Subjects -> HEALTH AND SAFETY (Total: 1540 journals)
    - CIVIL DEFENSE (22 journals)
    - DRUG ABUSE AND ALCOHOLISM (86 journals)
    - HEALTH AND SAFETY (722 journals)
    - HEALTH FACILITIES AND ADMINISTRATION (389 journals)
    - OCCUPATIONAL HEALTH AND SAFETY (108 journals)
    - PHYSICAL FITNESS AND HYGIENE (131 journals)
    - WOMEN'S HEALTH (82 journals)

HEALTH AND SAFETY (722 journals)                  1 2 3 4 | Last

Showing 1 - 200 of 203 Journals sorted alphabetically
16 de Abril     Open Access   (Followers: 4)
Acta Informatica Medica     Open Access   (Followers: 2)
Acta Scientiarum. Health Sciences     Open Access   (Followers: 3)
Adultspan Journal     Hybrid Journal   (Followers: 1)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 11)
Advances in Public Health     Open Access   (Followers: 28)
Adversity and Resilience Science : Journal of Research and Practice     Hybrid Journal   (Followers: 3)
African Health Sciences     Open Access   (Followers: 5)
African Journal for Physical, Health Education, Recreation and Dance     Full-text available via subscription   (Followers: 7)
African Journal of Health Professions Education     Open Access   (Followers: 6)
Afrimedic Journal     Open Access   (Followers: 3)
Ageing & Society     Hybrid Journal   (Followers: 47)
Air Quality, Atmosphere & Health     Hybrid Journal   (Followers: 7)
AJOB Empirical Bioethics     Hybrid Journal   (Followers: 3)
Akademika     Open Access   (Followers: 1)
American Journal of Family Therapy     Hybrid Journal   (Followers: 10)
American Journal of Health Economics     Full-text available via subscription   (Followers: 21)
American Journal of Health Education     Hybrid Journal   (Followers: 36)
American Journal of Health Promotion     Hybrid Journal   (Followers: 34)
American Journal of Health Sciences     Open Access   (Followers: 11)
American Journal of Health Studies     Full-text available via subscription   (Followers: 15)
American Journal of Preventive Medicine     Hybrid Journal   (Followers: 31)
American Journal of Public Health     Full-text available via subscription   (Followers: 276)
American Journal of Public Health Research     Open Access   (Followers: 28)
American Medical Writers Association Journal     Full-text available via subscription   (Followers: 6)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 8)
Annales des Sciences de la Santé     Open Access  
Annali dell'Istituto Superiore di Sanità     Open Access  
Annals of Global Health     Open Access   (Followers: 14)
Annals of Health Law     Open Access   (Followers: 6)
Annals of Tropical Medicine and Public Health     Open Access   (Followers: 15)
Applied Biosafety     Hybrid Journal   (Followers: 1)
Applied Research In Health And Social Sciences: Interface And Interaction     Open Access   (Followers: 5)
Apuntes Universitarios     Open Access   (Followers: 1)
Archive of Community Health     Open Access   (Followers: 1)
Archives of Community Medicine and Public Health     Open Access   (Followers: 2)
Archives of Medicine and Health Sciences     Open Access   (Followers: 5)
Archives of Suicide Research     Hybrid Journal   (Followers: 10)
Archivos de Prevención de Riesgos Laborales     Open Access   (Followers: 1)
Arquivos de Ciências da Saúde     Open Access  
Asia Pacific Journal of Counselling and Psychotherapy     Hybrid Journal   (Followers: 11)
Asia Pacific Journal of Health Management     Full-text available via subscription   (Followers: 5)
Asia-Pacific Journal of Public Health     Hybrid Journal   (Followers: 12)
Asian Journal of Gambling Issues and Public Health     Open Access   (Followers: 4)
Asian Journal of Medicine and Health     Open Access   (Followers: 1)
Atención Primaria     Open Access   (Followers: 2)
Atención Primaria Práctica     Open Access   (Followers: 1)
Australasian Journal of Paramedicine     Open Access   (Followers: 6)
Australian Advanced Aesthetics     Full-text available via subscription   (Followers: 4)
Australian Family Physician     Full-text available via subscription   (Followers: 3)
Australian Indigenous HealthBulletin     Free   (Followers: 5)
Autism & Developmental Language Impairments     Open Access   (Followers: 16)
Behavioral Healthcare     Full-text available via subscription   (Followers: 8)
Bijzijn     Hybrid Journal   (Followers: 1)
Bijzijn XL     Hybrid Journal  
Biomedical Safety & Standards     Full-text available via subscription   (Followers: 8)
Biosafety and Health     Open Access   (Followers: 4)
Biosalud     Open Access   (Followers: 1)
Birat Journal of Health Sciences     Open Access  
BLDE University Journal of Health Sciences     Open Access  
BMC Oral Health     Open Access   (Followers: 7)
BMC Pregnancy and Childbirth     Open Access   (Followers: 23)
BMJ Simulation & Technology Enhanced Learning     Hybrid Journal   (Followers: 13)
Boletin Médico de Postgrado     Open Access  
Brazilian Journal of Medicine and Human Health     Open Access  
British Journal of Health Psychology     Hybrid Journal   (Followers: 50)
Buletin Penelitian Kesehatan     Open Access   (Followers: 2)
Buletin Penelitian Sistem Kesehatan     Open Access  
Bulletin of the World Health Organization     Open Access   (Followers: 23)
Cadernos de Educação, Saúde e Fisioterapia     Open Access   (Followers: 1)
Cadernos de Saúde     Open Access   (Followers: 1)
Cadernos Saúde Coletiva     Open Access   (Followers: 1)
Cambridge Quarterly of Healthcare Ethics     Hybrid Journal   (Followers: 14)
Canadian Family Physician     Partially Free   (Followers: 13)
Canadian Journal of Community Mental Health     Full-text available via subscription   (Followers: 12)
Canadian Journal of Human Sexuality     Hybrid Journal   (Followers: 3)
Canadian Journal of Public Health     Hybrid Journal   (Followers: 25)
Cannabis and Cannabinoid Research     Hybrid Journal   (Followers: 2)
Carta Comunitaria     Open Access  
Case Reports in Women's Health     Open Access   (Followers: 4)
Case Studies in Fire Safety     Open Access   (Followers: 25)
CASUS : Revista de Investigación y Casos en Salud     Open Access   (Followers: 1)
Central Asian Journal of Global Health     Open Access   (Followers: 2)
CES Medicina     Open Access  
CES Salud Pública     Open Access   (Followers: 1)
Child Abuse Research in South Africa     Full-text available via subscription   (Followers: 1)
Child's Nervous System     Hybrid Journal  
Childhood Obesity and Nutrition     Open Access   (Followers: 11)
Children     Open Access   (Followers: 2)
CHRISMED Journal of Health and Research     Open Access   (Followers: 2)
Christian Journal for Global Health     Open Access  
Ciência & Saúde Coletiva     Open Access   (Followers: 2)
Ciencia & Salud     Open Access   (Followers: 2)
Ciencia & Trabajo     Open Access   (Followers: 1)
