A protocol for a scoping review of implementation strategies to scale up self-administered depot medroxyprogesterone acetate subcutaneous injectable contraception v1

Mapping Intimacies ◽

10.17504/protocols.io.b2asqaee ◽

2021 ◽

Author(s):

Adeniyi Kolade Aderoba ◽

Petrus Steyn ◽

James Njogu Kiarie

Keyword(s):

Low Income ◽

Medroxyprogesterone Acetate ◽

Implementation Strategy ◽

Scale Up ◽

Implementation Strategies ◽

Self Administration ◽

Middle Income ◽

Depot Medroxyprogesterone Acetate ◽

Middle Income Countries ◽

Roll Out

Self-administration of depot medroxyprogesterone acetate subcutaneous injectable contraception (DMPA-SC) is effective, safe and registered in many countries. It shows great potential to improve contraceptive access, continuation, and autonomy, including in low-income and middle-income countries. However, there are challenges to roll out this new efficacious intervention, and major implementation issues have been encountered for scale-up. This study aims to describe the implementation strategies to scale up self-administered DMPA-SC programs, the barriers, and facilitators to these programs, and the outcome of the implementation strategy used.

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Accelerating access and scale-up of optimized antiretroviral therapy in low-income and middle-income countries: results of a coordinated end-to-end approach

AIDS ◽

10.1097/qad.0000000000002951 ◽

2021 ◽

Vol 35 (Supplement 2) ◽

pp. S165-S171

Author(s):

Emily Lark Harris ◽

Katherine Blumer ◽

Carmen Perez Casas ◽

Danielle Ferris ◽

Carolyn Amole ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Low Income ◽

Scale Up ◽

Middle Income ◽

Middle Income Countries ◽

End To End

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Establishing Global School Feeding Program Targets: How Many Poor Children Globally Should Be Prioritized, and What Would Be the Cost of Implementation?

Frontiers in Public Health ◽

10.3389/fpubh.2020.530176 ◽

2020 ◽

Vol 8 ◽

Author(s):

Lesley J. Drake ◽

Nail Lazrak ◽

Meena Fernandes ◽

Kim Chu ◽

Samrat Singh ◽

...

Keyword(s):

Low Income ◽

School Health ◽

Scale Up ◽

Good Health ◽

Global Strategy ◽

Low Income Countries ◽

School Age Children ◽

Middle Income ◽

Middle Income Countries ◽

School Feeding

The creation of Human Capital is dependent upon good health and education throughout the first 8,000 days of life, but there is currently under-investment in health and nutrition after the first 1,000 days. Working with governments and partners, the UN World Food Program is leading a global scale up of investment in school health, and has undertaken a strategic analysis to explore the scale and cost of meeting the needs of the most disadvantaged school age children and adolescents in low and middle-income countries globally. Of the 663 million school children enrolled in school, 328 million live where the current coverage of school meals is inadequate (<80%), of these, 251 million live in countries where there are significant nutrition deficits (>20% anemia and stunting), and of these an estimated 73 million children in 60 countries are also living in extreme poverty (<USD 1.97 per day). 62.7 million of these children are in Africa, and more than 66% live in low income countries, with a substantial minority in pockets of poverty in middle-income countries. The estimated overall financial requirement for school feeding is USD 4.7 billion, increasing to USD 5.8 billion annually if other essential school health interventions are included in the package. The DCP3 (Vol 8) school feeding edition and the global coverage numbers were launched in Tunis, 2018 by the WFP Executive Director, David Beasley. These estimates continue to inform the development of WFP's global strategy for school feeding.

