Performance monitoring and accountability: The Agile Project’s protocol, record and experience

The Performance Monitoring and Accountability 2020 (PMA2020) project implemented a multi-country sub-project called PMA Agile, a system of continuous data collection for a probability sample of urban public and private health facilities and their clients that began November 2017 and concluded December 2019. The objective was to monitor the supply, quality and consumption of family planning services. In total, across 14 urban settings, nearly 2300 health facilities were surveyed three to six times in two years and a total sample of 48,610 female and male clients of childbearing age were interviewed in Burkina Faso, Democratic Republic of Congo, India, Kenya, Niger and Nigeria. Consenting female clients with access to a cellphone were re-interviewed by telephone after four months; two rounds of the client exit, and follow-up interviews were conducted in nearly all settings. This paper reports on the PMA Agile data system protocols, coverage and early experiences. An online dashboard is publicly accessible, analyses of measured trends are underway, and the data are publicly available.

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Performance monitoring and accountability: The Agile Project’s protocol, record and experience

Gates Open Research ◽

10.12688/gatesopenres.13119.2 ◽

2020 ◽

Vol 4 ◽

pp. 30

Author(s):

Amy Tsui ◽

Philip Anglewicz ◽

Titilope Akinlose ◽

Varsha Srivatsan ◽

Pierre Akilimali ◽

...

Keyword(s):

Performance Monitoring ◽

Democratic Republic Of Congo ◽

Total Sample ◽

Health Facilities ◽

Childbearing Age ◽

Public And Private ◽

Male Clients ◽

Early Experiences ◽

Female Clients

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1369Probabilistic data linkage of health facility and individual data using PMA2020 surveys

International Journal of Epidemiology ◽

10.1093/ije/dyab168.086 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

Author(s):

Cauane Blumenberg ◽

Franciele Hellwig ◽

Aluisio Barros

Keyword(s):

Health Facility ◽

Rural Areas ◽

Urban Areas ◽

Performance Monitoring ◽

Health Facilities ◽

Sufficient Information ◽

Public And Private ◽

Individual Level ◽

Match Rate ◽

Probabilistic Linkage

Abstract Background Most studies rely on clustered analyses to study how the characteristics of health facilities influence individual outcomes. Our aim was to perform a probabilistic linkage between individual and health facility data to enable individual-level analyses. Methods We linked data from the most recent female questionnaire from 11 countries monitored by the Performance Monitoring for Action 2020 to a master health facility dataset (appending all rounds of surveys). Only women that reported which type of facility they visited were considered in the analysis. A probabilistic linkage was performed using 13 blocking variables (e.g., facility type and cluster of residence/location of the woman/facility) and 11 matching variables (e.g., types of contraceptive methods used/offered by the women/facility). Each concordant matching variable received a + 1 score, or a 0 score otherwise. We assessed linkage quality by pooled odds ratio of non-matches according to wealth tertiles (richest vs. poorest) and area of residence (urban vs. rural) using a meta-analytical approach. Results A total of 21,102 women and 7,056 facilities were considered in the linkage process. The average match rate was 57.9%, ranging from 42.5% in Indonesia to 69.1% in Burkina Faso. The pooled odds of non-match were 74% higher for the richest women compared to the poorest, and 67% higher for women living in urban areas compared to rural areas. Conclusions High match rates were achieved in countries with sufficient information on public and private facilities. The lack of information about private facilities contributed to the higher odds of non-match among the better off. Key messages We performed a probabilistic linkage approach to link individual and health facility data, making it possible to understand how the characteristics of health facilities can influence individual-level outcomes. Our findings also bring light to the importance of sampling both public and private facilities, aiming to maximise match rates and reduce differences on match rates according to socio demographic characteristics of the sample.

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Service delivery point and individual characteristics associated with the adoption of modern contraceptive: A multi-country longitudinal analysis

PLoS ONE ◽

10.1371/journal.pone.0254775 ◽

2021 ◽

Vol 16 (8) ◽

pp. e0254775

Author(s):

Philip Anglewicz ◽

Carolina Cardona ◽

Titilope Akinlose ◽

Peter Gichangi ◽

Funmilola OlaOlorun ◽

...