Ciencia e Innovación en Salud     Open Access  
Ciencia y Cuidado     Open Access   (Followers: 1)
Ciencia y Salud     Open Access   (Followers: 4)
Ciencia y Salud Virtual     Open Access  
Ciencia, Tecnología y Salud     Open Access   (Followers: 2)
Cities & Health     Hybrid Journal   (Followers: 2)
Clinical and Experimental Health Sciences     Open Access   (Followers: 1)
ClinicoEconomics and Outcomes Research     Open Access   (Followers: 2)
Clocks & Sleep     Open Access   (Followers: 2)
CME     Hybrid Journal   (Followers: 2)
CoDAS     Open Access  
Community Health     Open Access   (Followers: 6)
Conflict and Health     Open Access   (Followers: 8)
Contraception and Reproductive Medicine     Open Access   (Followers: 2)
Cuaderno de investigaciones: semilleros andina     Open Access   (Followers: 3)
Cuadernos de la Escuela de Salud Pública     Open Access  
Current Opinion in Behavioral Sciences     Hybrid Journal   (Followers: 10)
Current Opinion in Environmental Science & Health     Hybrid Journal   (Followers: 1)
Day Surgery Australia     Full-text available via subscription   (Followers: 2)
Design for Health     Hybrid Journal  
Digital Health     Open Access   (Followers: 7)
Disaster Medicine and Public Health Preparedness     Hybrid Journal   (Followers: 14)
Diversity and Equality in Health and Care     Open Access   (Followers: 9)
Diversity of Research in Health Journal     Open Access  
Dramatherapy     Hybrid Journal   (Followers: 3)
Drogues, santé et société     Open Access   (Followers: 2)
Duazary     Open Access   (Followers: 1)
Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi / Journal of Duzce University Health Sciences Institute     Open Access  
Early Childhood Research Quarterly     Hybrid Journal   (Followers: 26)
East African Journal of Public Health     Full-text available via subscription   (Followers: 4)
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity     Hybrid Journal   (Followers: 24)
EcoHealth     Hybrid Journal   (Followers: 5)
Education for Health     Open Access   (Followers: 9)
electronic Journal of Health Informatics     Open Access   (Followers: 6)
ElectronicHealthcare     Full-text available via subscription   (Followers: 3)
Elsevier Ergonomics Book Series     Full-text available via subscription   (Followers: 5)
Emergency Services SA     Full-text available via subscription   (Followers: 2)
Ensaios e Ciência : Ciências Biológicas, Agrárias e da Saúde     Open Access  
Environmental Disease     Open Access   (Followers: 4)
Environmental Sciences Europe     Open Access   (Followers: 2)
Epidemics     Open Access   (Followers: 5)
Epidemiologic Perspectives & Innovations     Open Access   (Followers: 6)
Epidemiology, Biostatistics and Public Health     Open Access   (Followers: 22)
EsSEX : Revista Científica     Open Access   (Followers: 1)
Estudios sociales : Revista de alimentación contemporánea y desarrollo regional     Open Access   (Followers: 1)
Ethics & Human Research     Hybrid Journal   (Followers: 3)
Ethics, Medicine and Public Health     Full-text available via subscription   (Followers: 7)
Ethiopian Journal of Health Development     Open Access   (Followers: 7)
Ethiopian Journal of Health Sciences     Open Access   (Followers: 8)
Ethnicity & Health     Hybrid Journal   (Followers: 14)
Eurasian Journal of Health Technology Assessment     Open Access  
EUREKA : Health Sciences     Open Access   (Followers: 2)
European Journal of Investigation in Health, Psychology and Education     Open Access   (Followers: 5)
European Medical, Health and Pharmaceutical Journal     Open Access   (Followers: 1)
Evaluation & the Health Professions     Hybrid Journal   (Followers: 10)
Evidence-based Medicine & Public Health     Open Access   (Followers: 9)
Evidência - Ciência e Biotecnologia - Interdisciplinar     Open Access  
Expressa Extensão     Open Access  
Face à face     Open Access   (Followers: 1)
Families, Systems, & Health     Full-text available via subscription   (Followers: 9)
Family & Community Health     Hybrid Journal   (Followers: 14)
Family Medicine and Community Health     Open Access   (Followers: 10)
Family Relations     Partially Free   (Followers: 15)
Fatigue : Biomedicine, Health & Behavior     Hybrid Journal   (Followers: 2)
Finnish Journal of eHealth and eWelfare : Finjehew     Open Access  
Food and Public Health     Open Access   (Followers: 18)
Food Quality and Safety     Open Access   (Followers: 1)
Frontiers in Digital Health     Open Access   (Followers: 1)
Frontiers in Public Health     Open Access   (Followers: 9)
Frontiers of Health Services Management     Partially Free   (Followers: 4)
Gaceta Sanitaria     Open Access   (Followers: 3)
Galen Medical Journal     Open Access   (Followers: 1)
Ganesha Journal     Open Access  
Gazi Sağlık Bilimleri Dergisi     Open Access  
Geospatial Health     Open Access   (Followers: 1)
Gestão e Desenvolvimento     Open Access  
Gesundheitsökonomie & Qualitätsmanagement     Hybrid Journal   (Followers: 9)
Giornale Italiano di Health Technology Assessment     Full-text available via subscription  
Global Advances in Health and Medicine     Open Access  
Global Challenges     Open Access  
Global Health : Science and Practice     Open Access   (Followers: 8)
Global Health Annual Review     Open Access   (Followers: 4)
Global Health Journal     Open Access   (Followers: 2)
Global Health Promotion     Hybrid Journal   (Followers: 17)
Global Journal of Health Science     Open Access   (Followers: 10)
Global Journal of Public Health     Open Access   (Followers: 14)
Global Medical & Health Communication     Open Access   (Followers: 2)
Global Mental Health     Open Access   (Followers: 9)
Global Reproductive Health     Open Access   (Followers: 1)
Global Security : Health, Science and Policy     Open Access   (Followers: 1)
Global Transitions     Open Access   (Followers: 1)
Globalization and Health     Open Access   (Followers: 9)
Hacia la Promoción de la Salud     Open Access  
Hastane Öncesi Dergisi     Open Access  
Hastings Center Report     Hybrid Journal   (Followers: 5)
HCU Journal     Open Access  
HEADline     Hybrid Journal  
Health & Place     Hybrid Journal   (Followers: 19)
Health & Justice     Open Access   (Followers: 6)
Health : An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine     Hybrid Journal   (Followers: 14)
Health and Human Rights     Open Access   (Followers: 10)
Health and Research Journal     Open Access   (Followers: 5)
Health and Social Care Chaplaincy     Hybrid Journal   (Followers: 11)
Health and Social Work     Hybrid Journal   (Followers: 71)
Health Behavior and Policy Review     Full-text available via subscription   (Followers: 5)
Health Behavior Research     Open Access   (Followers: 5)

