- The document presents findings from a rapid assessment of the implications of the Ebola outbreak for routine reproductive, maternal, and child health (RMNCH) services in Guinea.
- Key indicators of RMNCH services like outpatient visits, modern contraceptive use, antenatal care visits, child vaccinations significantly declined between 2013 and 2014, especially in Ebola active areas.
- The declines were seen across hospitals and health centers in all study sites and for most RMNCH services, with the exception of some maternal health services which saw smaller declines.
Enhancing FP/RH Decision Making through GIS Data LinkingMEASURE Evaluation
This document discusses using geographic information systems (GIS) to link multi-sectoral data in order to enhance decision making for family planning and reproductive health programs in Rwanda. It provides an overview of a case study conducted in Rwanda that explored linking key data sources such as demographic health surveys, commodity distribution data, and poverty and agriculture data using common geographic identifiers. The case study found that free and open source GIS software like Excel to Google Earth, Quantum GIS, and OpenGeoDa could effectively link and visualize the data. Lessons learned included the importance of stakeholder engagement to access sensitive data, using accurate population data when normalizing indicators, and how GIS data linking can provide insights and incentives to improve health programs.
1) The document discusses how geographic information systems (GIS) and geospatial analysis can be applied to public health issues beyond simple mapping to provide predictive modeling, time-distance analysis, and service area analysis.
2) Examples are given of how GIS has been used to identify "hot spots" of high infant mortality in Richmond, Virginia and recommend optimal locations for maternity clinics in Tidewater, Virginia.
3) Additionally, the document discusses how GIS analysis could help identify potential areas of underreporting of breast cancer cases in southern Virginia and determine access to psychiatric facilities across the state based on drive time analysis.
Geospatial Analysis: Innovation in GIS for Better Decision MakingMEASURE Evaluation
Discussion led by John Spencer and Mark Janko. This webinar shared new techniques in geospatial analysis and how they have the potential to transform data-informed decision making.
Presented by Nate Heard, Office of the Geographer and Global Issues, at the MEASURE Evaluation Geographic Information Systems (GIS) Working Group Meeting.
Operational Guidelines for Monitoring and Evaluation of HIV Programmes for Se...MEASURE Evaluation
This document provides guidelines for monitoring and evaluating HIV programs for sex workers, men who have sex with men, and transgender people at the national, sub-national, and service delivery levels. It outlines an 8-step public health model approach involving understanding the epidemic, determinants of transmission, developing combination prevention programs, and evaluating impact. Key concepts covered include causal pathways, indicators, and emphasizing quality and involvement of key populations. The guidelines are meant to be adapted to local contexts.
Enhancing FP/RH Decision Making through GIS Data LinkingMEASURE Evaluation
This document discusses using geographic information systems (GIS) to link multi-sectoral data in order to enhance decision making for family planning and reproductive health programs in Rwanda. It provides an overview of a case study conducted in Rwanda that explored linking key data sources such as demographic health surveys, commodity distribution data, and poverty and agriculture data using common geographic identifiers. The case study found that free and open source GIS software like Excel to Google Earth, Quantum GIS, and OpenGeoDa could effectively link and visualize the data. Lessons learned included the importance of stakeholder engagement to access sensitive data, using accurate population data when normalizing indicators, and how GIS data linking can provide insights and incentives to improve health programs.
1) The document discusses how geographic information systems (GIS) and geospatial analysis can be applied to public health issues beyond simple mapping to provide predictive modeling, time-distance analysis, and service area analysis.
2) Examples are given of how GIS has been used to identify "hot spots" of high infant mortality in Richmond, Virginia and recommend optimal locations for maternity clinics in Tidewater, Virginia.
3) Additionally, the document discusses how GIS analysis could help identify potential areas of underreporting of breast cancer cases in southern Virginia and determine access to psychiatric facilities across the state based on drive time analysis.
