Abstract:
:Task-shifting the provision of pregnancy tests to community health workers (CHWs) in low-resource settings has the potential to reach significantly more underserved women at risk of pregnancy with essential reproductive health services. This study assessed whether an intervention to supply CHWs with home pregnancy tests brought more clients for antenatal care (ANC) counselling. We implemented a randomized controlled trial among CHWs providing reproductive health services to women in Eastern Madagascar. We used ordinary least squares regressions to estimate the effect of the intervention, with district- and month-fixed effects and CHW baseline characteristics as control variables. Our outcomes of interest included whether the intervention increased: (1) the number of women at risk of pregnancy who sought services from CHWs; (2) the number of these women who knew they were pregnant by the end of visit; and (3) the number of these women who received ANC counselling during visit. We found that providing pregnancy tests to CHWs to distribute to their clients for free significantly increased the number of women at risk of pregnancy who sought services from CHWs. At follow-up, treatment-group CHWs provided services to 6.3 clients compared with 4.2 clients among control-group CHWs, which represents a 50% relative increase from the control-group mean. A significantly higher number of these clients knew they were pregnant by the end of the visit, with a mean of 0.95 in treatment compared with 0.10 in control (Coeff. 0.86; 95% CI 0.59-1.13). A significantly higher number of these clients received antenatal counselling at the visit (Coeff. 0.4; 95% CI 0.14-0.64). Introducing free home pregnancy tests as part of community-based health services can improve pregnancy care by attracting more clients at risk of pregnancy to services at the community level, enabling more women to confirm they are pregnant and receive antenatal counselling.
journal_name
Health Policy Planjournal_title
Health policy and planningauthors
Comfort AB,Juras RC,Bradley SEK,Ranjalahy Rasolofomanana J,Noeliarivelo Ranjalahy A,Harper CCdoi
10.1093/heapol/czz080subject
Has Abstractpub_date
2019-10-01 00:00:00pages
566-573issue
8eissn
0268-1080issn
1460-2237pii
5549447journal_volume
34pub_type
杂志文章,随机对照试验abstract::Sector-wide approaches (SWAps) in health were developed in the early 1990s in response to widespread dissatisfaction with fragmented donor-sponsored projects and prescriptive adjustment lending. SWAps were intended to provide a more coherent way to articulate and manage government-led sectoral policies and expenditure...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czs128
更新日期:2013-12-01 00:00:00
abstract::Evidence regarding the role of nurses-in-leadership and how to engage nurses in policy decisions is minimal in sub-Saharan Africa. The purpose of this study was: (1) to assess the leadership practices of nurses-in-leadership in Uganda (by self-report) and from the perspective of 'followers' (direct-report, peers, co-w...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czaa100
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Lebanon, characterized by a free-market health care system, has one of the highest reported per capita rates of cardiac catheterization facilities and coronary angiographies in the world. The aim of this study is to evaluate the appropriateness of performance of coronary angiography procedures in Lebanon. M...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czn005
更新日期:2008-05-01 00:00:00
abstract::A decade after the first International Conference on Safe Motherhood, maternal mortality remains very high in most West African countries, even in capital cities. The detection of high risk pregnancies, known as the risk approach, during antenatal consultations has been the basis of most maternal and child health prog...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/15.1.11
更新日期:2000-03-01 00:00:00
abstract::This study examines the factors that influence patient choice of medical provider in the three-tier health care system in rural China: village health posts, township health centres, and county (and higher level) hospitals. The model is estimated using a multinomial logit approach applied to a sample of 1877 cases of o...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/13.3.311
更新日期:1998-09-01 00:00:00
abstract::Since 2001 substantial resources have been allocated to the reproductive, maternal, newborn and child health sector (RMNCH) in Pakistan. Many new programmes have been started and coverage of some existing programmes has been extended to un-served and rural areas. Despite these efforts the Millennium Development Goals ...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czx021
更新日期:2017-07-01 00:00:00
abstract::In most settings, a 'public' health service refers to a service which belongs to the state. The term 'private' is used when health care is delivered by individuals and/or institutions not administered by the state. In this paper it is argued that such a distinction, which is based on the institutional or administrativ...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/12.3.193
更新日期:1997-09-01 00:00:00
abstract:BACKGROUND:Afghanistan has one of the highest rates of maternal mortality in the world. We assess the health outcomes and cost-effectiveness of strategies to improve the safety of pregnancy and childbirth in Afghanistan. METHODS:Using national and sub-national data, we adapted a previously validated model that simulat...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czs026
更新日期:2013-01-01 00:00:00
abstract::Home visiting programmes are increasingly recognized as one of the most effective interventions to improve child health and development in low-income settings. However, the best platforms to deliver such programmes remain unclear. We conducted a randomized controlled trial to test the relative effectiveness of child d...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czaa195
更新日期:2021-01-26 00:00:00
abstract::Public sector price analyses of antiretroviral (ARV) medicines can provide relevant information to detect ARV procurement procedures that do not obtain competitive market prices. Price benchmarks provide a useful tool for programme managers and policy makers to support such planning and policy measures. The aim of the...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czs011
更新日期:2012-12-01 00:00:00
abstract::This paper reports an empirical investigation into the pattern of private health insurance coverage in South Africa before and after deregulation of the health insurance industry. More specifically, we sought to measure trends in risk-pooling over the period 1985-95, and to assess the impact of risk pooling on the cos...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/15.4.378
更新日期:2000-12-01 00:00:00
abstract::This paper examines healthcare utilization behaviour in Sri Lanka with special emphasis on the choice between costly private and free public healthcare services. We use a data set that combines nationwide household survey data and district level healthcare supply data. Our findings suggest that even with universal pub...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czx085
更新日期:2017-11-01 00:00:00
abstract::There is increasing interest among health policymakers, planners and donors in how corruption affects health care access and outcomes, and what can be done to combat corruption in the health sector. Efforts to explain the risk of abuse of entrusted power for private gain have examined the links between corruption and ...