        1 2 3 4 | Last

Similar Journals
Journal Cover
Global Health : Science and Practice
Journal Prestige (SJR): 1.315
Citation Impact (citeScore): 2
Number of Followers: 8  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2169-575X - ISSN (Online) 2169-575X
Published by U.S. Agency for International Development Homepage  [1 journal]
  • Learning From Neighbors

    • Authors: Stephen Hodgins
      Pages: 613 - 613
      PubDate: 2020-12-23T10:57:01-08:00
      DOI: 10.9745/GHSP-D-20-00639
      Issue No: Vol. 8, No. 4 (2020)
       
  • Go Where the Virus Is: An HIV Micro-epidemic Control Approach to Stop HIV
           Transmission

    • Authors: Michael M. Cassell; Rose Wilcher, Reshmie A. Ramautarsing, Nittaya Phanuphak, Timothy D. Mastro
      Pages: 614 - 625
      PubDate: 2020-12-23T10:57:01-08:00
      DOI: 10.9745/GHSP-D-19-00418
      Issue No: Vol. 8, No. 4 (2020)
       
  • Capturing Acquired Wisdom, Enabling Healthful Aging, and Building
           Multinational Partnerships Through Senior Global Health Mentorship

    • Authors: C. Norman Coleman; John E. Wong, Eugenia Wendling, Mary Gospodarowicz, Donna O’Brien, Taofeeq Abdallah Ige, Simeon Chinedu Aruah, David A. Pistenmaa, Ugo Amaldi, Onyi–Onyinye Balogun, Harmar D. Brereton, Silvia Formenti, Kristen Schroeder, Nelson Chao, Surbhi Grover, Stephen M. Hahn, James Metz, Lawrence Roth, Manȷit Dosanȷh
      Pages: 626 - 637
      PubDate: 2020-12-23T10:57:01-08:00
      DOI: 10.9745/GHSP-D-20-00108
      Issue No: Vol. 8, No. 4 (2020)
       
  • Prevention of COVID-19 in Internally Displaced Persons Camps in War-Torn
           North Kivu, Democratic Republic of the Congo: A Mixed-Methods Study

    • Authors: Kasereka M. Claude; Muyisa Sahika Serge, Kahindo Kahatane Alexis, Michael T. Hawkes
      Pages: 638 - 653
      Abstract: ABSTRACTBackground:The coronavirus disease (COVID-19) pandemic poses a grave threat to refugees and internally displaced persons (IDPs). We examined knowledge, attitudes, and practices with respect to COVID-19 prevention among IDPs in war-torn Eastern Democratic Republic of the Congo (DRC).Methods:Mixed-methods study with qualitative (focus group discussions, [FGDs]) and quantitative (52-item survey questionnaire) data collection and synthesis.Results:FGDs (N=23) and survey questionnaires (N=164 IDPs; N=143 comparison group) were conducted in May 2020. FGD participants provided narratives of violence that they had fled. IDPs were statistically more likely to have larger household size, experience more extreme poverty, have lower educational attainment, and have less access to information through media and internet versus the comparison group (P
      PubDate: 2020-12-23T10:57:01-08:00
      DOI: 10.9745/GHSP-D-20-00272
      Issue No: Vol. 8, No. 4 (2020)
       
  • Meeting the Global Target in Reproductive, Maternal, Newborn, and Child
           Health Care Services in Low- and Middle-Income Countries

    • Authors: Md. Mehedi Hasan; Ricardo J. Soares Magalhaes, Saifuddin Ahmed, Sayem Ahmed, Tuhin Biswas, Yaqoot Fatima, Md. Saimul Islam, Md. Shahadut Hossain, Abdullah A. Mamun
      Pages: 654 - 665
      Abstract: ABSTRACTIntroduction:Improving reproductive, maternal, newborn, and child health (RMNCH) care services is imperative for reducing maternal and child mortality. Many low- and middle-income countries (LMICs) are striving to achieve RMNCH-related Sustainable Development Goals (SDGs). We monitored progress, made projections, and calculated the average annual rate of change needed to achieve universal (100%) access of RMNCH service indicators by 2030.Methods:We extracted Demographic and Health Survey (DHS) data of 75 LMICs to estimate the coverage of RMNCH indicators and composite coverage index (CCI) to measure health system strengths. Bayesian linear regression models were fitted to predict the coverage of indicators and the probability of achieving targets.Results:The projection analysis included 64 countries with available information for at least 2 DHS rounds. No countries are projected to reach universal CCI by 2030; only Brazil, Cambodia, Colombia, Honduras, Morocco, and Sierra Leone will have more than 90% CCI. None of the LMICs will achieve universal coverage of all RMNCH indicators by 2030, although some may achieve universal coverage for specific services. To meet targets for universal service access by 2030, most LMICs must attain a 2-fold increase in the coverage of indicators from 2019 to 2030. Coverage of RMNCH indicators, the probability of target attainments, and the required rate of increase vary significantly across the spectrum of sociodemographic disadvantages. Most countries with poor historical and current trends for RMNCH coverage are likely to experience a similar scenario in 2030. Countries with lower coverage had higher disparities across the subgroups of wealth, place of residence, and women’s/mother’s education and age; these disparities are projected to persist in 2030.Conclusion:None of the LMICs will meet the SDG RMNCH 2030 targets without scaling up essential RMNCH interventions, reducing gaps in coverage, and reaching marginalized and disadvantaged populations.
      PubDate: 2020-12-23T10:57:01-08:00
      DOI: 10.9745/GHSP-D-20-00097
      Issue No: Vol. 8, No. 4 (2020)
       