Geospatial Analysis: Innovation in GIS for Better Decision MakingMEASURE Evaluation
Discussion led by John Spencer and Mark Janko. This webinar shared new techniques in geospatial analysis and how they have the potential to transform data-informed decision making.
Presented by Nate Heard, Office of the Geographer and Global Issues, at the MEASURE Evaluation Geographic Information Systems (GIS) Working Group Meeting.
Operational Guidelines for Monitoring and Evaluation of HIV Programmes for Se...MEASURE Evaluation
This document provides guidelines for monitoring and evaluating HIV programs for sex workers, men who have sex with men, and transgender people at the national, sub-national, and service delivery levels. It outlines an 8-step public health model approach involving understanding the epidemic, determinants of transmission, developing combination prevention programs, and evaluating impact. Key concepts covered include causal pathways, indicators, and emphasizing quality and involvement of key populations. The guidelines are meant to be adapted to local contexts.
This document summarizes a presentation on monitoring and evaluation given at an end-of-phase event on May 22, 2014. It discusses responsive M&E systems for program success and the importance of building national M&E capacity. It provides examples of tools and approaches used by MEASURE Evaluation to support countries, including developing M&E guidelines, training curricula, and providing technical assistance. Challenges in M&E like implementation, coordination and measuring achievements are also noted. The presentation emphasizes adapting local M&E systems as contexts change from malaria control to elimination.
Evaluation of the Impact of Malaria Control Interventions on All-Cause Mortal...MEASURE Evaluation
This document summarizes an evaluation of the impact of malaria control interventions on child mortality in Liberia from 2005-2013. It finds that coverage of key interventions like insecticide-treated bed nets and intermittent preventative treatment for pregnant women increased substantially. Malaria morbidity indicators like parasite prevalence and confirmed cases declined. However, declines in overall child mortality were likely driven more by improvements in other health and development factors rather than malaria control alone during the evaluation period. The expansion of interventions is still ongoing and may need to reach higher levels to significantly reduce malaria-attributable child deaths.
Key Populations and the HIV Epidemic: Lessons Learned in M&E and Future Direc...MEASURE Evaluation
MEASURE Evaluation is a global health project funded by USAID to strengthen health information systems in over 25 countries. The project works to improve collection, analysis and use of health data to support decision making. Sharon Weir presented on lessons learned from monitoring and evaluating programs for key populations affected by HIV. She discussed how surveillance can provide more immediate information for programs if distinguished from other monitoring and evaluation activities. The presentation also covered adaptations made to the PLACE method over time to better align with prevention goals and strategically target local HIV epidemics.
This document discusses global health monitoring and evaluation (M&E) and outlines what may come next. It notes the progress made in bending the curve of HIV/AIDS and tuberculosis incidence through programs like PEPFAR and PMI. It then describes MEASURE Evaluation's contributions in measuring change, building workforce capacity, strengthening health systems, guiding resource allocation, and creating tools and methods. The document concludes by suggesting areas of future focus, including scaling up successful systems, approaches and tools; filling gaps like interoperable data systems and evaluating structural interventions; incorporating more systems thinking; and focusing on developing a strong and sustainable M&E workforce.
Collecting the PEPFAR OVC MER Essential Survey Indicators: Frequently Asked Q...MEASURE Evaluation
Gretchen Bachman and Christine Fu (USAID); Lisa Parker, Jenifer Chapman, Lisa Marie Albert, Walter Obiero, and Susan Settergren from MEASURE Evaluation. January 2017 Webinar.
Extrapolation of data from key population surveys and programsMEASURE Evaluation
1. The document discusses approaches for estimating national indicators related to key populations, such as the size of female sex workers, when existing data are incomplete.
2. It describes using an augmented inverse probability weighted estimator to combine data from surveys of a subset of areas with covariate data available nationwide in order to estimate proportions for the entire country.
3. Sensitivity analyses and discussion with stakeholders are recommended to understand uncertainties and ensure the method's assumptions adequately reflect the population.
