Beyond the science: advancing the “art and craft” of implementation in the training and practice of global health

Interesting debates are ongoing on how to develop practical implementation science competencies that can bridge the “know-do” gap in global health. We advance these debates by arguing that apprenticeship and mentorship models drawn from “art and craft” used in industry is the missing piece of the puzzle that will bridge the persisting gap between academics and real-world practitioners. We propose examples of such models and how they can be applied to improve existing capacity building programs, as well as implementation in practice

Beyond the Science: Advancing the "Art and Craft" of Implementation in the Training and Practice of Global Health

Interesting debates are ongoing on how to develop practical implementation science competencies that can bridge the "know-do" gap in global health. We advance these debates by arguing that apprenticeship and mentorship models drawn from "art and craft" used in industry is the missing piece of the puzzle that will bridge the persisting gap between academics and real-world practitioners. We propose examples of such models and how they can be applied to improve existing capacity building programs, as well as implementation in practice

Beyond the Science: Advancing the "Art and Craft" of Implementation in the Training and Practice of Global Health

Interesting debates are ongoing on how to develop practical implementation science competencies that can bridge the "know-do" gap in global health. We advance these debates by arguing that apprenticeship and mentorship models drawn from "art and craft" used in industry is the missing piece of the puzzle that will bridge the persisting gap between academics and real-world practitioners. We propose examples of such models and how they can be applied to improve existing capacity building programs, as well as implementation in practice

Any and every cure for COVID-19: an imminent epidemic of alternative remedies amidst the pandemic?

The magnitude of the COVID-19 pandemic is unprecedented, causing lots of apprehension among scientists, industry actors, politicians, and the general populace. Adverse health, social and economic effects of the pandemic have triggered an urgency among policy makers to seek an effective panacea. In this commentary, we examine the covert outbreak of a demand for alternative remedies with limited scientific evidence on their effectiveness to manage COVID-19 in Africa. Similar demands have been displayed in previous epidemics, though the ubiquity of social media in this current clime fuels such demands even more. We describe the attendant consequences of this demand surge on ongoing public health efforts to mitigate the spread of COVID-19 and highlight its future repercussions which may continue to plague health systems beyond the present outbreak. Going forward, governments must be proactive in surveillance of this covert epidemic, actively engage community influencers in knowledge transfer and implement targeted health promotion interventions

Aspirations and realities of intergovernmental collaboration in national- level interventions: Insights from maternal, neonatal and child health policy processes in Nigeria, 2009– 2019

In Nigeria’s federal government system, national policies assign concurrent healthcare responsibilities across constitutionally arranged government levels. Hence, national policies, formulated for adoption by states for implementation, require collaboration. This study examines collaboration across government levels, tracing implementation of three maternal, neonatal and child health (MNCH) programmes, developed from a parent integrated MNCH strategy, with intergovernmental collaborative designs, to identify transferable principles to other multilevel governance contexts, especially lowincome countries

Conditional cash transfers for maternal health interventions: Factors influencing uptake in North-Central Nigeria

Background: Nigeria accounts for a significant proportion of global maternal mortality figures with little progress made in curbing poor health indices. In a bid to reverse this trend, the Government of Nigeria initiated a conditional cash transfer (CCT) programme to encourage pregnant women utilize services at designated health facilities. This study aims to understand experiences of women who register for CCT services and explore reasons behind non-uptake of those women who do not register. Methods: We conducted this study in a rural community in North Central Nigeria. Having identified programme beneficiaries by randomly sampling contact details obtained from the programme database, using snowball sampling method we sourced non-beneficiaries list based on recommendations from beneficiaries and other community members. Thereafter we undertook semi-structured interviews on both beneficiaries and non-beneficiaries and analysed data obtained thematically. Results: Our findings revealed that, while beneficiaries of the programme were influenced by the cash transfers, cash may not be sufficient incentive for uptake by non-beneficiaries of CCT in Nigeria. Factors such as community and spousal influence, availability of free drugs, proximity to health facility are critical factors that affect uptake in our study context. On the other hand, poor programme administration, mistrust for government initiatives as well as poor quality of services could significantly constrain service utilization despite cash transfers. Conclusion: Considering that a number of barriers to uptake of the CCT programme are similar to barriers to maternal health services, it is essential that maternal health services are available, accessible and of acceptable quality to target recipients for CCT programmes to reach their full implementation potential

Aspirations and realities of intergovernmental collaboration in national- level interventions: Insights from maternal, neonatal and child health policy processes in Nigeria, 2009– 2019