  • Contraceptive Method Mix: Updates and Implications

    • Authors: Jane T. Bertrand; John Ross, Tara M. Sullivan, Karen Hardee, James D. Shelton
      Pages: 666 - 679
      Abstract: ABSTRACTContext:Improving contraceptive method choice is a goal of international family planning. Method mix—the percentage distribution of total contraceptive use across various methods—reflects both supply (availability of affordable methods) and demand (client preferences). We analyze changes in method mix, regional contrasts, and the relationship of the mix to contraceptive prevalence.Methods:We use 789 national surveys from the 1960s through 2019, from 113 developing countries with at least 1 million people and with data on use of 8 contraceptive methods. Two measures assess the “evenness” of the mix: method skew (more than 50% use is by 1 method), and the average deviation (AD) of the 8 methods’ shares from their mean value. Population weighted and unweighted results are compared because they can differ substantially.Results:Use of traditional methods has declined but still represents 11% of all use (population weighted) or 17% (unweighted country average). Vasectomy’s share was historically low with the exception of a few countries but is now even lower. The previous trend toward greater overall evenness in the mix has slowed recently. Sub-Saharan Africa shows a hormonal method progression from oral contraceptives to injectables to implants in a substantial number of countries. In some countries with high HIV prevalence, the condom share has increased. The leading method’s share differs by region: female sterilization in Asia (39%) and in Latin America (31%), the pill in the Middle East/North Africa (32%), and the injectable in sub-Saharan Africa (36%). Method skew persists in 30% of countries. “Evenness” of mix is not related to contraceptive prevalence.Conclusion:The marked diversity in predominant methods underscores the conclusion that no single method mix is ideal or appropriate everywhere. But that diversity across countries, coupled with the persisting high degree of extreme skewness in many of them, argues for continued concerted efforts for programs to increase method choice.
      PubDate: 2020-12-23T10:57:01-08:00
      DOI: 10.9745/GHSP-D-20-00229
      Issue No: Vol. 8, No. 4 (2020)
       
  • Health Care Worker Preferences and Perspectives on Doses per Container for
           2 Lyophilized Vaccines in Senegal, Vietnam, and Zambia

    • Authors: Natasha Kanagat; Kirstin Krudwig, Karen A. Wilkins, Sydney Kaweme, Guissimon Phiri, Frances D. Mwansa, Mercy Mvundura, Joanie Robertson, Debra Kristensen, Abdoulaye Gueye, Sang D. Dao, Pham Q. Thai, Huyen T. Nguyen, Thang C. Tran
      Pages: 680 - 688
      Abstract: ABSTRACTIntroduction:Limited information exists on health care workers’ (HCWs) perceptions about use of multidose vaccine vials and their preferences about doses per container (DPC). We present findings from qualitative studies conducted in Senegal, Vietnam, and Zambia to explore HCWs’ behavior regarding opening vials and their perceptions and preferences for the number of doses in vials of BCG and measles-containing vaccine (MCV). Zambia and Senegal currently offer MCV in 10-dose vials and BCG in 20-dose vials; 10-dose vials are used for both vaccines in Vietnam. Unused doses in vials of these reconstituted vaccines must be discarded within 6 hours.Methods:Key informant interviews (KIIs) were conducted with frontline HCWs in Senegal, Vietnam, and Zambia. In Senegal and Vietnam, the KIIs were conducted as part of broader formative research; in Zambia, KIIs were conducted in control districts using 10-dose MCV vials only and in intervention districts that switched from 10- to 5-dose vials during the study. During analysis, themes common to all 3 countries were synthesized. Critical themes relevant to country contexts were also examined.Results:HCWs in all 3 countries preferred containers with fewer doses for BCG and MCV to reduce wastage and increase the likelihood of vaccinating every eligible child. HCWs in Senegal and HCWs using 10-dose vials in Zambia reported sending unvaccinated children away because not enough children were present to warrant opening a new vial. In Vietnam, where sessions are typically held monthly, and in Zambia when the 5-dose vials were used, almost all HCWs reported opening a vial of MCV for even 1 child.Discussion:HCWs prefer vials with fewer DPC. Their concerns about balancing coverage and wastage influence their decisions to vaccinate every eligible child; and their perspectives are crucial to ensuring that all target populations are reached with vaccines in a timely manner.
      PubDate: 2020-12-23T10:57:01-08:00
      DOI: 10.9745/GHSP-D-20-00112
      Issue No: Vol. 8, No. 4 (2020)
       
  • Remote Mentorship Using Video Conferencing as an Effective Tool to
           Strengthen Laboratory Quality Management in Clinical Laboratories: Lessons
           From Cambodia