Health Information Systems Strengthening (HISS) in KenyaMEASURE Evaluation
This document discusses lessons learned from strengthening health information systems (HIS) in Kenya through the Health Information Systems Strengthening (HISS) model. It outlines how the MEASURE Evaluation PIMA project mapped its interventions to the HISS model components of creating an enabling environment, information generation, and ensuring HIS performance. Key contributions included tools and approaches for assessments, capacity building, and prioritizing data use. Moving forward, priorities include ensuring government ownership and sustainability, cost-effective capacity building, incorporating new technologies, and continuous learning to document best practices.
RHINO Forum: How can RHIS improve the delivery of HIV/AIDS services?MEASURE Evaluation
This document discusses how routine health information systems (RHIS) can be improved to better monitor linkages between HIV/AIDS services and other health services. Integrating separate vertical program reporting systems into a single national RHIS could facilitate client referrals, continuity of care, and achievement of program goals. However, challenges include harmonizing different recording forms and integrating programs not designed to be combined. The discussion forum explores issues around monitoring individual clients versus aggregates, defining linkage indicators, and ensuring data quality when integrating systems.
Building a Resilient Health System in Liberia: Health Information System (HIS...MEASURE Evaluation
The document summarizes Liberia's process of developing a strategic plan for its health information system (HIS) from 2015-2016. It involved four main stages: 1) consensus building among HIS stakeholders on the process; 2) conducting assessments of the existing HIS; 3) developing strategic and operational plans based on the assessments; 4) validating and finalizing the plans. The outcome was strategic and operational plans for 2016-2021 to create a more integrated and coordinated HIS to support a resilient health system. Challenges included the complexity of the process, but leadership and coordination mechanisms helped ensure stakeholder involvement and progress. Lessons learned will be used to improve strategic planning guidelines.
Using Maps for Prevention, Planning, and Targeting Experiences from SwazilandMEASURE Evaluation
Using mapping techniques, researchers were able to estimate HIV prevalence at a granular level across Swaziland's regions. This allowed the country to better target its HIV prevention efforts. The analysis used routinely collected data to produce estimates for administrative levels down to 16 square kilometers. This continuous monitoring approach provided valuable information not available from other surveys, which have smaller sample sizes and do not occur regularly. The maps showed HIV prevalence varied significantly across regions, from 12.8-56%, and revealed dense populations of people living with HIV to strategically locate prevention and treatment services.
1) Data science integrates locating key data, turning data into actionable information, and communicating information effectively to address challenges in analyzing the growing amount of global data.
2) MEASURE Evaluation uses data science to strengthen health information systems and decision-making in over 25 countries by improving data collection, analysis, and management capacity.
3) Examples show how data science can leverage new data sources like mobile phones and social media to provide insights into health issues and help achieve USAID priorities like the AIDS Free Generation.
Adapting and enhancing malaria information systems in countries entering pre-...MEASURE Evaluation
As countries reduce malaria transmission, strong health information systems are needed to monitor progress and tailor new approaches. A literature review identified key aspects of health information system functionality for countries at various stages of malaria control. Personnel, data quality, and system structure were the most influential aspects. Assessments are important to identify areas for improvement and allow comparison across countries and over time. The results will help develop country case studies and guidance to help strengthen routine data capture as countries adapt their health information systems for changing malaria epidemiology.
Empowering Local Decision Makers in Iringa, Tanzania:PLACE Lite and the Irin...MEASURE Evaluation
This document summarizes a participatory mapping exercise conducted in Iringa and Njombe regions of Tanzania to identify HIV prevention and treatment service coverage gaps at local levels. Key findings from the mapping included higher than national HIV prevalence rates in the regions, with truck stops frequented mainly by migrant workers having low condom availability. The mapping data was then used by local decision-makers to advocate for additional HIV care and treatment sites in underserved areas. The document promotes engaging local stakeholders in data collection and sharing findings in accessible formats like maps to encourage use of local data for local health decisions.
