Learning the Smart Way: Lessons Learned by the Reaching Agents of Change Project.

The Reaching Agents of Change (RAC) project was a pilot that advocated for increased investment in orange-fleshed sweetpotato to combat vitamin A deficiency among young children and women of reproductive age. It was implemented by the International Potato Center and Helen Keller International primarily in Nigeria, Mozambique, Tanzania and to a lesser extent in Ghana and Burkina Faso between 2011 and 2014. The project had multiple deliverables in advocacy for raising of new investment, policy change and strengthening of institutional and individual capacities in the project countries. RAC incorporated a systematic and comprehensive results-based monitoring and evaluation system and continuously documented the implementation process over the project period. This booklet shares the learning process that RAC adopted and highlights some useful and replicable lessons learned

A mixed methods study on continuity and care coordination based on the obstetric near miss approach

Background: The near-miss approach assumes that mothers facing life-threatening conditions such as severe pre-eclampsia and postpartum haemorrhage share common risk factors. Among these women, those who survive (near-miss cases) can offer insights into the determinants, providing valuable lessons for understanding underlying factors. Aim: To investigate elements of continuity and coordination leading to obstetric near misses. Setting: A major referral hospital and its referral pathway in Kenya. Methods: Explanatory sequential mixed-methods design. Results: Near-miss survivors had lower continuity and coordination of care indices during antenatal visits (COCI = 0.80, p = 0.0026), (modified continuity of care index [MCCI] = 0.62, p = 0.034), and those with non-life-threatening morbidity in the first trimester were more likely to experience a near miss (aOR = 4.34, p = 0.001). Facilities in the western region had a higher burden of near misses compared to the Eastern region. Qualitatively, three deductive themes were identified: sequential coordination, parallel coordination and continuity, along with factors classified as access. In mixed integration, poor continuity indices were explained by quality of interpersonal relationships and woman centredness. Poor coordination was explained by inadequate teamwork between providers in referring and referral facilities and between primary health facilities and the community. Higher near-miss rates in the western region resulted from differences in human and physical resources. Conclusion: Promoting woman-centred care, teamwork, improving communication and introducing innovative coordination roles like case and care managers can enhance continuity and coordination of maternal healthcare. Contributions: This study contributes to our understanding of the challenges of continuity and coordination in maternal healthcare in resource-poor settings by applying the WHO operationalisation of continuity and coordination using mixed methodology

) May (2011) Res

Abstract An identification has been achieved of only 1:1 and 1:2 chelates of hexahydroxystannat

) May (2011) Res

Abstract An identification has been achieved of only 1:1 and 1:2 chelates of hexahydroxystannat

Fréquence et facteurs de risque des infections néonatales à l’Hôpital Général de Référence d’Uvira (Est de la RD Congo)

The objective of this study was to determine the frequency and risk factors of neonatal infections within the hospital of Uvira. A survey case-witness concerned the aged newborns of 0 to 28 days staying more than 48 hours to the service of neonatology of this hospital on a period of 12 months (January 1st to December 31, 2012). Sources of data were cards of partogram, the register of childbirth and cards of newborn hospitalization. A frequency of 15.53% of neonatal infections has been determined there with 17% of lethality rate. Risk factors associated to neonatal infections were low birth weight, prematurity, urogenital infection of the 3th quarter, fever maternal 48 hours before the childbirth,   mechanical ventilation, feeding by nasogastric catheter and an amniotic liquid either tinted meconial (p < 0,05). This study recommends respecting measures of strict hygiene in charge all along the hold of newborns, to limit invasiveness gestures in frequency and in length and to lead a good followed clinic and paraclinic of all pregnant woman.L’objectif de cette étude était de déterminer la fréquence et les facteurs de risque associés aux infections néonatales au sein de l’hôpital d’Uvira. Une étude cas-témoins a concerné les nouveau-nés âgés de 0 à 28 jours séjournant plus de 48 heures au service de néonatologie de cet hôpital sur une période de 12 mois (allant du 1er janvier au 31 décembre 2012). Les sources des données étaient les fiches de partogrammes, le registre d’accouchement et les fiches d’hospitalisation des nouveau-nés. Une fréquence de 15,5% des infections néonatales a été observée et  la proportion de décès néonatal parmi ces infections était de  17%. Les facteurs associés aux infections néonatales étaient l’hypotrophie néonatale, la prématurité, l’infection urogénitale du 3ème trimestre, la fièvre maternelle 48 heures avant l’accouchement, la ventilation mécanique, l’alimentation par sonde nasogastrique et un liquide amniotique teinté ou méconial (p < 0,05). Cette étude recommande de respecter les mesures d’hygiène stricte tout au long de la prise en charge des nouveau-nés, de limiter les gestes invasifs en fréquence et en durée et de mener un bon suivi clinique et paraclinique de toute femme enceinte

