Maternal mortality remains the leading cause of death and disability for reproductive-age women in resource-poor countries. The impact a mother's on child outcomes is likely severe but has not been well quantified. This analysis examines survival children whose mothers die during or shortly after childbirth Butajira, Ethiopia. study uses data from Butajira Health Demographic Surveillance System (HDSS) site. Child were assessed using statistical tests to compare trajectories age-specific...

Health information systems are central to strong health systems. They assist with patient and program management, quality improvement, disease surveillance, strategic use of information. Many donors have worked improve systems, particularly by supporting the introduction electronic (EHIS), which considered more responsive efficient than older, paper-based As many donor-driven programs increasing their focus on country ownership, sustainability these investments is a key concern. This...

Little is known about coronavirus disease 2019 (COVID-19) vaccination in Africa. We sought to understand Malawian healthcare workers' (HCWs') COVID-19 and its hypothesized determinants. In March 2021, as the vaccine roll-out commenced Malawi, we surveyed clinical lay cadre HCWs (n=400) their uptake of potential correlates (informed by WHO Behavioral Social Drivers Vaccination framework). analyzed used adjusted multivariable logistic regression models explore how 'what people think feel'...

Objective The aim of this study was to assess the effects COVID-19 on antenatal care (ANC) utilisation in Kenya, including women’s reports COVID-related barriers ANC and correlates at individual household levels. Design Cross-sectional study. Setting Six public private health facilities associated catchment areas Nairobi Kiambu Counties Kenya. Participants Data were collected from 1729 women, 1189 women who delivered healthcare before pandemic (from September 2019–January 2020) 540 during...

Long-acting pre-exposure prophylaxis (PrEP) options could overcome barriers to oral PrEP persistence during pregnancy and postpartum. We evaluated long-acting preferences among PrEP-experienced pregnant postpartum women in South Africa Kenya, countries with high coverage pending regulatory approvals for injectable cabotegravir the dapivirine vaginal ring (approved Africa, under review Kenya).From September 2021 February 2022, we surveyed enrolled studies Kenya. attitudes methods...

Abstract Background Policy is receiving increasing attention in the field of implementation science. However, there remains a lack clear, concise guidance about how policy can be conceptualized science research. Building on Curran’s article “Implementation made too simple”—which defines “the thing” as intervention, practice, or innovation need support—we offer typology four very basic ways to conceptualize We provide examples studies that have these different and connect aspects established...

Access to removal of long-acting reversible contraception (LARCs) (e.g., implants and intrauterine devices (IUDs)) is an essential part contraceptive care. We conducted a secondary analysis cross-sectional survey data from randomized controlled trial. analyzed 5,930 client surveys 259 provider 73 public sector facilities in Tanzania examine the receipt desired LARC services among clients association between person-centered used contextualize these findings, describing attitudes training...

Countdown to 2015 was a multi-institution consortium tracking progress towards Millennium Development Goals (MDGs) 4 and 5. Case studies explore factors contributing (or lack of progress) in reproductive, maternal, newborn child health (RMNCH) were undertaken in: Afghanistan, Bangladesh, China, Ethiopia, Kenya, Malawi, Niger, Pakistan, Peru, Tanzania. This paper aims identify cross-cutting themes on how why these countries achieved or did not achieve MDG progress. Applying standard...

The growing burden of noncommunicable diseases (NCDs) may pose challenges for resource-limited health systems. This study used standardized, nationally representative data from Service Provision Assessments conducted in 2013-15 and the Availability Readiness Assessment methodology to examine NCD service availability readiness Bangladesh, Haiti, Malawi, Nepal, Tanzania. Both were found be very low: Very few facilities fully "ready" provide any one service. Shortages trained workers essential...

