Reproductive Health

Considerations for Linking South Africa’s Youth-Friendly Services to its Community Health Worker Programme

In this article, we open the debate on whether or not South Africa’s Youth-friendly Services (YFS) programmes should be linked to community health worker (CHW) programmes. Both are important in South Africa’s efforts to re-engineer primary healthcare in the country. This article presents the pros and cons of linking the two programmes by incorporating YFS into the current list of CHW competencies. Also, we explore the alternative of training specialist CHWs to deliver YFS. [from abstract]

Magnitude and Trends of Inequalities in Antenatal Care and Delivery Under Skilled Care Among Different Socio-Demographic Groups in Ghana from 1988 – 2008

Improving maternal and reproductive health still remains a major challenge in most low-income countries especially in sub-Saharan Africa. The growing inequality in access to maternal health interventions is an issue of great concern. In Ghana, inadequate attention has been given to the inequality gap that exists amongst women when accessing antenatal care during pregnancy and skilled attendance at birth.

Improving Maternal and Newborn Health: Effectiveness of a Community Health Worker Program in Rural Kenya

Volunteer community health workers (CHWs) form an important element of many health systems, and in Kenya these volunteers are the foundation for promoting behavior change through health education, earlier case identification, and timely referral to trained health care providers. This study examines the effectiveness of a community health worker project conducted in rural Kenya that sought to promote improved knowledge of maternal newborn health and to increase deliveries under skilled attendance. [from abstract]

The Effectiveness of mHealth Interventions for Maternal, Newborn and Child Health in Low– and Middle–Income Countries: Protocol for a Systematic Review and Meta–Analysis

mHealth has attracted considerable attention as a means of supporting maternal, newborn and child health in developing countries and research to assess the impacts of mHealth interventions is increasing. While a number of expert reviews have attempted to summarise this literature, there remains a need for a fully systematic review employing gold standard methods of evidence capture, critical appraisal and meta–analysis, in order to comprehensively map, quality assess and synthesise this body of knowledge. [from abstract]

Is There Any Role for Community Involvement in the Community-Based Health Planning and Services Skilled Delivery Program in Rural Ghana?

This paper presents findings from a study designed to assess the extent to which community residents and leaders participated in the skilled delivery program and the specific roles they played in its implementation and effectiveness. [from abstract]

Pregnancy Tests Increase Contraceptive Clients among Health Workers: Evidence from a Randomized Controlled Trial in Madagascar

One challenge that community health workers face when they provide hormonal contraceptives to new clients is ruling out pregnancy. A randomized controlled trial in Madagascar found that offering the health workers pregnancy tests to distribute for free increases their number of new contraceptive clients. [from introduction]

Comprehensive Reproductive Health and Family Planning Curriculum: Module 11: MVA for the Treatment of Incomplete Abortion

This training manual prepares health workers to counsel women who come to a facility for treatment of an incomplete or septic abortion and to assess and manage the complications of incomplete and septic abortions. It includes information on preparation of MVA equipment, infection prevention procedures, processing MVA equipment for reuse, pain control, the MVA procedure, management of complications of the MVA procedure, and the introduction of comprehensive PAC services in a clinical setting.

Capacity Building of Institutions in the Health Sector: Review of Experiences in Uttar Pradesh, Uttarakhand and Jharkhand.

This report documents the efforts and contributions made by USAID through the Innovations in Family Planning Services (IFPS) Project towards capacity building and strengthening of public and private institutions in the health sector
in India. The report highlights the support rendered at the national level and in three Indian states: Uttar
Pradesh, Uttarakhand, and Jharkhand. [from introduction]

Reducing Maternal and Neonatal Mortality in Indonesia: Saving Lives, Saving the Future. Chapter Five: Quality of Care

Quality of care is at the heart of any health care program, and yet it is defined in different ways and is difficult to measure. It is determined not only by the capabilities of health facilities and health providers but also by many other variables. Even among formal research studies, the variables measured differ from study to study. [from introduction]

Performance-based Incentives to Improve Health Status of Mothers and Newborns: What Does the Evidence Show?