A twostep qualityimprovement intervention to address Pap smear quality at public health facilities in South Africa

Background. The endocervical component of a Pap smear is an important indicator of sample quality – or ‘adequacy’. However, only 6 of 52 districts in South Africa (SA) meet the Department of Health (DoH) performance benchmark: a 70% adequacy rate. We implemented a quality-improvement (QI) intervention to address suboptimal Pap smear quality in Tshwane District, Gauteng Province, SA.Objectives. To determine whether training with the wooden Ayre spatula (step 1) or introduction of the cytobroom (step 2) resulted in greater improvements in Pap smear adequacy rates.Methods. Two Tshwane District health facilities participated in our QI project between May 2016 and February 2017. In step 1, staff received training on the Ayre spatula. In step 2, the spatula was replaced with the cytobroom. Pap smear volumes, adequacy rates and results are reported for the pre-intervention period and after each QI step. We compared adequacy rates using Fisher’s exact test, with a significance level of p=0.05.Results. In the pre-intervention period, 304 of 965 Pap smears were deemed adequate (32%; 95% confidence interval (CI) 29 - 35%). After step 1, the proportion increased to 109 of 191 (57%; 95% CI 50 - 64%; p<0.01). Similarly, after step 2, the proportion increased to 155 of 192 (81%; 95% CI 74 - 86%; p<0.01). The proportion of abnormal smears increased from 13% before the QI intervention to 17% after step 1 and 22% after step 2.Conclusion. Although training in Pap smear collection using the Ayre spatula resulted in modest improvements in quality, facilities only achieved the DoH benchmark of a 70% adequacy rate after the introduction of the cytobroom

The Building Nutritious Food Baskets Project ‘Insights from the Field’

This booklet is a compilation of insights and success stories from the field during the implementation of the Building Nutritious Food Baskets (BNFB) project; a three-year project (November 2015 to October 2018) implemented in Nigeria and Tanzania and funded by the Bill & Melinda Gates Foundation. The objective of compiling these insights and success stories is to showcase and highlight BNFB’s experiences and interactions with various stakeholders during implementation, highlight successful partnerships and to provide a ‘human touch’ in narrating the process and how the project was able to deliver results, outcomes and the emerging impact of these efforts

Evaluating repellence properties of catnip essential oil against the mosquito species Aedes aegypti using a Y-tube olfactometer

The mosquito species Aedes aegypti (L.) is known to act as a vector in the transmission of various diseases, including dengue fever and yellow fever. The use of insect repellents is one of precautionary measures used to mitigate the risk of these diseases in humans by reducing mosquito biting. Nepetalactone, a potent natural insect repellent primarily found in catnip (Nepeta cataria) essential oil, has emerged as a promising candidate for mosquito repellence. Here, we evaluated the potential of catnip essential oil (> 95% nepetalactone) for use as a mosquito repellent. Using a Y-tube olfactometer and human hands as an attractant, we analysed the effectiveness of catnip oil at repelling the mosquito species Aedes aegypti. We tested a range of dilutions of catnip essential oil and found that concentrations as low as 2% were effective at repelling > 70% of mosquitoes for between one and four hours after repellent application. These findings suggest that nepetalactone could potentially be used as a natural, effective alternative to synthetic mosquito repellents, thereby offering protection against vector-borne diseases