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In 2012-2013, Family Care International conducted a mapping analysis in Uganda to gather information on the maternal health policy environment; the organizations, partnerships, and networks currently and potentially engaged in maternal health advocacy; and the advocacy goals, strategies, resources, and core messages being used.

Harmoniser les services de santé : Sauver des vies grâce à l’intégration des programmes de santé reproductive, maternelle, néonatale et infantile avec ceux relatifs au VIH/SIDA, à la tuberculose et au paludisme (French title)

Mobilising Communities on Young People's Health and Rights: An Advocacy Toolkit for Programme Managers leads the user through the stages of planning and launching an advocacy campaign to ensure that government commitments are translated into programs that meet young people's sexual and reproductive health needs.

National Essential Medicines lists (EMLs) indicate medicines that meet the priority health needs of the population and often guide a government’s purchasing and distribution decisions for public health facilities.

This infographic, developed with support from Johnson & Johnson, highlights the critical role that midwives play in improving maternal and newborn health around the world. Midwives have a powerful voice in changing policies and practices that support the availability, accessibility, acceptability, and quality of health services.

Plaidoyer, approbation, accés : le misoprostol pour l'Hémorragie du post-partum Guide pour un plaidoyer efficace (French title)

Developed by Family Care International on behalf of the Reproductive Health Supplies Coalition (RHSC), this set of 7 policy briefs identifies key challenges and strategies for increasing the availability of three essential maternal health medicines: oxytocin, misoprostol, and magnesium sulfate, which can prevent or treat the leading causes of maternal death (postpartum hemorrhage and pre-eclampsia

This publication presents case studies from three countries — Bangladesh, Nepal, and Zambia — that have introduced and scaled up the use of misoprostol for postpartum hemorrhage (PPH).

East Africa, Latin America and the Caribbean, Middle East and North Africa, South Asia, Francophone West Africa

Developed by Family Care International and Gynuity Health Projects, the Misoprostol for Postpartum Hemorrhage Information Kit contains four publications. Postpartum Hemorrhage: A Challenge for Safe Motherhood

This policy brief, published by FCI in partnership with Gynuity Health Projects, PATH, and FIGO, explores strategies to help governments and partners improve maternal health by expanding access to misoprostol for postpartum hemorrhage (PPH), one of the leading causes of maternal death.

In recent years, the Government of Kenya has endorsed a range of global and regional initiatives for accelerating action to improve the health and well-being of women and their children, including the Global Strategy for Women's and Children's Health, the Maputo Plan of Action, and CARMMA, and has made specific commitments to achieve them.

This fact sheet presents an overview of the Mobilizing Advocates from Civil Society (MACS) project led by FCI from 2012 to 2015.

This video highlights the critical role of civil society organizations and alliances in holding governments accountable for fulfilling their commitments to protect women's and children's lives, health, and wellbeing, especially among the poorest and most vulnerable.

In this video, Family Care International (FCI) makes the case for clear and transparent national budgets that reflect the people's needs and priorities and that fulfill government commitments to protect the health and well-being of all women, newborns, and children.

A government budget must be comprehensive and transparent to allow citizens to hold government accountable for managing public funds.

The FCI Program created this infographic to convey key messages and data from We Decide, a UNFPA-led initiative to promote gender equality and social inclusion of young people with disabilities and to prevent sexual violence.

We reviewed literature on HIV and tuberculosis in sub-Saharan African prisons published between 2011 and 2015, and identified data from only 24 of the 49 countries in the region. Where data were available, they were frequently of poor quality and rarely nationally representative. Prevalence of HIV infection ranged from 2·3% to 34·9%, and of tuberculosis from 0·4 to 16·3%; detainees nearly always had a higher prevalence of both diseases than did the non-incarcerated population in the same country.We identified barriers to prevention, treatment, and care services in published work and through five case studies of prison health policies and services in Zambia, South Africa, Malawi, Nigeria, and Benin. These barriers included severe financial and human-resource limitations and fragmented referral systems that prevent continuity of care when detainees cycle into and out of prison, or move between prisons. These challenges are set against the backdrop of weak health and criminal-justice systems, high rates of pre-trial detention, and overcrowding. A few examples of promising practices exist, including routine voluntary testing for HIV and screening for tuberculosis upon entry to South African and the largest Zambian prisons, reforms to pre-trial detention in South Africa, integration of mental health services into a health package in selected Malawian prisons, and task sharing to include detainees in care provision through peer-educator programmes in Rwanda, Zimbabwe, Zambia, and South Africa. However, substantial additional investments are required throughout sub-Saharan Africa to develop country-level policy guidance, build human-resource capacity, and strengthen prison health systems to ensure universal access to HIV and tuberculosis prevention, treatment, and care of a standard that meets international goals and human rights obligations.

