improvement Initiatives to Improve the Use of Adolescent- and Youth-Friendly Health Services in Zou, Benin.","authors":"Josephat Avocè, Mamadou Kandji, Vanessa Mitchell, Koami Maurice Mensah, Hugues Gnahoui, Hawa Talla, René Jean Firmin Nakoulma, Cheikh Ibrahima Diop, Moussa Faye, Fatimata Sow, Krishna Bose","doi":"10.9745/GHSP-D-22-00223","DOIUrl":"10.9745/GHSP-D-22-00223","url":null,"abstract":"<p><strong>Introduction: </strong>In Benin, the unmet need for family planning services is especially high for adolescent girls and youth aged 15-24 years. The Challenge Initiative (TCI) supported the health system to assess and improve the quality of adolescent and youth sexual reproductive health services and enhance contraceptive uptake in 65 service delivery points (SDPs) of the Zou department.</p><p><strong>Program description: </strong>Between June 2019 and March 2021, TCI supported the health districts in Zou to train an assessment team to complete 3 cycles of quality assessments (QAs) using a QA checklist adapted to the local context. Based on assessment scores, the SDPs were categorized into poor, moderate, or good to excellent quality. The SDP managers developed remedial action plans after each cycle and for each SDP and followed up with supportive supervision.</p><p><strong>Results: </strong>The first QA cycle showed that 52% of assessed SDPs achieved a good to excellent classification; by the second QA cycle, this reached 74%. However, the quality of adolescent- and youth-friendly health services regressed during the third QA cycle (during COVID-19 pandemic disruptions), when only 40% of SDPs achieved the good to excellent category. Between the first and second QA cycles, contraceptive uptake for adolescents and youth improved in the SDPs that had good or excellent quality of services, compared to the ones that were of lower quality (established significance level of 5% with a <i>P</i> value of .031).</p><p><strong>Conclusion: </strong>Further assessments could deepen our understanding of the internal and external factors that can affect service quality. The findings reinforce the importance of investing in quality improvement strategies to maximize the use of sexual and reproductive health services among adolescents and youth. They also underscore the need for a contextual and nuanced approach to ensure enduring results.</p>","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11111105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140863737","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":"The Thai Health Promotion Foundation: Two Decades of Joint Contributions to Addressing Noncommunicable Diseases and Creating Healthy Populations.","authors":"Viroj Tangcharoensathien, Supreda Adulyanon, Nuttapun Supaka, Rungsun Munkong, Shaheda Viriyathorn, Siriya Sirithienthong, Siriyaporn Kanhachon, Robert Marten","doi":"10.9745/GHSP-D-23-00311","DOIUrl":"10.9745/GHSP-D-23-00311","url":null,"abstract":"","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11057797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140049243","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":"The Role of Adults in Poliovirus Transmission to Infants and Children.","authors":"T Jacob John, Dhanya Dharmapalan, Robert Steinglass, Norbert Hirschhorn","doi":"10.9745/GHSP-D-23-00363","DOIUrl":"10.9745/GHSP-D-23-00363","url":null,"abstract":"","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":"12 2","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11057798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140863738","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":"Adopting Data to Care to Identify and Address Gaps in Services for Children and Adolescents Living With HIV in Mozambique.","authors":"Belmiro Sousa, Sergio Chiale, Hayley Bryant, Lisa Dulli, Tanya Medrano","doi":"10.9745/GHSP-D-23-00130","DOIUrl":"10.9745/GHSP-D-23-00130","url":null,"abstract":"<p><strong>Background: </strong>The Data to Care (D2C) strategy uses multiple sources of complementary data on HIV clients and related services to identify individuals with gaps in HIV treatment. Although D2C has been widely used in the United States, there is no evidence on its use in other settings, such as countries most affected by the epidemic.</p><p><strong>Strategy implementation: </strong>The D2C strategy was implemented within the context of a project that provided community-based support to children and adolescents living with HIV (C/ALHIV) in Mozambique. A data tracking tool and a standard operating procedure manual for local partner community organizations and health care facilities were developed to support the effort. Project staff met with local project implementing partners to discuss and coordinate the intervention in pilot health facilities.