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Identifying health policy and systems research priorities on multisectoral collaboration for health in low-income and middle-income countries

BMJ Global Health ◽

10.1136/bmjgh-2018-000970 ◽

2018 ◽

Vol 3 (Suppl 4) ◽

pp. e000970 ◽

Cited By ~ 11

Author(s):

Douglas Glandon ◽

Ankita Meghani ◽

Nasreen Jessani ◽

Mary Qiu ◽

Sara Bennett

Keyword(s):

Low Income ◽

Health Sector ◽

Research Priorities ◽

Implementation Strategies ◽

Health Coverage ◽

Middle Income ◽

The Sustainable Development ◽

Middle Income Countries ◽

Systems Research ◽

Review Articles

IntroductionWhile efforts to achieve Universal Health Coverage (UHC) and the Sustainable Development Goals (SDGs) have reinvigorated interest in multisectoral collaborations (MSCs) among the global health and development community, there remains a plethora of questions about how best to conceptualise, plan, implement, evaluate and sustain MSCs. The objective of this paper is to present research priorities on MSC for health from researchers and policymakers around the globe, with an emphasis on low-income and middle-income countries.MethodsThe authors identified 30 priority research questions from two sources: (1) 38 review articles on MSC for health, and (2) interviews and focus groups with a total of 81 policymakers, including government officials (largely from ministries of health and state/provincial departments of health, but also offices of planning, public service, social development, the prime minister and others), large multilateral or bilateral organisations, and non-governmental organisations. In a third phase, questions were refined and ranked by a diverse group of researchers from around the globe using an online voting platform.ResultsThe top-ranked questions focused predominantly on pragmatic questions, such as how best to structure, implement and sustain MSCs, as well as how to build stakeholder capacity and community partnerships. Despite substantial variation between review articles, policymakers’ reflections and online ranking by researchers, two topics emerged as research priorities for all three: (1) leadership, partnership and governance structures for MSCs; and (2) MSC implementation strategies and mechanisms. The review articles underscored the need for more guidance on appropriate study designs and methods for investigating MSCs, which may be a prerequisite for other identified research priorities.ConclusionThese findings could inform efforts within and beyond the health sector to better align research objectives and funding with the evidence needs of policymakers grappling with questions about how best to leverage MSCs to achieve UHC and the SDGs.

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Evidence gap map of performance measurement and management in primary healthcare systems in low-income and middle-income countries

BMJ Global Health ◽

10.1136/bmjgh-2019-001451 ◽

2019 ◽

Vol 4 (Suppl 8) ◽

pp. e001451 ◽

Cited By ~ 2

Author(s):

Wolfgang Munar ◽

Birte Snilstveit ◽

Ligia Esther Aranda ◽

Nilakshi Biswas ◽

Theresa Baffour ◽

...

Keyword(s):

Performance Measurement ◽

Systematic Reviews ◽

Low Income ◽

Primary Healthcare ◽

Implementation Strategies ◽

Sub Saharan Africa ◽

Audit And Feedback ◽

Unintended Effects ◽

Middle Income ◽

Middle Income Countries

IntroductionWe mapped available evidence on performance measurement and management (PMM) strategies in primary healthcare (PHC) systems of low-income and middle-income countries (LMICs). Widely used, their effectiveness remains inconclusive. This evidence gap map characterises existing research and evidence gaps.MethodsSystematic mapping of performance measurement and management research in LMICs from 2000 to mid-2018; literature searches of seven academic databases and institutional repositories of impact evaluations and systematic reviews. Using a combination of manual screening and machine learning, four reviewers appraised 38 088 titles and abstracts, and extracted metadata from 137 impact evaluations and 18 systematic reviews that met the inclusion criteria. The resulting visual representation of the evidence base was uploaded to a web-based platform.ResultsSince 2000, the number of studies has increased; the first systematic reviews were completed in 2010. Two-thirds of the studies were conducted in sub-Saharan Africa and South Asia. Randomised controlled trials were the most frequently used study design. The evidence is concentrated in two types of PMM strategies: implementation strategies (in-service training, continuing education, supervision) and performance-based financing. Major gaps exist in accountability arrangements particularly the use of audit and feedback. The least studied types of outcomes were unintended effects, harm and social equity.ConclusionsThe evidence is clustered around interventions that are unlikely to achieve transformational change in health outcomes. The gaps identified suggest that routinely used PMM strategies are implemented without sufficient knowledge of their effects. Future efforts at redesigning PHC systems need to be informed by evidence on the most effective approaches for using PMM strategies.