Keyword(s):

Family Planning ◽

Service Delivery ◽

Health Facility ◽

Performance Monitoring ◽

Democratic Republic Of Congo ◽

Individual Characteristics ◽

Modern Contraceptive ◽

Modern Contraception ◽

The Future

Background Women who start using contraception (“adopters”) are a key population for family planning goals, but little is known about characteristics that predict the adoption of contraception as opposed to current use. We used prospective data from women and facilities for five countries, (Democratic Republic of Congo, India, Kenya, Nigeria, and Burkina Faso) and identified baseline characteristics that predicted adoption of modern contraception in the short term. Methods We used data from the Performance Monitoring for Action (PMA) Agile Project. PMA Agile administered service delivery point (SDP) client exit interview (CEI) surveys in urban sites of these five countries. Female clients responding to the CEI were asked for phone numbers that were used for a phone follow-up survey approximately four months later. For our analysis, we used data from the SDP and CEI baseline surveys, and the phone follow up to compare women who start using contraception during this period with those who remain non-users. We used characteristics of the facility and the woman at baseline to predict her contraception adoption in the future. Results Discussing FP with a partner at baseline was associated with greater odds of adoption in DRC (OR 2.34; 95% CI 0.97–5.66), India (OR 2.27; 95% CI 1.05–4.93), and Kenya (OR 1.65; 95% CI 1.16–2.35). Women who discussed family planning with any staff member at the health facility had 1.72 greater odds (95% CI 1.13–2.67) of becoming an adopter in Nigeria. The odds of adoption were lower in Nigerian facilities that had a stockout (OR 0.66 95% CI 0.44–1.00) at baseline. Other characteristics associated with contraception adoption across settings were education, age, wealth, parity, and marital status. Conclusions Characteristics of both the woman and the health facility were associated with adoption of modern contraception in the future. Some characteristics, like discussing family planning with a spouse, education, and parity, were associated with contraceptive adoption across settings. Other characteristics that predict contraceptive use, such as health facility measures, varied across countries.

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Pengaruh Konsumsi Cookies Kerang Dara (Anadara Granosa) terhadap Perubahan Kadar Haemoglobin Wanita Usia Subur

Journal of Holistic Nursing Science ◽

10.31603/nursing.v7i2.3126 ◽

2020 ◽

Vol 7 (2) ◽

pp. 169-179 ◽

Cited By ~ 1

Author(s):

Vera Iriani Abdullah ◽

C.H Haumahu

Keyword(s):

Data Collection ◽

Perinatal Death ◽

Design Method ◽

Statistical Tests ◽

Total Sample ◽

Control Group ◽

Childbearing Age ◽

Control Group Design ◽

Quasi Experimental ◽

Anadara Granosa

In the world, around 1.62 billion people have low HB levels, around 30.2% occur in the group of women aged 15-49. In Indonesia, anemia cases rank 4th in the top 10 most disease groups. Prolonged iron deficiency can cause anemia, so it needs to be treated immediately so it doesn’t continue into pregnancy age which can cause complications until maternal and perinatal death. Papua has an abundance of marine wealth; one of those is Kerang Dara. Through this study, researchers wanted to explore the health benefits of nature. The aim is to see the effect of Consumption of Kerang Dara Cookies (Anadara Granosa) on Changes of Hemoglobin Levels of in Woman of Childbearing Age as an Effort to Prevent Anemia in District Aimas, Klaigit Village. Type of this research is quasi-experimental by pretest-posttest control group design method. The population of all the women of Childbearing who live in Klaigit Village, with a total sample of 14 people divided into 2 groups: control and intervention. Data collection techniques using random sampling. The time of data collection occurred for 2 weeks, starting from September 20th to October 4th. The results based on statistical tests using T-Test, then the value 884 is greater than the value of the table 0.05, then the conclusion is there is an Effect of Consumption Kerang Dara Cookies (Anadara Granosa) Towards the Increased of Woman of Childbearing Hemoglobin Levels in Klaigit Village in District Aimas in 2019.

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Patterns of multimorbidity and risk of disability in community-dwelling older persons

Aging Clinical and Experimental Research ◽

10.1007/s40520-020-01773-z ◽

2021 ◽

Author(s):

Alessandra Marengoni ◽

Roselyne Akugizibwe ◽

Davide L. Vetrano ◽

Albert Roso-Llorach ◽

Graziano Onder ◽

...