    • Authors: Grant Donovan; Siew Kim Ong, Sophanna Song, Nayah Ndefru, Chhayheng Leang, Sophat Sek, Lucy A. Perrone
      Pages: 689 - 698
      Abstract: ABSTRACTBackground:Providing professional development opportunities to staff working in clinical laboratories undergoing quality improvement programs can be challenged by limited funding, particularly in resource-limited countries such as Cambodia. Using innovative approaches such as video conferencing can connect mentors with practitioners regardless of location. This study describes and evaluates the methods, outputs, and outcomes of a quality improvement program implemented in 12 public hospital laboratories in Cambodia between January 2018 and April 2019. The program used mixed intervention methods including both in-person and remote-access training and mentorship.Methods:Training outputs were quantified from the activity reports of program trainers and mentors. Program outcomes were measured by pre- and postimplementation audits of laboratory quality management system conformity to international standards. Variations in improved outcomes were assessed in relation to the time spent by laboratory personnel in video conference training and mentoring activity. An additional cross-sectional comparison described the difference in final audit scores between participating and nonparticipating laboratories.Results:Laboratories significantly improved their audit scores over the project period, showing significant improvement in all sections of the ISO 15189 standard. Pre- and postaudit score differences and laboratory personnel participation time in remote mentoring activities showed a strong monotonic relationship. Average input per laboratory was 6,027±2,454 minutes of participation in video conference activities with mentors. Audit scores of participating laboratories were significantly higher than those of laboratories with no quality improvement program.Conclusion:Laboratories improved significantly in ISO 15189 conformity following structured laboratory quality management systems training supported by remote and on-site mentoring. The correlation of laboratory participation in video conference activities highlights the utility of remote video conferencing technology to strengthen laboratories in resource-limited settings and to build communities of practice to address quality improvement issues in health care. These findings are particularly relevant in light of the COVID-19 pandemic.
      PubDate: 2020-12-23T10:57:01-08:00
      DOI: 10.9745/GHSP-D-20-00128
      Issue No: Vol. 8, No. 4 (2020)
       
  • Using Community Health Workers and a Smartphone Application to Improve
           Diabetes Control in Rural Guatemala

    • Authors: Sean Duffy; Derek Norton, Mark Kelly, Aleȷandro Chavez, Rafael Tun, Mariana Nino de Guzman Ramirez, Guanhua Chen, Paul Wise, Jim Svenson
      Pages: 699 - 720
      Abstract: ABSTRACTBackground:The global prevalence of diabetes has nearly doubled since 1980. Seventy-five percent of patients with diabetes live in low- and middle-income countries, such as Guatemala, where health care systems are often poorly equipped for chronic disease management. Community health workers (CHWs) and mobile health technology have increasingly been applied to the diabetes epidemic in these settings, although mostly in supportive rather than primary roles in diabetes management. We sought to improve diabetes care in rural Guatemala through the development of a CHW-led diabetes program and a smartphone application to provide CHWs with clinical decision support.Methods:We worked with our local partners to develop a program model and the smartphone application (using the CommCare platform) and to train CHWs. We recruited patients with type 2 diabetes living in rural communities. Program evaluation used a single-group, pre-post design. Primary outcomes were hemoglobin A1c and the percentage of patients meeting A1c goals compared with baseline. We also followed a variety of process metrics, including application reliability.Results:Eighty-nine patients enrolled during the study period. The hemoglobin A1c percentage decreased significantly at 3 months (-1.0; 95% CI=-1.7, -0.6), 6 months (-1.5; 95% CI=-2.2, -0.8), 9 months (-1.3; 95% CI=-2.0, -0.6), and 12 months (-1.0; 95% CI=-1.7, -0.4). The percentage of patients with A1c ≤ 8% increased significantly at 3 months (23.6% to 44.4%, P=.007), 6 months (22.0% to 44.0%, P=.015), and 9 months (23.9% to 45.7%, P=.03). CHWs and supervising physicians agreed with application medication recommendations>90% of the time.Conclusion:Our results suggest that CHWs can safely and effectively manage diabetes with the assistance of a smartphone application and remote physician supervision. This model should be evaluated versus other standards of care and could be adapted to other low-resource settings and chronic diseases.
      PubDate: 2020-12-23T10:57:01-08:00
      DOI: 10.9745/GHSP-D-20-00076
      Issue No: Vol. 8, No. 4 (2020)
       
  • Behavioral Insights Into Micronutrient Powder Use for Childhood Anemia in
           Arequipa, Peru

    • Authors: Jessica D. Brewer; Julianna Shinnick, Karina Roman, Maria P. Santos, Valerie A. Paz–Soldan, Alison M. Buttenheim
      Pages: 721 - 731
      Abstract: ABSTRACTChildhood anemia remains a significant driver of morbidity in low- and middle-income countries, including Peru. To identify behavioral challenges to using micronutrient powder (MNP) that is given to supplement children’s diets and prevent anemia, we applied a behavioral design approach to interviews and focus groups with 129 caregivers in Arequipa, Peru. We examined 3 key points in the decision-making process: accessing MNP through the health system; forming intentions to use MNP; and MNP use at the time of child feeding. Using the NUDGE (Narrow, Understand, Discover, Generate, Evaluate) approach, we identified the following behavioral barriers and facilitators: (1) caregivers’ experiences with health care providers shaped their motivation to access MNP; (2) caregivers felt accessing MNP at clinics was inconvenient and created hassle factors; (3) caregivers’ mental models about anemia prevention shaped MNP intentions and use; (4) caregivers’ salient negative experiences could have caused them to stop giving MNP; (5) caregivers forgot to give MNP if they did not have cues to remind them but could be prompted with salient cues; and (6) caregivers were affected by emotional, cognitive, and attentional factors during feeding that were difficult to anticipate. Our results, based on a behavioral design approach, suggest opportunities to adapt current messaging, counseling, and education around MNP use. Adaptations include providing culturally relevant messages, leveraging caregivers’ emotional and cognitive states, and encouraging small but impactful changes to feeding routines to address barriers to MNP use.
      PubDate: 2020-12-23T10:57:01-08:00
      DOI: 10.9745/GHSP-D-20-00078
      Issue No: Vol. 8, No. 4 (2020)
       
  • A Cluster-Randomized Trial to Test Sharing Histories as a Training Method
           for Community Health Workers in Peru