This document summarizes a presentation on monitoring and evaluation given at an end-of-phase event on May 22, 2014. It discusses responsive M&E systems for program success and the importance of building national M&E capacity. It provides examples of tools and approaches used by MEASURE Evaluation to support countries, including developing M&E guidelines, training curricula, and providing technical assistance. Challenges in M&E like implementation, coordination and measuring achievements are also noted. The presentation emphasizes adapting local M&E systems as contexts change from malaria control to elimination.
Evaluation of the Impact of Malaria Control Interventions on All-Cause Mortal...MEASURE Evaluation
This document summarizes an evaluation of the impact of malaria control interventions on child mortality in Liberia from 2005-2013. It finds that coverage of key interventions like insecticide-treated bed nets and intermittent preventative treatment for pregnant women increased substantially. Malaria morbidity indicators like parasite prevalence and confirmed cases declined. However, declines in overall child mortality were likely driven more by improvements in other health and development factors rather than malaria control alone during the evaluation period. The expansion of interventions is still ongoing and may need to reach higher levels to significantly reduce malaria-attributable child deaths.
Key Populations and the HIV Epidemic: Lessons Learned in M&E and Future Direc...MEASURE Evaluation
MEASURE Evaluation is a global health project funded by USAID to strengthen health information systems in over 25 countries. The project works to improve collection, analysis and use of health data to support decision making. Sharon Weir presented on lessons learned from monitoring and evaluating programs for key populations affected by HIV. She discussed how surveillance can provide more immediate information for programs if distinguished from other monitoring and evaluation activities. The presentation also covered adaptations made to the PLACE method over time to better align with prevention goals and strategically target local HIV epidemics.
This document discusses global health monitoring and evaluation (M&E) and outlines what may come next. It notes the progress made in bending the curve of HIV/AIDS and tuberculosis incidence through programs like PEPFAR and PMI. It then describes MEASURE Evaluation's contributions in measuring change, building workforce capacity, strengthening health systems, guiding resource allocation, and creating tools and methods. The document concludes by suggesting areas of future focus, including scaling up successful systems, approaches and tools; filling gaps like interoperable data systems and evaluating structural interventions; incorporating more systems thinking; and focusing on developing a strong and sustainable M&E workforce.
Collecting the PEPFAR OVC MER Essential Survey Indicators: Frequently Asked Q...MEASURE Evaluation
Gretchen Bachman and Christine Fu (USAID); Lisa Parker, Jenifer Chapman, Lisa Marie Albert, Walter Obiero, and Susan Settergren from MEASURE Evaluation. January 2017 Webinar.
Extrapolation of data from key population surveys and programsMEASURE Evaluation
1. The document discusses approaches for estimating national indicators related to key populations, such as the size of female sex workers, when existing data are incomplete.
2. It describes using an augmented inverse probability weighted estimator to combine data from surveys of a subset of areas with covariate data available nationwide in order to estimate proportions for the entire country.
3. Sensitivity analyses and discussion with stakeholders are recommended to understand uncertainties and ensure the method's assumptions adequately reflect the population.
Health Information Systems Strengthening (HISS) in KenyaMEASURE Evaluation
This document discusses lessons learned from strengthening health information systems (HIS) in Kenya through the Health Information Systems Strengthening (HISS) model. It outlines how the MEASURE Evaluation PIMA project mapped its interventions to the HISS model components of creating an enabling environment, information generation, and ensuring HIS performance. Key contributions included tools and approaches for assessments, capacity building, and prioritizing data use. Moving forward, priorities include ensuring government ownership and sustainability, cost-effective capacity building, incorporating new technologies, and continuous learning to document best practices.