journal_title:Health policy and planning
pub_type: 杂志文章,评审
doi:10.1093/heapol/czm048
更新日期:2008-03-01 00:00:00
abstract::The persistently low quality and inadequacy of health services provided in public facilities has made the private sector an unavoidable choice for consumers of health care in Nigeria. Ineffective state regulation, however, has meant little control over the clinical activities of private sector providers while the pric...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/14.2.174
更新日期:1999-06-01 00:00:00
abstract::In 1991, Zimbabwe introduced cost recovery measures as part of its programme of economic reforms, following a course taken by many developing countries. The system of user fees in public health care, aimed to 'protect and support the vulnerable groups' by exemption or incremental fees based on 4 income brackets. Drugs...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/10.3.319
更新日期:1995-09-01 00:00:00
abstract::Neonatal deaths account for about half of all deaths among children under 5 years of age in Bangladesh, making prevention a major priority. This paper reports on a study of neonatal deaths in 12 areas of Bangladesh served by a large NGO programme, which had high coverage of reproductive health outreach services and re...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czl024
更新日期:2006-11-01 00:00:00
abstract::Although logic models are now touted as an important component of health promotion planning, implementation and evaluation, there are few published manuscripts that describe the process of logic model development, and fewer which do so with community involvement, despite the increasing emphasis on participatory resear...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czr001
更新日期:2011-11-01 00:00:00
abstract::In countries with large gender disparities in health status, can investments in local communities mitigate the gender bias observed in intra-household resource allocations? This paper explores the evidence for gender differences in the impact of community prices and infrastructure on child nutritional outcomes. Standa...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czl007
更新日期:2006-05-01 00:00:00
abstract::This article examines the role of health governance in shaping the outcomes of healthcare reforms in China. The analysis shows that the failure of reforms during the 1980s and 1990s was in part due to inadequate attention to key aspects in health governance, such as strategic interactions among government, providers a...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czs109
更新日期:2014-09-01 00:00:00
abstract::Facing escalating health care expenditures, the governments of countries with national health insurance programs are trying to control or even to reduce health care utilization. Little research has examined the effects of decreased health care utilization on health outcomes. Applying a natural experiment design to the...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czr080
更新日期:2012-10-01 00:00:00
abstract::Traditional medicine is commonly assumed to be a crucial health care option for poor households in developing countries. However, little research has been done in Asia to quantify the reliance on traditional medicine and its determinants. This research contributes to filling in this knowledge gap using household surve...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czv060
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVE:Irrational use of medicines is a serious problem in China and has been the primary target of China's national essential medicines programme (NEMP). The aim of this study was to evaluate the effect of the NEMP on rational use of medicines in China. METHODS:A nationwide sample of 3 76 700 prescriptions written...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czv008
更新日期:2016-02-01 00:00:00
abstract::How do practitioners respond to the mental distress of HIV-affected women and communities? And do their understandings of patients' distress matter? The World Health Organization (WHO) along with advocates from the Movement for Global Mental Health (MGMH) champion a primary mental health care model to address burgeoni...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czu092
更新日期:2015-09-01 00:00:00
abstract::The challenge of achieving community participation as a component of health sector reform is especially great in low- and middle-income countries where there is limited experience of community participation in social policy making. This paper concentrates on the social representations of different actors at different ...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/16.suppl_2.52
更新日期:2001-12-01 00:00:00
abstract::Existing accountability efforts in Nigeria primarily serve as retrospective policing. To enable accountability to guide change prospectively and preemptively, we drew from a literature review to develop a framework that highlights mutually reinforcing dimensions of accountability in health systems along three counterb...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czw057
更新日期:2016-11-01 00:00:00
abstract::The scale and severity of the impact of the global HIV/AIDS pandemic on low-income countries, mainly those in sub-Saharan Africa, is almost unimaginable to people in high-income countries. There is a particularly pressing need to understand better how to ensure the translation into policy and practice of important res...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/17.2.196
更新日期:2002-06-01 00:00:00
abstract::Contributing to the ongoing debate about policy feedback in comparative public policy research, this article examines the evolution of healthcare financing policy in Ghana. More specifically, this article investigates the shift in healthcare financing from full cost recovery, known as 'cash-and-carry', to a nation-wid...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czaa080
更新日期:2020-11-20 00:00:00
abstract::Formalized task shifting structures have been used to rapidly scale up antiretroviral service delivery to underserved populations in several countries, and may be a promising mechanism for accomplishing universal health coverage. However, studies evaluating the quality of service delivery through task shifting have la...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czu072
更新日期:2014-09-01 00:00:00
abstract::In 2014, the Indonesian government passed the Mental Health Act (MHA) to address the country's complex mental health situation. The implementation of the MHA has been slow, and little is known about how the MHA is perceived by mental healthcare providers within local settings. This study aimed to obtain insight into p...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czaa139
更新日期:2020-11-23 00:00:00
abstract::The financial remuneration of health workers (HWs) is a key concern to address human resources for health challenges. In low-income settings, the exploration of the sources of income available to HWs, their determinants and the livelihoods strategies that those remunerations entail are essential to gain a better under...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czv131
更新日期:2016-11-01 00:00:00