    • Authors: Laura C. Altobelli; Jose Cabreȷos–Pita, Mary Penny, Stan Becker
      Pages: 732 - 758
      Abstract: ABSTRACTBackground:Community health workers (CHWs) are increasingly deployed to support mothers’ adoption of healthy home practices in low- and middle-income countries. However, little is known regarding how best to train them for the capabilities and cultural competencies needed to support maternal health behavior change. We tested a CHW training method, Sharing Histories (SH), in which CHWs recount their own childbearing and childrearing experiences on which to build new learning.Methods:We conducted an embedded cluster-randomized trial in rural Peru in 18 matched clusters. Each cluster was a primary health facility catchment area. Government health staff trained female CHWs using SH (experimental clusters) or standard training methods (control clusters). All other training and system-strengthening interventions were equal between study arms. All CHWs conducted home visits with pregnant women and children aged 0–23 months to teach, monitor health practices and danger signs, and refer. The primary outcome was height-for-age (HAZ)
      PubDate: 2020-12-23T10:57:01-08:00
      DOI: 10.9745/GHSP-D-19-00332
      Issue No: Vol. 8, No. 4 (2020)
       
  • A Rapid Cost Modeling Tool for Evaluating and Improving Public Health
           Supply Chain Designs

    • Authors: Michael Krautmann; Mariam Zameer, Dorothy Thomas, Nora Phillips-White, Ana Costache, Pascale R. Leroueil
      Pages: 759 - 770
      Abstract: ABSTRACTEffective and efficient health supply chains play a vital role in achieving health outcomes by ensuring supplies are available for people to access quality health services. However, supplying health commodities to service delivery points is complex and costly in many low- and middle-income countries. Thus, governments and partner organizations are often interested in understanding how to design their health supply chains more cost efficiently.Several modeling tools exist in the public and private market that can help assess supply chain efficiency and identify supply chain design improvements. These tools are generally capable of providing users with very precise cost estimates, but they often use proprietary software and require detailed data inputs. This can result in a somewhat lengthy and expensive analysis process, which may be prohibitive for many decision makers, especially in the early stages of a supply chain design process. For many use cases, such as advocacy, informing workshop and technical meetings, and narrowing down initial design options, decision makers may often be willing to trade some detail and accuracy in exchange for quicker and lower-cost analysis results. To our knowledge, there are no publicly available tools focused on generating quick, high-level estimates of the cost and efficiency of different supply chain designs.To address this gap, we designed and tested an Excel-based Rapid Supply Chain Modeling (RSCM) Tool. Our assessment indicated that, despite requiring significantly less data, the RSCM Tool can generate cost estimates that are similar to other common analysis and modeling methods. Furthermore, to better understand how the RSCM Tool aligns with real-world processes and decision-making timelines, we used it to inform an ongoing immunization supply chain redesign in Angola. For the use cases described above we believe that the RSCM Tool addresses an important need for quicker and less expensive ways to identify more cost-efficient supply chain designs.
      PubDate: 2020-12-23T10:57:01-08:00
      DOI: 10.9745/GHSP-D-20-00227
      Issue No: Vol. 8, No. 4 (2020)
       
  • Lessons Learned From Implementing Prospective, Multicountry Mixed-Methods
           Evaluations for Gavi and the Global Fund

    • Authors: Emily Carnahan; Nikki Gurley, Gilbert Asiimwe, Baltazar Chilundo, Herbert C. Duber, Adama Faye, Carol Kamya, Godefroid Mpanya, Shakilah Nagasha, David Phillips, Nicole Salisbury, Jessica Shearer, Katharine Shelley, for the Gavi Full Country Evaluations Consortium; Global Fund Prospective Country Evaluation Consortium
      Pages: 771 - 782
      Abstract: ABSTRACTIntroduction:As global health programs have become increasingly complex, corresponding evaluations must be designed to assess the full complexity of these programs. Gavi and the Global Fund have commissioned 2 such evaluations to assess the full spectrum of their investments using a prospective mixed-methods approach. We aim to describe lessons learned from implementing these evaluations.Methods:This article presents a synthesis of lessons learned based on the Gavi and Global Fund prospective mixed-methods evaluations, with each evaluation considered a case study. The lessons are based on the evaluation team’s experience from over 7 years (2013–2020) implementing these evaluations. The Centers for Disease Control and Prevention Framework for Evaluation in Public Health was used to ground the identification of lessons learned.Results:We identified 5 lessons learned that build on existing evaluation best practices and include a mix of practical and conceptual considerations. The lessons cover the importance of (1) including an inception phase to engage stakeholders and inform a relevant, useful evaluation design; (2) aligning on the degree to which the evaluation is embedded in the program implementation; (3) monitoring programmatic, organizational, or contextual changes and adapting the evaluation accordingly; (4) hiring evaluators with mixed-methods expertise and using tools and approaches that facilitate mixing methods; and (5) contextualizing recommendations and clearly communicating their underlying strength of evidence.Conclusion:Global health initiatives, particularly those leveraging complex interventions, should consider embedding evaluations to understand how and why the programs are working. These initiatives can learn from the lessons presented here to inform the design and implementation of such evaluations.
      PubDate: 2020-12-23T10:57:01-08:00
      DOI: 10.9745/GHSP-D-20-00126
      Issue No: Vol. 8, No. 4 (2020)
       
  • Effects of a Community-Based Program on Voluntary Modern Contraceptive
           Uptake Among Young First-Time Parents in Cross River State, Nigeria

    • Authors: Gwendolyn Morgan; Anjala Kanesathasan, Akinsewa Akiode
      Pages: 783 - 798
      Abstract: ABSTRACTBackground:Reproductive health programs for youth have largely overlooked first-time parents (FTPs)—defined as young women younger than 25 years old who are pregnant or already have 1 child, and their partners. To address this gap, we implemented and evaluated a program to improve child spacing, modern contraceptive use, and related gender outcomes among FTPs in Cross River State (CRS), Nigeria. This paper examines the effectiveness of FTP interventions in improving voluntary uptake of contraception.Methods:We conducted small group sessions and home visits with FTPs from May to August 2018 in 2 local government areas of CRS. A pretest–posttest study examined the effectiveness of these interventions regarding healthy timing and spacing of pregnancy/family planning knowledge, attitudes, intentions, communication, decision making, and contraceptive use. We performed a bivariate analysis and logistic binomial regression to confirm change over time in the primary study outcome, current use of a modern method of contraception. We also performed analysis of demographic characteristics and secondary outcomes (e.g., birth spacing intentions and couple communication).Results:We interviewed 338 participating first-time mothers (FTMs) and 224 participating partners at baseline and endline. Important indicators of contraceptive awareness, attitudes, and couples’ communication increased significantly from baseline to endline. Voluntary current modern contraceptive use increased from 26% to 79% among nonpregnant FTMs (P
      PubDate: 2020-12-23T10:57:01-08:00
      DOI: 10.9745/GHSP-D-20-00111
      Issue No: Vol. 8, No. 4 (2020)
       