RHINO Forum: How can RHIS improve the delivery of HIV/AIDS services?MEASURE Evaluation
This document discusses how routine health information systems (RHIS) can be improved to better monitor linkages between HIV/AIDS services and other health services. Integrating separate vertical program reporting systems into a single national RHIS could facilitate client referrals, continuity of care, and achievement of program goals. However, challenges include harmonizing different recording forms and integrating programs not designed to be combined. The discussion forum explores issues around monitoring individual clients versus aggregates, defining linkage indicators, and ensuring data quality when integrating systems.
Building a Resilient Health System in Liberia: Health Information System (HIS...MEASURE Evaluation
The document summarizes Liberia's process of developing a strategic plan for its health information system (HIS) from 2015-2016. It involved four main stages: 1) consensus building among HIS stakeholders on the process; 2) conducting assessments of the existing HIS; 3) developing strategic and operational plans based on the assessments; 4) validating and finalizing the plans. The outcome was strategic and operational plans for 2016-2021 to create a more integrated and coordinated HIS to support a resilient health system. Challenges included the complexity of the process, but leadership and coordination mechanisms helped ensure stakeholder involvement and progress. Lessons learned will be used to improve strategic planning guidelines.
Using Maps for Prevention, Planning, and Targeting Experiences from SwazilandMEASURE Evaluation
Using mapping techniques, researchers were able to estimate HIV prevalence at a granular level across Swaziland's regions. This allowed the country to better target its HIV prevention efforts. The analysis used routinely collected data to produce estimates for administrative levels down to 16 square kilometers. This continuous monitoring approach provided valuable information not available from other surveys, which have smaller sample sizes and do not occur regularly. The maps showed HIV prevalence varied significantly across regions, from 12.8-56%, and revealed dense populations of people living with HIV to strategically locate prevention and treatment services.
1) Data science integrates locating key data, turning data into actionable information, and communicating information effectively to address challenges in analyzing the growing amount of global data.
2) MEASURE Evaluation uses data science to strengthen health information systems and decision-making in over 25 countries by improving data collection, analysis, and management capacity.
3) Examples show how data science can leverage new data sources like mobile phones and social media to provide insights into health issues and help achieve USAID priorities like the AIDS Free Generation.
Adapting and enhancing malaria information systems in countries entering pre-...MEASURE Evaluation
As countries reduce malaria transmission, strong health information systems are needed to monitor progress and tailor new approaches. A literature review identified key aspects of health information system functionality for countries at various stages of malaria control. Personnel, data quality, and system structure were the most influential aspects. Assessments are important to identify areas for improvement and allow comparison across countries and over time. The results will help develop country case studies and guidance to help strengthen routine data capture as countries adapt their health information systems for changing malaria epidemiology.
Empowering Local Decision Makers in Iringa, Tanzania:PLACE Lite and the Irin...MEASURE Evaluation
This document summarizes a participatory mapping exercise conducted in Iringa and Njombe regions of Tanzania to identify HIV prevention and treatment service coverage gaps at local levels. Key findings from the mapping included higher than national HIV prevalence rates in the regions, with truck stops frequented mainly by migrant workers having low condom availability. The mapping data was then used by local decision-makers to advocate for additional HIV care and treatment sites in underserved areas. The document promotes engaging local stakeholders in data collection and sharing findings in accessible formats like maps to encourage use of local data for local health decisions.
Reduction in Disparity of Insecticide-Treated Nets Ownership and Use among So...MEASURE Evaluation
This study assessed changes in disparities in insecticide-treated net (ITN) ownership and use among socioeconomic groups in Uganda between 2006 and 2011. It found significant increases in household ITN ownership (from 16% to 60%) and children under 5 sleeping under an ITN (from 10% to 43%). Disparities between wealth quintiles were reduced, as shown by a decrease in the concentration index from 0.11 to 0.02 for household ownership and from 0.04 to 0.01 for children's use. This achievement is likely due to Uganda's shift to universal coverage and free mass distribution campaigns of long-lasting insecticidal nets from 2009. However, further efforts are needed to increase overall coverage and reduce
Investigating the Potential Circular Effect of Mosquito Net Ownership on Unde...MEASURE Evaluation
This study investigated the potential circular relationship between mosquito net ownership and under-five mortality in Uganda. The study used 2011 Uganda DHS data to analyze whether households were more likely to own nets after experiencing an under-five death, through a logistic regression adjusting for covariates. The results showed no association between past death and net ownership, suggesting the circular effect does not impact estimates of the relationship between net ownership and mortality risk. However, this circular relationship should still be accounted for in analyses.
