JSI staff regularly publish their research and results from work in peer-reviewed journals. This section provides a brief abstract with a link to the journal where you can read more and either download or order the article, depending on the journal.
Feasibility and acceptability of oral cholera vaccine mass vaccination campaign in response to an outbreak and floods in Malawi in The Pan African Medical Journal. 2016;23:203
Despite some improvement in provision of safe drinking water, proper sanitation and hygiene promotion, cholera still remains a major public health problem in Malawi with outbreaks occurring almost every year since 1998.
In response to 2014/2015 cholera outbreaks, the ministry of health and partners assessed the feasibility and acceptability of conducting a mass oral cholera vaccine (OCV) as an additional public health measure. This paper highlights the burden of the 2014/15 cholera outbreak, successes and challenges of OCV campaign conducted in March and April 2015.
This was a documentation of the first OCV campaign conducted in Malawi. The campaign targeted over 160,000 people aged one year or more living in 19 camps of people internally displaced by floods and their surrounding communities in Nsanje district. It was a reactive campaign as additional measure to improved water, sanitation and hygiene in response to the laboratory confirmed cholera outbreak.
This documentation has demonstrated that it was feasible, acceptable by the community to conduct a large-scale mass OCV campaign in Malawi within five weeks. Of 320,000 OCV doses received, Malawi managed to administer at least 294,221 (91.9%) of the doses. OCV could therefore be considered to be introduced as additional measure in cholera hot spot areas in Malawi.
Authors: Kelias Phiri Msyamboza, Maurice M’bang’ombe, Hannah Hausi, Alexander Chijuwa, Veronica Nkukumila, Hudson Wenji Kubwalo, Sachin Desai, Lorenzo Pezzoli, Dominique Legros
Variation in Human Papillomavirus Vaccine Uptake and Acceptability Between Female and Male Adolescents and Their Caregivers in Journal of Community Health, doi: 10.1007/s10900-016-0284-5
HPV vaccination coverage is suboptimal. Previous research largely focused on vaccinating girls. This study aimed to identify factors associated with HPV vaccination among male and female adolescents. A secondary analyses was conducted using the National Immunization Survey-Teen. Parallel logistic models were specified to examine associations of adolescent, caregiver, and provider characteristics with vaccination status among boys and girls.
Vaccination rates were higher among teens receiving a provider recommendation. Moreover, provider recommendation was associated with caregivers’ intent to initiate vaccination. Provider recommendation for vaccination was the strongest predictor for both genders; however, it is insufficient to achieve high coverage rates, especially among boys. Factors associated with HPV vaccination were different for males and females. These findings suggest providers should consider gender bias with regard to HPV vaccination.
Authors: Kristin Johnson, Meng-Yun Lin, Howard Cabral, Lewis Kazis and Ingrid Katz
Healthy Futures Program and Adolescent Sexual Behaviors in 3 Massachusetts Cities: A Randomized Controlled Trial in American Journal of Public Health, Vol. 106, No. S1, pp. S103-S109
Evaluation of the impact of a 3-year Healthy Futures program on reducing sexual behaviors among middle school students in 15 public middle schools in Haverhill, Lowell, and Lynn, Massachusetts. Student survey data was collected at baseline and immediately after each Nu-CULTURE curriculum (classroom component of Healthy Futures) in the sixth, seventh, and eigth grades, and at a 1-year follow up in the ninth grade.
There was some evidence of delaying sexual initiation by the end of Nu-CULTURE, for girls and Hispanics, but not for boys. Future research should focus on improving implementation of the supplemental components intended to foster interpersonal and environmental protective factors associated with sustained delays in sexual activity.
Research methods and results are presented in the full article, available at American Journal of Public Health
Authors: Tamara Calise, Wendy Chow, Katelyn Dore, Michael O'Brien, Elizabeth Heitz, Rebecca Millock.
The power of siblings and caregivers: under-explored types of social support among children affected by HIV and AIDS in AIDS Care, Vol 28:sup2, 110-117, DOI: 10.1080/09540121.2016.1178942
A study conducted by JSI staff looks at social support among children affected by HIV. Children affected by HIV and AIDS have significantly higher rates of mental health problems than unaffected children. There is a need for research to examine how social support functions as a source of resiliency for children in high HIV-prevalence settings such as South Africa.
This study explored how family social support relates to depression, anxiety, and post-traumatic stress (PTS). Using the ecological model as a frame, data were drawn from a 2011 cross-sectional study of 1380 children classified as either orphaned by AIDS and/or living with an AIDS-sick family member. The children were from high-poverty, high HIV-prevalent rural and urban communities in South Africa.