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Cost of scaling up mental healthcare in low-and middle-income countries

The British Journal of Psychiatry ◽

10.1192/bjp.bp.107.038463 ◽

2007 ◽

Vol 191 (6) ◽

pp. 528-535 ◽

Cited By ~ 62

Author(s):

Dan Chisholm ◽

Crick Lund ◽

Shekhar Saxena

Keyword(s):

Low Income ◽

Scale Up ◽

Mental Healthcare ◽

Scaling Up ◽

Psychosocial Treatment ◽

Economic Evaluations ◽

Middle Income ◽

Middle Income Countries ◽

Per Capita ◽

Low And Middle Income

BackgroundNo systematic attempt has been made to calculate the costs of scaling up mental health services in low-and middle-income countries.AimsTo estimate the expenditures needed to scale up the delivery of an essential mental healthcare package over a 10-year period (2006–2015).MethodA core package was defined, comprising pharmacological and/or psychosocial treatment of schizophrenia, bipolar disorder, depression and hazardous alcohol use. Current service levels in 12 selected low-and middle-income countries were established using the WHO–AIMS assessment tool. Target-level resource needs were derived from published need assessments and economic evaluations.ResultsThe cost per capita of providing the core package attarget coverage levels (in US dollars) ranged from $1.85 to $2.60 per year in low-income countries and $3.20 to $6.25 per year in lower-middle-income countries, an additional annual investment of $0.18–0.55 per capita.ConclusionsAlthough significant new resources need to be invested, the absolute amount is not large when considered at the population level and against other health investment strategies.

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Innovative financing to fund surgical systems and expand surgical care in low-income and middle-income countries

BMJ Global Health ◽

10.1136/bmjgh-2020-002375 ◽

2020 ◽

Vol 5 (6) ◽

pp. e002375 ◽

Cited By ~ 1

Author(s):

Ché L Reddy ◽

Alexander W Peters ◽

Desmond Tanko Jumbam ◽

Luke Caddell ◽

Blake C Alkire ◽

...

Keyword(s):

Health Systems ◽

Low Income ◽

Critical Role ◽

Scale Up ◽

Surgical Care ◽

Healthcare Intervention ◽

Strengthen Health System ◽

Middle Income ◽

Middle Income Countries ◽

Fiscal Space

Strong surgical systems are necessary to prevent premature death and avoidable disability from surgical conditions. The epidemiological transition, which has led to a rising burden of non-communicable diseases and injuries worldwide, will increase the demand for surgical assessment and care as a definitive healthcare intervention. Yet, 5 billion people lack access to timely, affordable and safe surgical and anaesthesia care, with the unmet demand affecting predominantly low-income and middle-income countries (LMICs). Rapid surgical care scale-up is required in LMICs to strengthen health system capabilities, but adequate financing for this expansion is lacking. This article explores the critical role of innovative financing in scaling up surgical care in LMICs. We locate surgical system financing by using a modified fiscal space analysis. Through an analysis of published studies and case studies on recent trends in the financing of global health systems, we provide a conceptual framework that could assist policy-makers in health systems to develop innovative financing strategies to mobilise additional investments for scale-up of surgical care in LMICs. This is the first time such an analysis has been applied to the funding of surgical care. Innovative financing in global surgery is an untapped potential funding source for expanding fiscal space for health systems and financing scale-up of surgical care in LMICs.

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Accelerating access and scale-up of optimized ART in low-income and middle-income countries

Current Opinion in HIV and AIDS ◽

10.1097/coh.0000000000000383 ◽

2017 ◽

Vol 12 (4) ◽

pp. 383-389 ◽

Cited By ~ 3

Author(s):

Emily Harris ◽

Carmen Pérez-Casas ◽

Matthew Barnhart ◽

Amy H. Lin ◽

Danielle Ferris ◽

...