Association between increasing ITN use and reductions in moderate-to-severe a...MEASURE Evaluation
Increases in ITN use were associated with reductions in moderate-to-severe anemia in children aged 6-23 months across 11 countries. Data from DHS surveys between 2001-2011 showed dramatic increases in ITN use alongside decreases in anemia prevalence. Statistical models found that increased ITN use explained 24.9% of the total reduction in anemia, more than other factors like wealth, residence, or education. The results suggest scaling up malaria control interventions can lower anemia levels in young children.
Worsening Socio-economic Disparities in ITN Ownership, Access and Use from 20...MEASURE Evaluation
Between 2006/7 and 2011 in Angola:
- Insecticide-treated net (ITN) ownership, access, and use among children under five increased, however disparities between socioeconomic groups also worsened. ITN ownership became less equitable in 2011 compared to 2006/7 as measured by concentration indices.
- In 2011, 44% of households in the least poor wealth quintile owned at least one ITN compared to 15% in the poorest quintile, whereas in 2006/7 the rates were 31% and 26% respectively.
- Concentration indices also showed worsening inequities in ITN access and use among children under five between the two time periods. A different ITN
Botswana’s Integration of Health Data Quality Assurance Into Standard Operati...MEASURE Evaluation
The document describes the development of data quality assurance procedures for Botswana's health ministry (MoH) in collaboration with MEASURE Evaluation. Key deliverables included standard operating procedures for data quality, a routine data quality assessment tool customized for Botswana, and a data quality curriculum and training workshops. The process took 16 months and $300,000. It established guidelines for ensuring quality data collection and use at service delivery, district, and national levels in Botswana.
The Impact of the Scale Up of Malaria Control Interventions in Senegal, 2006-...MEASURE Evaluation
1) The study evaluated the impact of scaling up malaria control interventions in Senegal between 2006-2010, which included insecticide-treated bed nets, indoor residual spraying, intermittent preventive treatment for pregnant women, rapid diagnostic tests, and artemisinin-based combination therapy.
2) Coverage of interventions like insecticide-treated bed nets increased substantially during this period, with the largest gains in poorer regions and populations.
3) Analysis found that malaria parasite prevalence and all-cause under-5 mortality decreased significantly, with the greatest declines in poorer areas with higher coverage of interventions. The scaling up of interventions was estimated to have averted over 5,000 under-5 deaths.
Evaluating Impact: Lessons Learned from MEASURE EvaluationMEASURE Evaluation
During a September presentation at South Africa’s Department of Planning, Monitoring and Evaluation, Dr. Jason Smith shared experiences and lessons learned on evaluating impact from MEASURE Evaluation Phase III implementation
Using Data to Support the Most Vulnerable: An OVC Information Needs FrameworkMEASURE Evaluation
The "Using Data to Support the Most Vulnerable: An OVC Information Needs Framework" webinar, organized by the HIV/AIDS Monitoring and Evaluation Network (AIMEnet), presented the OVC Information Needs Framework. MEASURE Evaluation's Molly Cannon and Lisa Parker led the one-hour webinar.