</p><p><strong>Strategy piloting: </strong>The project initiated a pilot D2C intervention in 2019, working with 14 health facilities across 5 additional districts within 1 province. COVida project data were compared with clinical data from facilities serving C/ALHIV. The D2C intervention identified gaps in HIV treatment for a substantial number of C/ALHIV, and targeted support services were provided to address those gaps. Viral load (VL) monitoring was added in March 2020. Before the intervention, 71% of C/ALHIV reported to be on HIV treatment by their caregivers were documented as on treatment in health facilities. Support interventions targeted those not on treatment, and this proportion increased to 96% within 1 year of implementation. Additionally, 12 months later, the proportion of C/ALHIV with a documented VL test increased from 52% to 72%.</p><p><strong>Conclusion: </strong>Introducing the D2C pilot intervention was associated with substantial improvements in HIV treatment for C/ALHIV, including increased linkage to and continuity in treatment and increased VL testing. D2C may be a useful approach to improve health outcomes for C/ALHIV in settings outside of the United States.</p>","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11057801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140039119","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":"Applying a Three-Tier Approach to Address Gaps in Oral Pre-Exposure Prophylaxis Uptake and Continuity in Uganda: A Mixed Methods Approach.","authors":"Simon Sensalire, Abel Nkolo, Juliana Nabwire Ssali, Martin Muhire, Augustin Muhwezi, Herbert Kadama","doi":"10.9745/GHSP-D-23-00229","DOIUrl":"10.9745/GHSP-D-23-00229","url":null,"abstract":"<p><strong>Background: </strong>We describe a 3-tier approach involving a gap analysis, root cause analysis, and pre-exposure prophylaxis (PrEP) collaborative to understand the gap and identify and address the main barriers to oral PrEP uptake and continuity in Uganda.</p><p><strong>Methods: </strong>We used a mixed methods design with retrospective, cross-sectional, and prospective components. The gap analysis involved descriptive analysis of PrEP uptake and continuity. The RCA identified the main barriers to initiation and continuity on PrEP among 1,334 clients who declined to start PrEP and 1,266 who missed their appointment but were at risk. The PrEP collaborative tested changes mapped onto specific barriers to optimize the PrEP clinical service delivery. A trend analysis of routinely collected data of the PrEP cascade determined significant shifts and trends in PrEP uptake and continuity.</p><p><strong>Results: </strong>Only 60% of the high-risk population eligible for PrEP were enrolled, while fewer than 30% of the cumulative number of PrEP users were refilled each quarter. Uncertainty and fear of side effects, perceptions about the harmfulness of the medication, perceived inability to adhere to PrEP, and stigma were the main reasons why clients rejected PrEP. Lack of access to the facility, side effects, pill burden, stigma, perceived low-risk exposure to HIV, and preference of staying at work as opposed to picking up refills affected continuity on PrEP. The collaborative registered statistically significant shifts in PrEP enrollment from 64% to 89% and continuity from 51% to 78% between July 21 and November 22 following the collaborative intervention.</p><p><strong>Conclusions: </strong>We recommend using a 3-tier approach for other similar implementation contexts to strengthen PrEP programming, given the marked statistical shift in PrEP uptake and continuity. This begins with understanding the gap and barriers to use among clients, followed by mapping interventions to specific barriers through a quality improvement collaborative.</p>","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11057795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140101431","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":"How Can Community Data Be Leveraged to Advance Primary Health Care? A Scoping Review of Community-Based Health Information Systems.","authors":"Shivani Pandya, Lena Kan, Emily Parr, Claire Twose, Alain B Labrique, Smisha Agarwal","doi":"10.9745/GHSP-D-23-00429","DOIUrl":"10.9745/GHSP-D-23-00429","url":null,"abstract":"<p><strong>Background: </strong>Community-based health information systems (CBISs) can provide critical insights into how community health systems function, and digitized CBISs may improve the quality of community-level data and facilitate integration and use of CBISs within the broader health system. This scoping review aims to understand how CBISs have been implemented, integrated, and used to support community health outcomes in low- and middle-income countries (LMICs).