Keyword(s):

Low Income ◽

Scale Up ◽

Middle Income ◽

Middle Income Countries

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Understanding the implementation (including women’s use) of maternity waiting homes in low-income and middle-income countries: a realist synthesis protocol

BMJ Open ◽

10.1136/bmjopen-2020-039531 ◽

2021 ◽

Vol 11 (3) ◽

pp. e039531

Author(s):

Daphne N McRae ◽

Anayda Portela ◽

Tamara Waldron ◽

Nicole Bergen ◽

Nazeem Muhajarine

Keyword(s):

Low Income ◽

Implementation Strategies ◽

Realist Synthesis ◽

Plain Language ◽

Programme Theory ◽

Middle Income ◽

Middle Income Countries ◽

Maternity Waiting Homes ◽

Wide Range ◽

Maternity Waiting Home

IntroductionMaternity waiting homes in low-income and middle-income countries provide accommodation near health facilities for pregnant women close to the time of birth to promote facility-based birth and birth with a skilled professional and to enable timely access to emergency obstetric services when needed. To date, no studies have provided a systematic, comprehensive synthesis explaining facilitators and barriers to successful maternity waiting home implementation and whether and how implementation strategies and recommendations vary by context. This synthesis will systematically consolidate the evidence, answering the question, ‘How, why, for whom, and in what context are maternity waiting homes successfully implemented in low-income and middle-income countries?’.Methods and analysisMethods include standard steps for realist synthesis: determining the scope of the review, searching for evidence, appraising and extracting data, synthesising and analysing the data and developing recommendations for dissemination. Steps are iterative, repeating until theoretical saturation is achieved. Searching will be conducted in 13 electronic databases with results managed in Eppi-Reviewer V.4. There will be no language, study-type or document-type restrictions. Items documented prior to 1990 will be excluded. To ensure our initial and revised programme theories accurately reflect the experiences and knowledge of key stakeholders, most notably the beneficiaries, interviews will be conducted with maternity waiting home users/nonusers, healthcare staff, policymakers and programme designers. All data will be analysed using context–mechanism–outcome configurations, refined and synthesised to produce a final programme theory.Ethics and disseminationEthics approval for the project will be obtained from the Mozambican National Bioethical Commission, Jimma University College of Health Sciences Institutional Review Board and the University of Saskatchewan Bioethical Research Ethics Board. To ensure results of the evaluation are available for uptake by a wide range of stakeholders, dissemination will include peer-reviewed journal publication, a plain-language brief, and conference presentations to stakeholders’ practice audiences.PROSPERO registration numberCRD42020173595.

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Using social networks to scale up and sustain community-based programmes to improve physical activity and diet in low-income and middle-income countries: a scoping review protocol

BMJ Open ◽

10.1136/bmjopen-2021-053586 ◽

2021 ◽

Vol 11 (9) ◽

pp. e053586

Author(s):

Nina Abrahams ◽

Estelle V Lambert ◽

Frederick Marais ◽

Zoi Toumpakari ◽

Charlie Foster

Keyword(s):

Physical Activity ◽

Social Networks ◽

Scoping Review ◽

Low Income ◽

Scale Up ◽

Community Based ◽

Middle Income ◽

Middle Income Countries ◽

Review Protocol

IntroductionThe World Health Organisation endorses community-based programmes as a cost-effective, feasible and a ‘best buy’ in the prevention and management of non-communicable diseases (NCDs). These programmes are particularly successful when the community actively participates in its design, implementation and evaluation. However, they may be only useful insofar as they can be scaled up and sustained in some meaningful way. Social network research may serve as an important tool for determining the underlying mechanisms that contribute to this process. The aim of this planned scoping review is to map and collate literature on the role of social networks in scaling-up and sustaining community-based physical activity and diet programmes in low-income and middle-income countries.Methods and analysisThis scoping review protocol has been planned around the Arksey and O'Malley framework and its enhancement. Inclusion criteria are peer-reviewed articles and grey literature exploring the role of social networks in the scale-up and/or sustainability of NCD prevention community-based programmes in adult populations. Studies must have been published since 2000, in English, and be based in a low-income or middle-income country. The following databases will be used for this review: PubMed, Cochrane, Scopus, Web of Science, CINAHL, SocIndex, the International Bibliography of the Social Sciences, Google and Google Scholar. Books, conference abstracts and research focused only on children will be excluded. Two reviewers will independently select and extract eligible studies. Included publications will be thematically analysed using the Framework Approach.Ethics and disseminationEthical approval will not be sought for this review as no individual-level data or human participants will be involved. This protocol is registered on the Open Science Framework (https://doi.org/10.17605/OSF.IO/KG7TX). The findings from the review will be published in an accredited journal. The Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews checklist will be used to support transparency and guide translation of the review.

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