It is well known that safe delivery in a health facility reduces the risks of maternal and infant mortality resulting from perinatal complications. What is less understood are the factors associated with safe delivery practices. We investigated factors influencing health facility delivery practices while adjusting for multiple other factors simultaneously, spatial heterogeneity, and trends over time. We fitted a logistic regression model to Lot Quality Assurance Sampling (LQAS) data from Uganda in a framework that considered individual-level covariates, geographical features, and variations over five time points. We showed that ease of access, maternal age and education are strongly associated with delivery in a health facility; after accounting for this, there remains a significant trend towards greater uptake over time. We used this model together with known demographics to formulate a nascent early warning system that identifies candidate districts expected to have low prevalence of facility-based delivery in the immediate future. We provided a statistical method for using inexpensive and routinely collected monitoring and evaluation data to answer complex epidemiology and public health questions in a resource-poor setting.

Uganda introduced a multipronged intervention, the supervision, performance assessment, and recognition strategy (SPARS), to improve medicines management (MM) in public and not-for-profit health facilities. This paper, the first in a series, describes the SPARS intervention and reports on the MM situation in Uganda before SPARS (baseline).

This assessment of the Scaling Up Family Planning Initiative was conducted as part of USAID's Evidence Project. The Scaling Up Family Planning Initiative aimed to strengthen the public sector's ability to expand access to contraception and family planning services.

Beginning in 2003, Uganda used Lot Quality Assurance Sampling (LQAS) to assist district managers collect and use data to improve their human immunodeficiency virus (HIV)/AIDS program. Uganda's LQAS-database (2003–2012) covers up to 73 of 112 districts. Our multidistrict analysis of the LQAS data-set at 2003–2004 and 2012 examined gender variation among adults who ever tested for HIV over time, and attributes associated with testing. Conditional logistic regression matched men and women by community with seven model effect variables. HIV testing prevalence rose from 14% (men) and 12% (women) in 2003–2004 to 62% (men) and 80% (women) in 2012. In 2003–2004, knowing the benefits of testing, knowing where to get tested, and secondary education were significantly associated with HIV testing. By 2012, knowing the benefits of testing, where to get tested, primary education, being female, and being married were significantly associated with HIV testing. HIV testing prevalence in Uganda has increased dramatically, more for women than men. Our results concurred with other authors that education, knowledge of HIV, and marriage (women only) are associated with testing for HIV and suggest that couples testing is more prevalent than other authors found.

SETTING: Amhara and Oromia Regions, Ethiopia.OBJECTIVE: To determine trends in case notification rates (CNRs) among new tuberculosis (TB) cases and treatment outcomes of sputum smear-positive (SS+) patients based on geographic setting, sex and age categories.METHODS: We undertook a trend analysis over a 4-year period among new TB cases reported in 10 zones using a trend test, a mean comparison t-test and one-way analysis of variance.RESULTS: The average CNR per 100 000 population was 128.9: 126.4 in Amhara and 131.4 in Oromia. The CNR in the project-supported zones declined annually by 6.5%, compared with a 14.5% decline in Tigray, the comparator region. TB notification in the intervention zones contributed 26.1% of the national TB case notification, compared to 13.3% before project intervention. The overall male-to-female ratio was 1.2, compared to 0.8 among SS+ children, with a female preponderance. Over 4 years, the cure rate increased from 75% to 88.4%, and treatment success from 89% to 93%. Default, transfer out and mortality rates declined significantly.CONCLUSION: Project-supported zones had lower rates of decline in TB case notification than the comparator region; their contribution to national case finding increased, and treatment outcomes improved significantly. High SS+ rates among girls deserve attention.

Universal health coverage (UHC) has gained prominence as a global health priority. The UHC movement aims to increase access to quality, needed health services while reducing financial hardship from health spending, particularly in low- and middle-income countries. As a policy agenda, UHC has been identified primarily with prepayment and risk-pooling programs. While financing policies provide important benefits, increasing access to health services will require broader reforms. For lessons, the UHC movement should look to the global HIV response, which has confronted many of the same barriers to access in weak health systems. Considerable success on HIV has resulted from innovative approaches that UHC efforts can build upon, in areas including governance, financing, service delivery, political mobilization, accountability, and human rights. UHC and HIV efforts must capitalize on potential synergies, especially in settings with a high HIV burden and major resource limitations.

The objective of this study was to compare the diagnostic yield of GeneXpert MTB/RIF with Ziehl-Neelson (ZN) sputum smear microscopy among index TB cases and their household contacts. A cross sectional study was conducted among sputum smear positive index TB cases and their household contacts in Northern Ethiopia. Results: Of 353 contacts screened, 41 (11%) were found to have presumptive TB. GeneXpert test done among 39 presumptive TB cases diagnosed 14 (35.9%) cases of TB (one being rifampicin resistant), whereas the number of TB cases diagnosed by microscopy was only 5 (12.8%): a 64.3% increased positivity rate by GeneXpert versus ZN microscopy. The number needed to screen and number needed to test to diagnose a single case of TB was significantly lower with the use of GeneXpert than ZN microscopy. Of 119 index TB cases, GeneXpert test revealed that 106 (89.1%) and 5 (4.2%) were positive for rifampicin sensitive and rifampicin resistant TB, respectively. GeneXpert test led to increased TB case detection among household contacts in addition to its advantage in the diagnosis of Rifampicin resistance among contacts and index TB cases. There should be a consideration in using GeneXpert MTB/RIF as a point of care TB testing tool among high risk groups.

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