</p><p><strong>Methods: </strong>Both peer-reviewed and gray literature were included; relevant articles were identified using key terms and controlled vocabulary related to community/primary health care, health information systems, digital health, and LMICs. A total of 11,611 total records were identified from 5 databases and the gray literature. After deduplication, 6,985 peer-reviewed/gray literature were screened, and 95 articles/reports were included, reporting on 105 CBIS implementations across 38 countries.</p><p><strong>Results: </strong>Findings show that 55% of CBISs included some level of digitization, with just 28% being fully digitized (for data collection and reporting). Data flow from the community level into the health system varied, with digitized CBISs more likely to reach national-level integration. National-level integration was primarily seen among vertical CBISs. Data quality challenges were present in both paper-based and digitized CBISs, exacerbated by fragmentation of the community health landscape with often parallel reporting systems. CBIS data use was constrained to mostly vertical and digitized (partially or fully) CBISs at national/subnational levels.</p><p><strong>Conclusion: </strong>Digitization can play a pivotal role in strengthening CBIS use, but findings demonstrate that CBISs are only as effective as the community health systems they are embedded within. Community-level data are often not being integrated into national/subnational health information systems, undermining the ability to understand what the community health needs are. Furthermore, stronger investments within community health systems need to be in place broadly to reduce fragmentation and provide stronger infrastructural and systemic support to the community health workforce.</p>","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":"12 2","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11057800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140859915","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":"Couple-Years of Protection Indicator: New Global Guidance for Updating Existing Methods and Adding New Methods.","authors":"Elena Lebetkin, Markus J Steiner, Emily Sonneveldt, Amani Selim, Bamikale Feyisetan, Baker Maggwa Ndugga, A Wezi Munthali, Morrisa Malkin, Fatou Jallow","doi":"10.9745/GHSP-D-23-00388","DOIUrl":"10.9745/GHSP-D-23-00388","url":null,"abstract":"<p><strong>Background: </strong>Couple-years of protection (CYP) is an indicator that allows for monitoring and evaluating of family planning (FP) program performance through simple calculations. The CYP for each contraceptive method is calculated by multiplying the number of contraceptive commodity units distributed to clients over a 1-year period by a conversion factor that quantifies the duration of contraceptive protection provided per unit distributed. CYP calculations across methods were previously updated in 2000 and 2011, resulting in changes in methodology, factor inclusion, and specific methods. Since the 2011 update, changes and additions to the modern contraceptive method mix required new CYP conversion factors for 4 methods of contraception: Levoplant implant, progestin-only pills (POPs), Caya diaphragm, and the hormonal intrauterine device.</p><p><strong>Methods: </strong>We conducted literature reviews of both published and gray literature and consulted with experts to identify updated data on continuation rates, duration of efficacy, and method effectiveness for the 4 methods. New CYP conversion factors were calculated for the 4 methods either by using the same calculation used previously for the method considering new data or, for new methods, using calculations for similar methods.</p><p><strong>Results: </strong>New CYP conversion factors were assigned to the 4 methods of contraception covered in this update: Levoplant, 2.5 CYP per implant inserted; POPs, 0.0833 CYP per pack (i.e., 12 cycles per CYP); Caya diaphragm, 1 CYP per device, and hormonal intrauterine device, 4.8 CYP per device inserted.</p><p><strong>Conclusions: </strong>CYP is an important indicator for FP programs. As new methods of contraception are developed and new evidence is generated for current methods, the indicator may need to be updated. A standard process for updating and documenting future CYP updates is recommended.</p>","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":"12 2","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11057804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860490","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":"Current Approaches to Following Up Women and Newborns After Discharge From Childbirth Facilities: A Scoping Review.","authors":"Maxine Pepper, Oona M R Campbell, Susannah L Woodd","doi":"10.9745/GHSP-D-23-00377","DOIUrl":"10.9745/GHSP-D-23-00377","url":null,"abstract":"<p><strong>Introduction: </strong>The postpartum period is critical for the health and well-being of women and newborns, but there is limited research on the most effective methods of post-childbirth follow-up. This scoping review synthesizes evidence from high-, middle-, and low-income countries on approaches to following up individuals after discharge from childbirth facilities.