South Sudan has borne the brunt of years of chronic warfare and probably has the highest malaria burden in sub-Saharan Africa. Malaria is the leading cause of morbidity and mortality in the country. This nationally representative survey aimed to provide data on malaria indicators at household level across the country. The observed high malaria prevalence could be due to low levels of coverage and utilization of interventions coupled with low knowledge levels. Therefore, access and utilization of malaria control tools should be increased through scaling up coverage and improving behaviour change communication.
Effective surveillance systems are required to track malaria testing and treatment practices. A 26-week study “SMS for Life” was piloted in five rural districts of Kenya to examine whether SMS reported surveillance data could ensure real-time visibility of accurate data and their use by district managers to impact on malaria case-management. The study demonstrated the feasibility of using simple mobile phone text messages to transmit timely surveillance data from peripheral health facilities to higher levels. However, accuracy of data reported was suboptimal. Future work should focus on improving quality of SMS reported surveillance data.
Abstract An increasing number of countries are exploring the introduction or expansion of autonomous hospitals as one of the numerous health reforms they are introducing to their health system. Hospital autonomy is one of the forms of decentralization that is focused on a specific institution rather than on a political unit.
Abstract Objective To assess the sustainability, robustness and economic advantages of high-performance thin layer chromatography (HPTLC) for quality control of pharmaceutical products. Method We compared three laboratories where three lots of cotrimoxazole tablets were assessed using different techniques for quantifying the active ingredient.
Malaria during pregnancy is a major public health problem in Nigeria especially in malaria-endemic areas. It increases the risk of low birth weight and child/maternal morbidity/mortality. This paper addresses the impact of radio campaigns on the use of insecticide-treated bed nets among pregnant women in Nigeria. Pregnant women who listened to mass media campaigns were more likely to adopt strategies to protect themselves from malaria.
Monitoring implementation of the ‘‘test and treat’’ case-management policy for malaria is an important component of all malaria control programmes in Africa. Unfortunately, routine information systems are commonly deficient to provide necessary information. Using health facility surveys we monitored health systems readiness and malaria case management practices prior to and following implementation of the 2010 ‘‘test and treat’’ policy in Kenya. Between 2010 and 2013 six national, cross-sectional, health facility surveys were undertaken. Major improvements in the implementation of the ‘‘test and treat’’ policy were observed. Some gaps towards universal targets still remained. Other countries facing similar needs and challenges may consider health facility surveys to monitor malaria case-management.
To better meet women's emergency contraceptive needs and to contribute to the limited knowledge base regarding this method in Africa, this study examines data from a sample of EC users drawn from a large, representative household survey that included sexually experienced women in urban Kenya and Nigeria. Bivariate and multivariate analyses reveal greater knowledge of EC among these urban women than was reported in other nationally representative surveys. Recent users of EC were more likely to be in their 20s, unmarried, and more highly educated than never users or ever users of EC in both countries. Results contradict public perceptions of EC users as young adolescents and indicate the importance of strengthening EC provision in Africa, including targeting information and services to unmarried women and supporting private pharmacies in delivering quality services.
The shortage of skilled birth attendants has been a key factor in the high maternal and newborn mortality in Afghanistan. Efforts to strengthen pre-service midwifery education in Afghanistan have increased the number of midwives from 467 in 2002 to 2954 in 2010. We analyzed the costs and graduate performance outcomes of the two types of pre-service midwifery education programs in Afghanistan that were either established or strengthened between 2002 and 2010 to guide future program implementation and share lessons learned. CME graduates achieved an overall mean competency score of 63.2% on the clinical competency assessment, compared to 57.3% for IHS graduates. Reproductive health activities accounted for 76% of midwives' time over an average of three months. Approximately 1% of childbirths required referral or resulted in maternal death. On the basis of known costs for the programs, the estimated cost of graduating a class with 25 students averaged US$298,939, or US$10,784 per graduate.
We examined the spatial pattern and risk factors of co-morbidity of malaria and non-malarial febrile illness among children aged 6-59 months in Nigeria. Using data from the 2010 Nigeria Malaria Indicator Survey, we considered the co-morbidity of malaria and non-malarial febrile illness among the children as multicategorical and selected a mixed multinomial logit model capable of incorporating covariates of different types. Inference was Bayesian, based on multicategorical linear mixed-model representation. We found that the risk of co-morbidity of malaria and non-malarial febrile illness increases as a child advances in age while the risk of non-malarial fever reduces after about 32 months of age. Area of residence (urban or rural), wealth index and type of roofing material used in the dwelling are other important risk factors for the co-morbidity found in this study. Further, children from four of Nigeria's 37 states are at high risk of malaria. Disease preventive measures need to be intensified, with more focus on rural areas and the poor. Campaigns for use of insecticide-treated bed nets need be more aggressive in all Nigerian states.
This compendium is for the use of national TB program staff in high burden settings who are trying to identify strategies to reach at-risk and vulnerable communities more effectively it contains very summarized descriptions of over 120 approaches to reach and serve at-risk and vulnerable populations, and links to over 650 tools and reference materials.
Study Tour Summary Document: February 14–23, 2014 Management Sciences for Health (MSH) and the LIVESTRONG Foundation (LIVESTRONG) sponsored a delegation of US Senate staffers, policy experts, and researchers to Uganda and Rwanda to examine the key elements of the countries’ health systems, with a particular focus on how the countries are addressing non-communicable diseases
In the DRC, under-five, infant and neonatal mortality rates remain high with 158, 97, and 42 deaths per 1,000 live births, respectively. As a consequence, close to half a million children die every year before their fifth birthday.
Nigeria is home to 17.5 million orphans and vulnerable children (OVC). According to the Federal Ministry of Women Affairs and Social Development, one in every four children in Nigeria is considered vulnerable due to unmet needs for nutrition, education, shelter, care, or support.
The Need for New Solutions
Nigeria is home to 17.5 million children who are considered vulnerable due to unmet needs for food, shelter, education, protection, or care With 3.4 million citizens living with HIV & AIDS, Nigeria has the second highest HIV burden in the world.
In Nigeria, as in most countries, women and girls assume the bulk of the caregiving burden for those infected with HIV and children left vulnerable or orphaned by AIDS. These responsibilities often prevent girls and women from obtaining an education and developing income-generating skills.
Prevention of mother-to-child transmission of HIV (PMTCT) programs can greatly reduce the vertical transmission rate (VTR) of HIV, and Malawi is expanding PMTCT access by offering HIV-infected pregnant women life-long antiretroviral therapy (Option B+). There is currently no empirical data on the effectiveness of Malawian PMTCT programs. This study describes a surveillance approach to obtain population-based estimates of the VTR of infants
Abstract In 2001, Afghanistan's Ministry of Public Health inherited a devastated health system and some of the worst health statistics in the world. The health system was rebuilt based on the Basic Package of Health Services (BPHS). This paper examines why the BPHS was needed, how it was developed, its content and the changes resulting from the rebuilding.