  • Routine Family Planning Data in the Low- and Middle-Income Country
           Context: A Synthesis of Findings From 17 Small Research Grants

    • Authors: Bridgit Adamou; Janine Barden–O’Fallon, Katie Williams, Amani Selim
      Pages: 799 - 812
      Abstract: ABSTRACTHealth information systems rely on high-quality data to measure, track, and inform decision making. Currently, the quality, uptake, and use of family planning data in routine health information systems is limited, presenting an opportunity for improvement on many levels. The current synthesis assessed findings from 17 small grants that MEASURE Evaluation issued to low- and middle-income country research teams between 2015 and 2019. Main findings from that research were collaboratively categorized in 4 major themes: (1) the enabling environment for managing and using family planning information; (2) barriers to integration of family planning in routine health information systems; (3) gaps in the analysis, interpretation, and use of routine family planning data; and (4) family planning data use in management, programmatic, and budgetary decisions. Data quality at the systemic, organizational, technical, and output levels was a crosscutting theme. Collectively, the findings outline barriers to and opportunities for improved integration of family planning data and subsequent strengthening of routine health information systems.
      PubDate: 2020-12-23T10:57:01-08:00
      DOI: 10.9745/GHSP-D-20-00122
      Issue No: Vol. 8, No. 4 (2020)
       
  • Effectiveness of mHealth Interventions for Improving Contraceptive Use in
           Low- and Middle-Income Countries: A Systematic Review

    • Authors: Banyar Aung; Jason W. Mitchell, Kathryn L. Braun
      Pages: 813 - 826
      Abstract: ABSTRACTBackground:mHealth interventions are being tested to improve contraceptive uptake in low- and middle-income countries (LMICs); however, the effectiveness of these interventions has not been systematically reviewed.Objectives:The primary objective of this systematic review was to assess the effectiveness of mHealth interventions to improve contraceptive uptake and adherence in LMICs. A second objective was to identify mHealth features and behavior change communication components used in these mHealth interventions.Methods:A systematic search was conducted of online databases for peer-reviewed articles that reported on intervention studies with men and women from LMICs and measured mHealth intervention impact on contraceptive uptake and/or adherence. Key search terms included “mHealth” or “mobile health,” “contraception” or “family planning,” and “low- and middle-income countries.” PRISMA guidelines were followed for reporting review methods and findings. The Cochrane risk-of-bias 2 tool for randomized trials was used to assess the risk of bias of the included studies. The GRADE approach was used to determine the quality of evidence.Results:Eight randomized controlled trial studies met the inclusion criteria. Four studies experienced implementation challenges (e.g., intervention components were not utilized fully by participants, intervention participants did not receive the full intervention content, contamination, low response rate, and/or missing data). Only 3 interventions were found to be effective, and these included a “push” approach, interactive communication, information tailored to participants, motivational messaging, and male partner involvement.Conclusion:To date, the delivery of mHealth interventions for improving family planning in LMICs has met with implementation challenges that have reduced the researcher’s ability to test intervention effectiveness. Although 3 of 8 studies found improved contraceptive use in the intervention group, the review cannot draw concrete conclusions on the overall effectiveness of mHealth interventions to increase contraceptive use in LMICs. Further research with robust program fidelity is recommended.
      PubDate: 2020-12-23T10:57:01-08:00
      DOI: 10.9745/GHSP-D-20-00069
      Issue No: Vol. 8, No. 4 (2020)
       
  • A Practical Guide to Using Time-and-Motion Methods to Monitor Compliance
           With Hand Hygiene Guidelines: Experience From Tanzanian Labor Wards

    • Authors: Giorgia Gon; Said M. Ali, Robert Aunger, Oona M. Campbell, Micheal de Barra, Mariȷn de Bruin, Mohammed Juma, Stephen Nash, Amour Taȷo, Johanna Westbrook, Susannah Woodd, Wendy J. Graham
      Pages: 827 - 837
      Abstract: ABSTRACTBackground:Good-quality evidence on hand hygiene compliance among birth attendants in low-resource labor wards is limited. The World Health Organization Hand Hygiene Observation Form is widely used for directly observing behaviors, but it does not support capturing complex patterns of behavior. We developed the HANDS at Birth tool for direct observational studies of complex patterns of hand rubbing/washing, glove use, recontamination, and their determinants among birth attendants. Understanding these behaviors is particularly critical in wards with variable patient volumes or unpredictable patient complications, such as emergency departments, operating wards, or triage and isolation wards during epidemics. Here we provide detailed information on the design and implementation of the HANDS at Birth tool, with a particular focus on low-resource settings. We developed the HANDS at Birth tool from available guidelines, unstructured observation, and iterative refinement based on consultation with collaborators and pilot results. We designed the tool with WOMBAT software, which supports collecting multidimensional time-and-motion data. Our analysis of the tool’s performance centered on interobserver agreement and convergent validity and the implications of the data structure for data analysis. The HANDS at Birth tool encompasses various hand actions and context-relevant information. Hand actions include procedures relevant during labor and delivery; hand hygiene or glove actions; and other types of touch. During field implementation, we used the tool for continuous observation of the birth attendant. Interobserver agreement was good (kappa range: 0.7–0.9), and the tool showed convergent validity. Using the HANDS at Birth tool is a feasible way to obtain useful information about compliance with hand hygiene procedures. The tool could be used after simple training and allows for collection of reliable information about the complex pattern of hygiene behaviors. Future studies should explore using this tool to observe behavior in labor wards in other settings and in other types of wards.
      PubDate: 2020-12-23T10:57:01-08:00
      DOI: 10.9745/GHSP-D-20-00221
      Issue No: Vol. 8, No. 4 (2020)
       