Social support was analyzed in depth by examining the source (e.g. caregiver, sibling) and the type (e.g. emotional, instrumental, quality). These variables were entered into multiple regression analyses to estimate the most parsimonious regression models to show the relationships between social support and depression, anxiety, and PTS symptoms among the children. Siblings emerged as the most consistent source of social support on mental health. Authors: Melissa Sharer, Lucie Cluver, Joseph J. Shields, Joseph Ahearn
Quality improvement practices to institutionalize supply chain best practices for iCCM: Evidence from Rwanda and Malawi in Research in Social & Administrative Pharmacy, 2016 Jul 28 (Epub ahead of print)
Supply chain bottlenecks that prevent community health workers (CHWs) from accessing essential medicines significantly increase under-5 child mortality, particularly in poor and rural areas. Using implementation research, interventions aimed at improving supply chain practices and access to medicines were tested in Malawi and Rwanda. These interventions included simple demand-based resupply procedures, using mobile technology and traditional methods for communication, and multilevel, performance-driven quality improvement (QI) teams.
While simple, streamlined, demand-based resupply procedures provide the basis for regular, functional, and efficient resupply of CHWs, the procedures alone are not sufficient to create consistent change in product availability. Supporting these procedures with multilevel QI teams reinforces the correct and consistent use of resupply procedures.
Yasmin Chandani, Malia Duffy, Barbara Lamphere, Megan Noel, Alexis Heaton and Sarah Andersson.
John Snow, Inc and JSI Research and Training Institute, Inc. 2016
Uncivil and skewed language on civil society? in The Lancet, Volume 387, No. 10036, P2377
This Comment published in the Lancet responds to questions that editor Richard Horton made in his "Offline" commentary, (March 12, 2016, p 1041), which summarised comments from a forum on the role of nongovernmental organisations (NGOs) in global health. Horton's "Offline" echoed a prevalent systematic bias in the treatment of NGOs.
The authors, including JSI's Craig Burgess, point out that NGOs are diverse and dynamic entities that are responsive to social, cultural, and political trends, with varying missions, foci, technical acumen, religious affiliation, experience, and quality assurance standards. The one-size-fits-all label of NGO is outdated. To tackle serious problems, the authors write, we need to evolve our language, and be both more specific and more systemic. Horton questioned the appropriateness of “uncritical acceptance of NGO participation” in global health on the basis of broadly assigned dysfunctions and with a passing acknowledgment that these dysfunctions also apply to other actors. Authors: Eric Gilles Sarriot, Karen LeBan, Emma Sacks, Christine Sow, Craig Burgess
The Ethiopian Health Extension Program and Variation in Health Systems Performance: What Matters? in Plos One, 11(5): e0156438
Primary health care services are fundamental to improving health and health equity, particularly in the context of low and middle-income settings where resources are scarce. During the past decade, Ethiopia undertook an ambitious investment in primary health care known as the Ethiopian Health Extension Program that recorded impressive gains in several health outcomes. Despite this progress, substantial disparities in health outcomes persist across the country. The objective of this study was to understand how variation in the implementation of the primary health care efforts may explain differences in key health outcomes.
Authors: Netsanet Fetene, Erika Linnander, Binyam Fekadu, Hibret Alemu, Halima Omer, Maureen Canavan, Janna Smith, Peter Berman, Elizabeth Bradley
Assessment of Enterococcus Levels in Recreational Beach Sand in Journal of Environmental Health, Volume 78, No. 8, 12–17
Recent studies have shown that coastal beach sand as well as coastal ocean water can be contaminated with fecal indicator Enterococcus bacteria (ENT). A study of sand ENT concentrations over a four-week period at 12 Rhode Island beaches was conducted during the summer of 2009. While average contamination was low relative to water quality standards, every beach had at least one day with very high sand ENT readings. On 10 of the 12 beaches, a statistically significant gradient occurred in geometric mean ENT concentrations among tidal zones, with dry (supratidal, or above high tide mark) sand having the highest level, followed by wet (intratidal, or below high tide mark) and underwater sand. Beaches with higher wave action had significantly lower ENT levels in wet and underwater sand compared to beaches with lower wave action.
Authors: Eugenie Coakley, JSI Research and Training Institute; Amie L. Parris, Rhode Island Department of Health; Al Wyman, Permanent Environmental Solutions, LLC; Gretchen Latowsky, JSI Research and Training Institute
Sociocultural determinants of home delivery in Ethiopia: a qualitative study in International Journal of Women's Health, April 2016
Maternal health remains a major public health problem in Ethiopia. Despite the government’s measures to ensure institutional delivery assisted by skilled attendants, home delivery remains high, estimated at over 80% of all pregnant women.
This study, conducted by the Addis Ababa School of Public Health with JSI's IFHP+ program, aims to identify determinants that sustain home delivery in Ethiopia.