Performance-based incentives (PBIs) aim to counteract weak providers’ performance in health systems of many developing countries by providing rewards that are directly linked to better health outcomes for mothers and their newborns. This paper analyzes and synthesizes the available evidence from published studies on the impact of supply-side PBIs on the quantity and quality of health services for mothers and newborns. This paper reviews evidence from published and grey literature that spans PBI for public-sector facilities, PBI in social insurance reforms, and PBI in NGO contracting.

Home Visits by Community Health Workers to Prevent Neonatal Deaths in Developing Countries: a Systematic Review

To determine whether home visits for neonatal care by community health workers can reduce infant and neonatal deaths and stillbirths in resource-limited settings. [from abstract]

Task Shifting to Improve Access to Contraceptive Methods

This document summarizes the WHO recommendations on the cadres ranging from lay health workers to mid-level providers that may be trained and supported to provide the following contraceptive methods safely: tubal ligation, vasectomy, intrauterine device (IUD), implants, injectables, as well as promotional activities. The process of enabling additional cadres to provide a specific health intervention is referred to here as ‘task shifting’ but is also widely known as ‘task sharing’. [from introduction]

Reproductive Health, and Child Health and Nutrition in India: Meeting the Challenge

In 2005, India embarked on the National Rural Health Mission, an extraordinary effort to strengthen the health systems. However, coverage of priority interventions remains insufficient, and the content and quality of existing interventions are suboptimum.

Impact of health systems strengthening on coverage of maternal health services in Rwanda, 2000–2010: a systematic review

Between 2006 and 2010, the following increases in coverage took place as compared to 2000–2005, particularly in rural areas, where most poor women live: births with skilled attendance (77% increase vs. 26%), institutional delivery (146% increase vs. 8%), and contraceptive prevalence (351% increase vs. 150%). The primary factors in these improvements were increases in the health workforce and their skills, performance-based financing, community-based health insurance, and better leadership and governance.

Rewarding Provider Performance to Enable a Healthy Start to Life: Evidence from Argentina's Plan Nacer

Argentina’s Plan Nacer provides insurance for maternal and child health care to uninsured families. This paper analyzes the impact of Plan Nacer on birth outcomes. The analysis uses data from the universe of birth records in seven Argentine provinces for 2004 to 2008 and exploits the geographic phasing in of Plan Nacer over time. [adapted from abstract]

Interprofessional Education Case Study: Master of Science degree programme in Reproductive Health at Kamuzu College of Nursing, Malawi

The purpose of this paper is to share the case study of developing and implementing an IPE programme at Kamuzu College of Nursing (KCN). Included in the discussion are: the background to Kamuzu College of Nursing; the process of developing
the Master of Science (MSc) in Reproductive Health; the curriculum implementation model; and lessons learned and recommendations. [from introduction]

Effectiveness of female community health volunteers in the detection and management of low-birth-weight in Nepal

Low birth weight (LBW) is a major risk factor for neonatal death. However, most neonates in low-income countries are not weighed at birth. This results in many LBW infants being overlooked. Female community health volunteers (FCHVs) in Nepal are non-health professionals who are living in local communities and have already worked in a field of reproductive and child health under the government of Nepal for more than 20 years. The effectiveness of involving FCHVs to detect LBW infants and to initiate prompt action for their care was studied in rural areas of Nepal. [from abstract]Amano S

Unmet Need, Intention to Use Contraceptives And Unwanted Pregnancy in Rural Bangladesh

Using longitudinal data on more than 2,500 rural Bangladeshi women in 128 villages, this study links women’s contraceptive adoption and experience of unwanted pregnancy between 2006 and 2009 to their unmet need status and their stated intention to use contraceptives in 2006. [from abstract]