  • Implementation of a Pediatric Early Warning Score to Improve Communication
           and Nursing Empowerment in a Rural District Hospital in Rwanda

    • Authors: Shela Sridhar; Alexis Schmid, Francois Biziyaremye, Samantha Hodge, Ngamika Patient, Kim Wilson
      Pages: 838 - 845
      Abstract: ABSTRACTBackground:Pediatric early warning (PEW) scores represent a “track-and-trigger system” that identifies clinical deterioration in a patient’s condition in the hours preceding a sentinel event. Before implementation, nurses reported feeling unprepared to identify and advocate for acutely ill patients owing to a lack of skills, vocabulary, and agency. We implemented a Pediatric Early Warning Score for Resource-Limited Settings (PEWS-RL) with nurses in a rural district hospital in Rwanda. Although PEW scores can improve clinical outcomes, empowering nurses in resource-limited settings to discuss patient acuity with physicians is a critical first step. Our primary aims were to train nurses to obtain more accurate vital signs and assess their importance as early warning signs of clinical deterioration and use PEW scores to improve communication between nurses and physicians.Implementation:The PEWS-RL tool implementation began with a training program that was created through discussions with nurses, physicians, and the medical director of the hospital. The program included lectures and application of learned skills through direct clinical mentorship of nurses, as well as training of physicians regarding PEWS-RL as a communication tool.Evaluation:The PEWS-RL protocol was evaluated based on pre- and post-tests to assess improvement in nurses’ knowledge and skill, as well as skills assessments of accurate recognition of clinical deterioration. All 6 nurses passed skill testing with>80% accuracy. Nurses’ feelings of empowerment to advocate for patients and to escalate care were assessed through pre- and post-training interviews. Nurses described increased confidence in calling for physician support.Discussion:Implementation of PEW scores increased nurses’ technical skills and feelings of confidence and empowerment; however, the low-resource setting presented major challenges. Barriers to sustainable implementation include the rapid ward staff turnover as well as limited physician buy-in. Nevertheless, the PEWS-RL tool has the potential to empower nurses and improve patient outcomes if fully embraced by staff.
      PubDate: 2020-12-23T10:57:01-08:00
      DOI: 10.9745/GHSP-D-20-00075
      Issue No: Vol. 8, No. 4 (2020)
       
  • Juntos: A Support Program for Families Impacted by Congenital Zika
           Syndrome in Brazil

    • Authors: Antony Duttine; Tracey Smythe, Miriam Ribeiro Calheiros de Sa, Silvia Ferrite, Maria Elisabeth Moreira, Hannah Kuper
      Pages: 846 - 857
      Abstract: ABSTRACTBackground:The 2015–2016 Zika virus outbreak in Brazil was unprecedented and resulted in the birth of more than 3,000 children with congenital Zika syndrome (CZS). These children experience multiple complex health conditions and have limited services to support them and their family’s needs.Program Development and Piloting:An existing family support program for children with cerebral palsy (Getting to Know Cerebral Palsy) was adapted to the Zika context in Brazil through expert consultation. The program was pilot tested at 2 sites among 6 groups of caregivers (total of 48 families) from August 2017 to June 2018. Group observation and focus group discussions with facilitators and participants at the end of each session informed fast-track learning, which was used to tailor the program for future groups. Fast-track learning—adjusting the intervention in real time based on gathered feedback—was found to be a helpful process to inform and hone the program from its initial concept.Program Description:The intervention, Juntos, is a facilitated participatory group program for caregivers of children who have CZS. The group sessions are cofacilitated by a parent of a child who has CZS and an allied health professional. The group meets for 10 sessions that last 4 hours. Each session includes an icebreaker, activities, and group discussions. Content covers practical information on caring for a child with a developmental disability including that caused by Zika. Psychosocial support forms an important component, and families are guided from the first week to define and develop their own communities of support. Six pilot groups were successfully run in Rio de Janeiro and Greater Salvador, Bahia. The groups gave positive feedback on acceptability and demand.Conclusions:The program has the potential to be an important tool for community health and social support services in South America in response to Zika. The program can also be applied to children with neurodevelopmental disabilities other than those caused by the Zika virus, which could be important in ensuring families of children with CZS are less isolated.
      PubDate: 2020-12-23T10:57:01-08:00
      DOI: 10.9745/GHSP-D-20-00018
      Issue No: Vol. 8, No. 4 (2020)
       
  • Improving Hospital Oxygen Systems for COVID-19 in Low-Resource Settings:
           Lessons From the Field

    • Authors: Hamish R. Graham; Sheillah M. Bagayana, Ayobami A. Bakare, Bernard O. Olayo, Stefan S. Peterson, Trevor Duke, Adegoke G. Falade
      Pages: 858 - 862
      Abstract: ABSTRACTOxygen therapy is an essential medicine and core component of effective hospital systems. However, many hospitals in low- and middle-income countries lack reliable oxygen access—a deficiency highlighted and exacerbated by the coronavirus disease (COVID-19) pandemic. Oxygen access can be challenged by equipment that is low quality and poorly maintained, lack of clinical and technical training and protocols, and deficiencies in local infrastructure and policy environment. We share learnings from 2 decades of oxygen systems work with hospitals in Africa and the Asia-Pacific regions, highlighting practical actions that hospitals can take to immediately expand oxygen access. These include strategies to: (1) improve pulse oximetry and oxygen use, (2) support biomedical engineers to optimize existing oxygen supplies, and (3) expand on existing oxygen systems with robust equipment and smart design. We make all our resources freely available for use and local adaptation.
      PubDate: 2020-12-23T10:57:01-08:00
      DOI: 10.9745/GHSP-D-20-00224
      Issue No: Vol. 8, No. 4 (2020)
       
  • Corrigendum: Parmaksiz K et al., What Makes a National Pharmaceutical
           Track and Trace Succeed' Lessons From Turkey

    • Pages: 863 - 863
      PubDate: 2020-12-23T10:57:01-08:00
      DOI: 10.9745/GHSP-D-20-00587
      Issue No: Vol. 8, No. 4 (2020)
       
 
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