</p><p><strong>Methods: </strong>Using a systematic search in Ovid MEDLINE, we identified quantitative studies describing post-discharge follow-up methods deployed up to 12 months postpartum. We searched for English-language, peer-reviewed articles published between January 1, 2007 and November 2, 2022, with search terms covering 2 broad areas: \"postpartum/postnatal period\" and \"surveillance.\" We single-screened titles and abstracts and double-extracted all included articles, recording study design and location, population, health outcome, method, timing and frequency of data collection, and percentage of study participants reached.</p><p><strong>Results: </strong>We identified 1,654 records, of which 31 studies were included. Eight studies used in-person visits to follow up participants, 10 used telephone calls, 7 used self-administered questionnaires, and 6 used multiple methods. Across studies, the minimum length of follow-up was 1 week after delivery, and up to 4 contacts were made within the first year after delivery. Follow-up (response) rates ranged from 23% to100%. Postpartum infection was the most common outcome investigated. Other outcomes included maternal (ill-)health, neonatal (ill-)health and growth, maternal mental health and well-being, care-giving/-seeking behaviors, and knowledge and intentions.</p><p><strong>Conclusion: </strong>Our scoping review identified multiple follow-up methods after discharge, ranging from home visits to self-administered electronic questionnaires, which could be implemented with high response rates. The studies demonstrated that post-discharge follow-up of women and newborns was feasible, well received, and important for identifying postpartum illness or complications that would otherwise be missed. Therefore, the identified methods have the potential to become an important component of fostering a continuum of care and measuring and addressing postpartum morbidity.</p>","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":"12 2","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11057794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140854755","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":"Budget Process and Execution: A Case Study on the Underperformance of the Peruvian Health System, 2000-2021.","authors":"Rolf Erik Hönger, Doreen Montag","doi":"10.9745/GHSP-D-23-00250","DOIUrl":"10.9745/GHSP-D-23-00250","url":null,"abstract":"<p><strong>Introduction: </strong>Health system financing for emerging economies with aging populations and changing epidemiological profiles is an increasing challenge. Peru, as one of the countries with the highest economic growth in this century, provides a good example for analyzing the impact of the budgeting process and the budget execution on the performance of a health system. This article aims to answer how policies and processes are the root causes of the performance gap of the Peruvian health system.</p><p><strong>Methods: </strong>We used a case study methodology composed of 17 semistructured interviews with senior national and regional actors conducted between the end of 2021 and the beginning of 2022. Participants were selected with a combination of purposive, convenience, and snowball sampling until reaching saturation at 14 interviews. Participants' answers were grouped according to the topics explored, enabling comparisons and identification of themes.</p><p><strong>Results: </strong>The responses revealed that 4 interconnected influences affect the Peruvian health system. Political instability affects the sustainable development of health policies. The fiscal cycle limits the public health expenditure to a low 3% of the gross domestic product. The budget cycle is based on the low motivation of the Ministry of Health (MOH) to establish a proper budgeting process. The execution cycle represents the results of chronic underinvestment with a lack of professionals, equipment, and data affecting the access to care expressed by a high out-of-pocket share in health expenditure.</p><p><strong>Conclusion: </strong>To escape these cycles, the MOH needs to be able to argue in economic terms for the prioritization of health, showing the economic rationale for investment in health. Taxes need to finance the additional investment within the available fiscal space. The rigidity of the budget law needs to be adapted, and a technical budget that is oriented to the current and future health priorities needs to be elaborated.</p>","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11057799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140174238","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}