An Introduction to the Manual:How Do We Know if a Program Made a Difference?...MEASURE Evaluation
The document discusses the need for a new manual on statistical methods for evaluating program impact. It notes that existing manuals are either too simplistic and limited in their explanations or too complex and mathematical. The proposed new manual aims to provide a consistent approach that is accessible yet sophisticated. It will explicitly show how to estimate impact evaluation models and provide practical examples using statistical software. The manual will cover key topics like randomized controlled trials, selection on observable variables, and instrumental variable methods. Future editions may expand the examples and behavioral models or cover additional methods and data types.
This webinar by Peter Lance considered impact evaluation estimation methods based on an identification strategy that assumes we can observe all factors that influence both program participation and the outcome of interest. It was the third webinar in a series of discussions on the popular MEASURE Evaluation manual, How Do We Know If a Program Made a Difference? A Guide to Statistical Methods for Program Impact Evaluation.
This document discusses challenges with evaluating the impact of programs and methods that can be used. Randomization is presented as the ideal approach, as it ensures participants and non-participants are similar on average. However, randomization has limitations in practice, as individuals may not comply with their assigned status or drop out. Experiments also have limited scope and may not generalize to full-scale programs. As a result, other quasi-experimental methods are discussed, but these rely on strong assumptions that may not hold. In general, accurately estimating a program's causal impact is challenging.
MEASURE Evaluation PIMA poster on maternal morbidity and mortality. Access a larger version at https://www.measureevaluation.org/pima/maternal-and-reproductive-health/maternal-mortality-poster.
Integrating GIS and Remote Sensing Technology In Contact Tracing Of Ebola Vir...ANUMBA JOSEPH UCHE
Contact tracing, is an essential step in breaking the chain of disease transmission and ending an outbreak. There is need to explore digital tools and skills which will enhance the collection and management of epidemiologic, clinical, and laboratory information for every case. This data is crucial for developing outbreak counter measures. In the context of ebola virus disease (EVD), developing a Geographical Information System (GIS) and remote sensing platform for contacting tracing and monitoring of cases will aid field workers visualize outbreak spread between people as well as provide automated tools that speed contact tracing and spatial data analysis. With a disease as often fatal as Ebola, quickly identifying and following up with those who may have been exposed is key to saving lives and containing the outbreak .
This paper gives a preliminary non-technical insight on how GIS and remote sensing can be integrated into existing methodologies to mitigate the challenges in contact tracing and monitoring of Ebola virus diseases cases in any given geographical location. Invariably, this can also be used to design appropriate tools for monitoring outbreaks of viral hemorrhagic fevers such as Ebola, Marburg, Rift Valley, Lassa, and Crimean-Congo hemorrhagic fevers.
This document is a curriculum vitae for Muhammed Ahmed Rameto. It outlines his personal and educational background, work experience, skills, and references. Currently, he is the CEO of Kulito Hospital in SNNPR, Ethiopia, where his responsibilities include overseeing medical staff, planning activities, improving access to healthcare services, and collaborating with partners. Previously, he worked as the Head of Halaba special woreda health office, managing rural and urban health programs related to reproductive health, child health, nutrition, malaria, and HIV/AIDS. He has a Bachelor's degree in natural science and a Master's in public health epidemiology.
This document is a curriculum vitae for Muhammed Ahmed Rameto. It outlines his personal and educational background, work experience, skills, and references. Currently, he is the CEO of Kulito Hospital in SNNPR, Ethiopia, where his responsibilities include overseeing medical staff, planning activities, improving access to healthcare services, and collaborating with partners. Previously, he worked as the Head of Halaba special woreda health office, managing rural and urban health programs related to reproductive health, child health, nutrition, malaria, and HIV/AIDS. He has a Bachelor's degree in natural science and a Master's in public health epidemiology.
Being chosen as one of the best practices of VSMMC to be presented during the 2nd DOH National Staff Meeting, the Program for Young Parents is a collaborative project to address the health needs of pregnant adolescents and provide comprehensive "one-stop shop" care for the pregnant adolescent, her partner and her infant.