Keyword(s):

Daily Living ◽

Older Persons ◽

Healthcare Resource ◽

Resource Planning ◽

Total Sample ◽

Community Dwelling ◽

National Study ◽

Sensory Impairment ◽

Multinomial Models

AbstractThe aim was to analyze the association between specific patterns of multimorbidity and risk of disability in older persons. Data were gathered from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K); 2066 60 + year-old participants living in the community and free from disability at baseline were grouped according to their multimorbidity patterns and followed-up for six years. The association between multimorbidity patterns and disability in basic (ADL) and instrumental (IADL) activities of daily living was examined through multinomial models. Throughout the follow-up, 434 (21.0%) participants developed at least one ADL and 310 (15.0%) at least one IADL. Compared to the unspecific pattern, which included diseases not exceeding their expected prevalence in the total sample, belonging to the cardiovascular/anemia/dementia, the sensory impairment/cancer and the musculoskeletal/respiratory/gastrointestinal patterns was associated with a higher risk of developing both ADL and IADL, whereas subjects in the metabolic/sleep disorders pattern showed a higher risk of developing only IADL. Multimorbidity patterns are differentially associated with incident disability, which is important for the design of future prevention strategies aimed at delaying functional impairment in old age, and for a better healthcare resource planning.

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Health workers’ perceptions on where and how to integrate tobacco use cessation services into tuberculosis treatment; a qualitative exploratory study in Uganda

BMC Public Health ◽

10.1186/s12889-021-11502-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Elizeus Rutebemberwa ◽

Kellen Nyamurungi ◽

Surabhi Joshi ◽

Yvonne Olando ◽

Hadii M. Mamudu ◽

...

Keyword(s):

Tobacco Use ◽

Tobacco Cessation ◽

Health Workers ◽

High Volume ◽

Health Facilities ◽

Hospital Treatment ◽

Management Support ◽

Tobacco Use Cessation ◽

Tb Treatment

Abstract Background Tobacco use is associated with exacerbation of tuberculosis (TB) and poor TB treatment outcomes. Integrating tobacco use cessation within TB treatment could improve healing among TB patients. The aim was to explore perceptions of health workers on where and how to integrate tobacco use cessation services into TB treatment programs in Uganda. Methods Between March and April 2019, nine focus group discussions (FGDs) and eight key informant interviews were conducted among health workers attending to patients with tuberculosis on a routine basis in nine facilities from the central, eastern, northern and western parts of Uganda. These facilities were high volume health centres, general hospitals and referral hospitals. The FGD sessions and interviews were tape recorded, transcribed verbatim and analysed using content analysis and the Chronic Care Model as a framework. Results Respondents highlighted that just like TB prevention starts in the community and TB treatment goes beyond health facility stay, integration of tobacco cessation should be started when people are still healthy and extended to those who have been healed as they go back to communities. There was need to coordinate with different organizations like peers, the media and TB treatment supporters. TB patients needed regular follow up and self-management support for both TB and tobacco cessation. Patients needed to be empowered to know their condition and their caretakers needed to be involved. Effective referral between primary health facilities and specialist facilities was needed. Clinical information systems should identify relevant people for proactive care and follow up. In order to achieve effective integration, the health system needed to be strengthened especially health worker training and provision of more space in some of the facilities. Conclusions Tobacco cessation activities should be provided in a continuum starting in the community before the TB patients get to hospital, during the patients’ interface with hospital treatment and be given in the community after TB patients have been discharged. This requires collaboration between those who carry out health education in communities, the TB treatment supporters and the health workers who treat patients in health facilities.

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A 20-Year Follow-Up Study of Objectively Measured Physical Activity

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18063076 ◽

2021 ◽

Vol 18 (6) ◽

pp. 3076

Author(s):

Anders Raustorp ◽

Andreas Fröberg

Keyword(s):

Physical Activity ◽

Early Adolescence ◽

Total Sample ◽

Short Time Span ◽

Steps Per Day ◽

Objectively Measured ◽

Short Time ◽

Objectively Measured Physical Activity

Background: The objectives of this study were to explore the effect of time, long-term tracking, and the proportion of objectively measured physical activity (PA) from early adolescence to the mid-thirties. Methods: PA was measured as mean steps per day (SPD) with pedometers during 2000 (T1), 2003 (T2), 2005 (T3), 2010 (T4), 2016 (T5) and 2020 (T6). Data from 64 participants (n = 32 males) were analysed from their early adolescence (T1) to their mid-thirties (T6). Results: SPD decreased in the total sample and among males and females (all, p < 0.001). Males took more mean SPD than females during T1 (p = 0.002), whereas females took more mean SPD during T2 (p = 0.009) and T6 (p = 0.008). Males’ mean SPD tracked between T1 and T2 (p = 0.021), T2 and T3 (p = 0.030), T3 and T4 (p = 0.015) and T4 and T5 (p = 0.003). Females’ mean SPD tracked between T3 and T4 (p = 0.024) and T5 and T6 (p < 0.001). In the total sample, more mean SPD were found on weekdays compared to weekend days at T3 (p = 0.017) and T5 (p < 0.001). Conclusions: SPD decreased between T1 and T6. Mean SPD tracked low-to-moderate in the short time span. From late adolescence to the mid-thirties, more mean SPD was observed during weekdays compared to weekend days.