In Nigeria’s federal government system, national policies assign concurrent healthcare responsibilities across constitutionally arranged government levels. Hence, national policies, formulated for adoption by states for implementation, require collaboration. This study examines collaboration across government levels, tracing implementation of three maternal, neonatal and child health (MNCH) programmes, developed from a parent integrated MNCH strategy, with intergovernmental collaborative designs, to identify transferable principles to other multilevel governance contexts, especially low income countries

Conditional Cash Transfers for Maternal Health Interventions: Factors Influencing Uptake in NorthCentral Nigeria

Abstract Background: Nigeria accounts for a significant proportion of global maternal mortality figures with little progress made in curbing poor health indices. In a bid to reverse this trend, the Government of Nigeria initiated a conditional cash transfer (CCT) programme to encourage pregnant women utilize services at designated health facilities. This study aims to understand experiences of women who register for CCT services and explore reasons behind non-uptake of those women who do not register. Methods: We conducted this study in a rural community in North Central Nigeria. Having identified programme beneficiaries by randomly sampling contact details obtained from the programme database, using snowball sampling method we sourced non-beneficiaries list based on recommendations from beneficiaries and other community members. Thereafter we undertook semi-structured interviews on both beneficiaries and non-beneficiaries and analysed data obtained thematically. Results: Our findings revealed that, while beneficiaries of the programme were influenced by the cash transfers, cash may not be sufficient incentive for uptake by non-beneficiaries of CCT in Nigeria. Factors such as community and spousal influence, availability of free drugs, proximity to health facility are critical factors that affect uptake in our study context. On the other hand, poor programme administration, mistrust for government initiatives as well as poor quality of services could significantly constrain service utilization despite cash transfers. Conclusion: Considering that a number of barriers to uptake of the CCT programme are similar to barriers to maternal health services, it is essential that maternal health services are available, accessible and of acceptable quality to target recipients for CCT programmes to reach their full implementation potential

'Any and every cure for COVID-19': an imminent epidemic of alternative remedies amidst the pandemic?

The magnitude of the COVID-19 pandemic is unprecedented, causing lots of apprehension among scientists, industry actors, politicians, and the general populace. Adverse health, social and economic effects of the pandemic have triggered an urgency among policy makers to seek an effective panacea. In this commentary, we examine the covert outbreak of a demand for alternative remedies with limited scientific evidence on their effectiveness to manage COVID-19 in Africa. Similar demands have been displayed in previous epidemics, though the ubiquity of social media in this current clime fuels such demands even more. We describe the attendant consequences of this demand surge on ongoing public health efforts to mitigate the spread of COVID-19 and highlight its future repercussions which may continue to plague health systems beyond the present outbreak. Going forward, governments must be proactive in surveillance of this covert epidemic, actively engage community influencers in knowledge transfer and implement targeted health promotion interventions

The cost of maternal health services in low-income and middle-income countries from a provider's perspective: a systematic review

Introduction Maternal health services are effective in reducing the morbidity and mortality associated with pregnancy and childbirth. We conducted a systematic review on costs of maternal health services in low-income and middle-income countries from the provider’s perspective. Methods We searched multiple peer-reviewed databases (including African Journal Online, CINAHL Plus, EconLit, Popline, PubMed, Scopus and Web of Science) and grey literature for relevant articles published from year 2000. Articles meeting our inclusion criteria were selected with quality assessment done using relevant cost-focused criteria of the Consolidated Health Economic Evaluation Reporting Standards checklist. For comparability, disaggregated costs data were inflated to 2019 US$equivalents. Costs and cost drivers were systematically compared. Where heterogeneity was observed, narrative synthesis was used to summarise findings. Results Twenty-two studies were included, with most studies costing vaginal and/or caesarean delivery (11 studies), antenatal care (ANC) (9) and postabortion care (PAC) (8). Postnatal care (PNC) has been least costed (2). Studies used different methods for data collection and analysis. Quality of peer-reviewed studies was assessed average to high while all grey literature studies were assessed as low quality. Following inflation, estimated provision cost per service varied (ANC (US$7.24–US$31.42); vaginal delivery (US$14.32–US$278.22); caesarean delivery (US$72.11–US$378.940; PAC (US$97.09–US$1299.21); family planning (FP) (US$0.82–US$5.27); PNC (US$5.04)). These ranges could be explained by intercountry variations, variations in provider type (public/private), facility type (primary/secondary) and care complexity (simple/complicated). Personnel cost was mostly reported as the major driver for provision of ANC, skilled birth attendance and FP. Economies of scale in service provision were reported. Conclusion There is a cost savings case for task-shifting and encouraging women to use lower level facilities for uncomplicated services. Going forward, consensus regarding cost component definitions and methodologies for costing maternal health services will significantly help to improve the usefulness of cost analyses in supporting policymaking towards achieving Universal Health Coverage