Health in the Post-2015 Development Framework

In order to ensure continued strong political and financial support for the global AIDS response in the post-2015 era, it is crucial to advocate for the inclusion of strong targets and indicators related to AIDS, sexual and reproductive health and rights and human rights under the new post-2015 health goal and other relevant goals. This paper is a helpful tool to influence your governments as they start developing their positions on the new post-2015 Framework. [from introduction]

A Pocket Guide to Thinking About Gender & Vaginal Microbicides in South Africa

This pocket card, created with input from the South African National AIDS Council (SANAC) Men’s and Women’s Sectors, is designed to build support for a gender-integrated microbicides rollout among both community members and policy makers. [from introduction]

Barriers to Accessing Health Care in Nigeria: Implications for Child Survival

There has not been a systematic attempt to examine the effects of barriers to health care on under-five mortality in Nigeria. This study is designed to address this knowledge gap. [from abstract]

Do Medical Students Want to Learn About Global Health?

The main objectives of this study were to establish the views of medical students on learning about women’s and children’s health in low-income countries, to identify the nature and extent of learning already experienced, and to assess the demand for such learning. [from abstract]

Competency-Based Training “Helping Mothers Survive: Bleeding after Birth” for Providers from Central and Remote Facilities in Three Countries

To validate a new training module for skilled and semiskilled birth attendants authorized to provide care at birth—Helping Mothers Survive: Bleeding After Birth (HMS:BAB) [from abstract]

Utilization of a State Run Public Private Emergency Transportation Service Exclusively for Childbirth: The Janani (Maternal) Express Program in Madhya Pradesh, India

The objective was to study (a) the utilization of an emergency obstetric transportation service among women delivering in health facilities, (b) factors associated with usage, (c) the timeliness of the service. [adapted from abstract]

Inadequate Knowledge of Neonatal Danger Signs among Recently Delivered Women in Southwestern Rural Uganda: A Community Survey

The aim of this study was to explore the knowledge of key newborn danger signs among mothers in southwestern Uganda. [from abstract]

Early pregnancy detection by female community health volunteers in Nepal facilitated referral for appropriate reproductive health services

This evaluation assessed the success of a pilot program that trained [Female community health volunteers] in early pregnancy detection using urine pregnancy tests (UPTs), counseling, and referral to appropriate antenatal, safe abortion, or family planning services. [from abstract]

Overview of Maternal, Neonatal and Child Deaths in South Africa: Challenges, Opportunities, Progress and Future Prospects

The overview involved a synthesis and review of recent data and information from key
national representative peer reviewed articles and grey literature from the National Department of
Health and related stakeholder reports. [from abstract]

Improving the Process of Antenatal Care to Increase Detection of Women with High-Risk Conditions in Zonal Hospital of Mandi, Himachal Pradesh, India

Zonal Hospital, Mandi identified that they were not identifying women with high risk conditions during their antenatal care (ANC) clinic. By re-organizing the clinic, the hospital was able to increase the proportion of pregnant women identified as being at high-risk from 1.6% to 12.3% in a matter of weeks. [from abstract]

Ghana's National Health Insurance Scheme in the Context of the Health MDGs - An Empirical Evaluation Using Propensity Score Matching

In 2003 the Government of Ghana established a National Health Insurance Scheme (NHIS) to improve health care access for Ghanaians and eventually replace the cash-and-carry system. This study evaluates the NHIS to determine whether it is fulfilling its purpose in the context of the Millennium Development Goals #4 and #5 which deal with the health of women and children. [from abstract]

Developing Capacities of Community Health Workers in Sexual and Reproductive, Maternal, Newborn, Child, and Adolescent Health: A Mapping and Review of Training Resources

A mapping of training resource packages for [community health workers] was undertaken with documents retrieved online and from key informants. Materials were classified by health themes and analysed using agreed parameters. Ways forward were informed by a subsequent expert consultation. [from abstract]