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Is Continuous Eruption Related to Periodontal Changes? A 16-Year Follow-up

Journal of Dental Research ◽

10.1177/0022034521999363 ◽

2021 ◽

pp. 002203452199936

Author(s):

C. Wiedemann ◽

C. Pink ◽

A. Daboul ◽

S. Samietz ◽

H. Völzke ◽

...

Keyword(s):

Tooth Wear ◽

Total Sample ◽

Population Based ◽

Tooth Eruption ◽

Reference Points ◽

3 Dimensional ◽

Probing Depth ◽

Molar Teeth ◽

Using Data

The aims of this study were to 1) determine if continuous eruption occurs in the maxillary teeth, 2) assess the magnitude of the continuous eruption, and 3) evaluate the effects of continuous eruption on the different periodontal parameters by using data from the population-based cohort of the Study of Health in Pomerania (SHIP). The jaw casts of 140 participants from the baseline (SHIP-0) and 16-y follow-up (SHIP-3) were digitized as 3-dimensional models. Robust reference points were set to match the tooth eruption stage at SHIP-0 and SHIP-3. Reference points were set on the occlusal surface of the contralateral premolar and molar teeth, the palatal fossa of an incisor, and the rugae of the hard palate. Reference points were combined to represent 3 virtual occlusal planes. Continuous eruption was measured as the mean height difference between the 3 planes and rugae fix points at SHIP-0 and SHIP-3. Probing depth, clinical attachment levels, gingiva above the cementoenamel junction (gingival height), and number of missing teeth were clinically assessed in the maxilla. Changes in periodontal variables were regressed onto changes in continuous eruption after adjustment for age, sex, number of filled teeth, and education or tooth wear. Continuous tooth eruption >1 mm over the 16 y was found in 4 of 140 adults and averaged to 0.33 mm, equaling 0.021 mm/y. In the total sample, an increase in continuous eruption was significantly associated with decreases in mean gingival height ( B = −0.34; 95% CI, −0.65 to −0.03). In a subsample of participants without tooth loss, continuous eruption was negatively associated with PD. This study confirmed that continuous eruption is clearly detectable and may contribute to lower gingival heights in the maxilla.

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Impact of the Healing in Harmony program on women's mental health in a rural area in South Kivu province, Democratic Republic of Congo

Global Mental Health ◽

10.1017/gmh.2021.11 ◽

2021 ◽

Vol 8 ◽

Author(s):

Justin Cikuru ◽

Ali Bitenga ◽

Juvenal Bazilashe Mukungu Balegamire ◽

Prince Mujumbe Salama ◽

Michelle M. Hood ◽

...

Keyword(s):

Mental Health ◽

Democratic Republic ◽

Democratic Republic Of Congo ◽

Women’S Mental Health ◽

Post Traumatic Stress ◽

Republic Of Congo ◽

Women's Mental Health ◽

Relative Risks ◽

Post Test

Abstract Background To assess whether Healing in Harmony (HiH), a form of music therapy, improved women's mental health following conflict-related trauma and sexual violence in the Democratic Republic of Congo. Methods This study used a step-wedged design and included 167 women, who completed up to two pre-tests, a post-test, and up to two follow-up interviews at 3 and 6 months after completing the program. The Hopkins Symptoms Checklist was used to measure anxiety and depression. The Harvard Trauma Questionnaire was used to measure post-traumatic stress disorder (PTSD). Generalized estimating equations with unstructured covariance were used to estimate mean change in mental health scores and relative risks (RRs) for screening positive. Results Prior to starting the HiH program, 73.9, 84.2, and 68.5% screened positive with median scores being 2.20, 2.70, and 2.06 for depression, anxiety, and PTSD, respectively. The RR for screening positive declined significantly (RR = 0.49 for depression, 0.61 for anxiety, and 0.54 for PTSD) and mean scores declined significantly by −0.54, −0.67, and −0.53 points, respectively, from the pre- to the post-test, declines that were sustained at the 3-month and 6-month follow-up interviews. Conclusion The HiH program was associated with significant improvement in women's mental health that was sustained up to 6 months post completion of the program despite instability in the region and evidence of continued experience of conflict-related trauma during the study. These data support the value of providing psychological care in the context of ongoing humanitarian crises.

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