<h3>ABSTRACT</h3> <h3>Introduction:</h3> Multimonth dispensing (MMD) of antiretroviral therapy (ART) is a differentiated model care that can help overcome health system challenges and reduce the burden HIV on clients. Although 3-month has been standard care, interest increased in extending refill intervals to 6 months. We explored client provider experiences with MMD Malawi as part cluster randomized trial evaluating 3- versus 6-month ART dispensing. <h3>Methods:</h3> Semi-structured...

Provider bias based on age, marital status, and parity may be a barrier to quality contraceptive care. However, the extent which leads disparities in care is not well understood. In this mixed-methods study, we used four different data sources from same facilities assess of how much it affects First, surveyed providers Tanzania Burkina Faso (N = 295) provider attitudes about young, unmarried, nulliparous clients. Second, mystery clients anonymously visited for randomly assigned reported each...

Background: Adolescents and young adults (AYA) in the United States are disproportionately affected by HIV. Few interventions designed to reduce new HIV infections for AYA populations or take AYA's developmental state into consideration. Setting: Ending Epidemic US (EHE) priority areas California, Florida, Illinois, Massachusetts, North Carolina. Methods: Thematic synthesis of 5 EHE projects was completed. Methodologic commonalities were identified summarized across identify key lessons...

Abstract Non-communicable diseases like hypertension are increasingly common among individuals living with HIV in low-resource settings. The prevalence of people Malawi, e.g. has been estimated to be as high 46%. However, few qualitative studies have explored the patient experience comorbid chronic disease. Our study aimed address this gap by using health belief model (HBM) examine how comparative perceptions illness and treatment participants both may affect medication adherence behaviours....

Multi-month dispensing of antiretroviral therapy (ART) has been taken to scale in many settings sub-Saharan Africa with the benefits improved client satisfaction and decreased costs. Six-month ART may further increase these benefits; however, data are lacking. Within a cluster-randomized trial three- versus six-month Malawi Zambia, we performed sub-study explore Zambian provider experiences multi-month dispensing. We conducted 18 in-depth interviews clinical officers nurses as part INTERVAL...

Trust, particularly during emergencies, is essential for effective health care delivery and policy implementation. We used data from the 2018 Wellcome Global Monitor survey (comprising nationally representative samples 144 countries) to examine levels correlates of trust in governments workers attitudes toward vaccines. Only one-quarter respondents globally expressed a lot their government (trust was more common among people with less schooling, those living rural areas, who were financially...

The Centers for Medicare & Medicaid Services uses a new peer group-based payment system to compare hospital performance as part of its Hospital Readmissions Reduction Program, which classifies hospitals into quintiles based on their share dual-eligible beneficiaries and Medicaid. However, little is known about the association hospital's with quality care outcomes patients heart failure (HF).To evaluate between proportion dual eligibility HF outcomes.This retrospective cohort study evaluated...

Abstract Background The SARS-CoV-2 pandemic has resulted in an increase telemedicine utilization for routine HIV care. However, there is limited information on perceptions of and experiences with from United States (U.S.) federally qualified health centers (FQHCs) offering We sought to understand stakeholders various roles: people living (PLHIV), clinical (clinicians case managers), programmatic (clinic administrators), policy (policymakers). Methods Qualitative interviews about benefits...

COVID-19 vaccine coverage in most countries Africa remains low. Determinants of uptake need to be better understood improve vaccination campaigns. Few studies from have identified correlates the general population. We surveyed adults at 32 healthcare facilities across Malawi, purposively sampled ensure balanced representation with and without HIV. The survey, informed by World Health Organization's Behavioural Social Drivers Vaccination Framework, asked about people's thoughts feelings...

Background Primary Health Care (PHC) is essential for effective, efficient, and more equitable health systems all people, including those living with HIV/AIDS. This study evaluated the impact of exposure to one largest community-based PHC programs in world, Brazilian Family Strategy (FHS), on AIDS incidence mortality. Methods findings A retrospective cohort carried out Brazil from January 1, 2007 December 31, 2015. We conducted an evaluation using a 3,435,068 ≥13 years low-income individuals...