Authors: Mirgissa Kaba, Tesfaye Bulto, Zergu Tafesse, Wassie Lingerh, Ismael Ali
A case study of community-based distribution and use of Misoprostol and Chlorhexidine in Sokoto State, Nigeria in Global Public Health, 2016
The United States Agency for International Development/Targeted States High Impact Project supported Sokoto State, Nigeria government in the development of a community-based intervention aimed at preventing post-partum hemorrhage (PPH) and cord infection among women and children, respectively. This paper describes the innovative intervention within the Nigeria health delivery system. It then explains the case study approach to assessing this intervention and summarizes findings. Ultimately, the intervention was received well in communities and both drugs were added to the procurement list of all health facilities providing maternity services in the State. Key factors leading to such success include early advocacy efforts at the state-level, broad stakeholder engagement in designing the distribution system, early community engagement about the value of the drugs and concerted efforts to monitor and ensure availability of the drugs. Implementation challenges occurred in some areas, including shortage of community-based health volunteers (CBHVs) and drug keepers, and socio-cultural barriers. To maximize and sustain the effectiveness of such interventions, state government needs to ensure constant drug supply and adequate human resources at the community level, enhance counselling and mobilization efforts, establish effective quality improvement strategies and implement a strong M&E system. JSI, 2016
Investing in health information management: The right people, in the right place, at the right time in Health Information Management Journal
The MEASURE Evaluation project helped lead a review of the training curriculum for health professionals in health information management in Nigeria. The study was conducted in response to an earlier assessment which found that many health professionals were inadequately skilled in information and communications technology. The study findings are published in the April 2016 issue of the Health Information Management Journal.
Authors: Olusesan Ayodeji Makinde; Mohammed Ibrahim Mami; Benson Macaulay Oweghoro; Kolawole Azeez Oyediran; Stephanie Mullen
Read the full article at SAGE Journals.
Decisions made at the household level, for example, to seek antenatal care or breastfeed, can have a direct impact on the health of mothers and newborns. The SMART Community-based Initiatives program in Egypt worked with community development associations to encourage better household decision-making by training community health workers to disseminate information and encourage healthy practices during home visits, group sessions, and community activities with pregnant women, mothers of young children, and their families. A quasi-experimental design was used to evaluate the program, with household surveys conducted before and after the intervention in intervention and comparison areas. Survey questions asked about women’s knowledge and behaviors related to maternal and newborn care and child nutrition and, at the endline, exposure to SMART activities. Findings suggest that there may have been a significant dose-response relationship between exposure to SMART activities and certain knowledge and behavioral indicators, especially in Upper Egypt. The findings demonstrate the ability of civil society organizations with minimal health programming experience to increase knowledge and promote healthy behaviors among pregnant women and new mothers. The SMART approach offers a promising strategy to fill gaps in health education and counseling and strengthen community support for behavior change.
Mapping the Prevalence and Sociodemographic Characteristics of Women Who Deliver Alone: Evidence From Demographic and Health Surveys From 80 Countries in Global Health: Science and Practice D-15-00261
An estimated 2 million women surveyed in low- and middle-income countries between 2005 and 2015 gave birth alone. This practice was concentrated in West and Central Africa and parts of East Africa. Women who delivered with no one present were very poor, uneducated, older, and of higher parity. Experience from northern Nigeria suggests the practice can be reduced markedly by mobilizing religious and civil society leaders to improve community awareness about the critical importance of having an attendant present.
Malaria accounts for about 300,000 childhood deaths and 30% of under-five year old mortality in Nigeria annually. JSI's Targeted States High Impact Project assessed the impact of intervention strategies that integrated Patent Medicines Vendors into community case management of childhood-diseases, improved access to artemisinin combination therapy (ACT) and distributed bed nets to households. Researchers explored the influence of household socioeconomic characteristics on the impact of the interventions on fever in the under-five year olds in Bauchi State Nigeria.
The study sampled 3077 and 2737 under-5 year olds from 1,588 and 1601 households in pre- and post-intervention periods respectively, wbetween 2013 to 2015. Read the full article at PLOS One.
Authors: Dele Abegunde, Nosa Orobaton , Amos Bassi , Olugbenga Oguntunde , Moyosola Bamidele , Masduq Abdulkrim , Ezenwa Nwizugbe
Value of Experiential STD Clinical Training in the Digital Age in Sexually Transmitted Diseases, Vol. 43 (2).
This publication looks at the importance of translating evidence-based guidelines for sexually transmitted disease (STD) care into clinical practice for the prevention and control of STDs. Conclusions will show that STD experiential clinical training program is still relevant to participants in the digital age and is valued more highly than other continuing education experiences.
Download the article or view it at the Journal of the American Sexually Transmitted Diseases Association
Prior to the 2014–2015 Ebola outbreak, infection prevention and control (IPC) activities in Liberian healthcare facilities were basic. There was no national IPC guidance, nor dedicated staff at any level of government or healthcare facility (HCF) to ensure the implementation of best practices. Efforts to improve IPC early in the outbreak were ad hoc and messaging was inconsistent. In September 2014, at the height of the outbreak, the national IPC Task Force was established with a Ministry of Health (MoH) mandate to coordinate IPC response activities. A steering group of the Task Force, including representatives of the World Health Organization (WHO) and the United States Centers for Disease Control and Prevention (CDC), supported MoH leadership in implementing standardized messaging and IPC training for the health workforce. This structure, and the activities implemented under this structure, played a crucial role in the implementation of IPC practices and successful containment of the outbreak. Moving forward, a nationwide culture of IPC needs to be maintained through this governance structure in Liberia’s health system to prevent and respond to future outbreaks.
Authors: Catherine Cooper, Dale Fisher, Neil Gupta, Rose MaCauley, and Carmem L. Pessoa-Silva