Delivery of Maternal and Child Nutritional Services in India During the COVID...POSHAN
This document analyzes how COVID-19 impacted the delivery of maternal and child nutrition services in India. Using district-level health management data from January 2018 to May 2021, it finds substantial declines in key services during the pandemic, especially in the initial months, including centers conducting health/nutrition activities, children receiving iron supplements, and pregnant women receiving tests and supplements. These declines do not appear to be fully explained by data reporting disruptions. The study aims to help assess actual declines in service provision versus reporting issues and inform policies to address nutrition service gaps during pandemics.
Introduction: Uganda has an estimated 95,000 children living with HIV and only 68% are currently in HIV care. Reaching the fi rst 90 in the UNAIDS 90-90-90 strategy for children is still a far off goal considering the national prevalence of 0.5%. In this study, we set out to determine the coverage and yield from HIV testing using different approaches both at the facility and the community.
M01 Introduction to EID and POC EID Testing.pptxDagneBodena1
This document provides an overview of early infant diagnosis of HIV and point-of-care testing. It discusses the basics of HIV and challenges diagnosing HIV in infants. Key points include: early infant diagnosis is important due to high mortality among untreated HIV-positive infants; nucleic acid testing is used to detect HIV in infants under 18 months since antibodies may be present from the mother; and the WHO provides recommendations around testing algorithms and returning results quickly to initiate treatment if needed.
This document provides an overview of viral load testing in Zambia. It defines viral load and viral load suppression. It discusses Zambia's achievement of 90-90-90 targets and the scale up of PCR labs across the country's 10 provinces. It reviews viral load testing platforms, sample types, and expected results and schedules for both adults and children, including a minimum 80% viral suppression rate expected in children by 6 months on first-line ART.
This document discusses hepatitis prevention and the burden of hepatitis globally and in Sri Lanka. Some key points:
- Globally, 400 million people live with chronic hepatitis B or C, causing over 1.4 million deaths per year. Chronic hepatitis B prevalence is highest in East Asia and Africa, while HCV prevalence is high in Central/East Asia and North Africa.
- In Sri Lanka, over 7,000 hepatitis cases were reported from 2010-2014, with over half occurring in 4 districts. The disease affects males more than females and incidence increases with age. Overall HBV and HCV seroprevalence is low (<2% and <1%).
- Transmission occurs through blood and body fluids. At-
This document summarizes Mrs. Beatrice Kunfah's 2014 half-year performance review. It outlines her municipality's priorities, key achievements and challenges. Some achievements include training staff, increasing skilled deliveries and ANC registration. Challenges include inadequate health staff and facilities, high disease burden, and delays in reimbursements. Key indicators like immunization coverage and malaria testing increased but teenage pregnancies and stillbirths remain issues.
Presentation given relating to the HSCIC report 'Focus on the health and care of young people June 2015' by Kate Croft, HSCIC Head of Statistical Response Unit. This took place at the Health+Care event at London's ExCel, on Thursday 25 June 2015.
Impact of COVID-19 Pandemic on Dietary Diversity and Nutritional Status of Pr...POSHAN
- The study assessed the impact of COVID-19 on dietary intake and nutritional status of pregnant women and children under 2 who were beneficiaries of a livelihood program in Bangladesh. It found that before COVID, the project beneficiaries had significantly better dietary diversity and nutritional outcomes. During COVID, these differences diminished as livelihoods and access to food and healthcare declined. The findings suggest the need for emergency food rations and maintaining nutrition support during crises to prevent worsening malnutrition.
This document provides a progress report on Sierra Leone's response to the Ebola outbreak and recovery efforts as of October 2015. It notes that active case finding has reduced cases to single digits in one district by mid-September 2015. It outlines WHO's support for strengthening surveillance, contact tracing, psychosocial support, case management, and care for survivors to consolidate gains and maintain zero cases. It also discusses efforts to safely restore essential health services impacted by the outbreak while preventing new outbreaks, including strengthening infection control and disease surveillance systems, reducing child and maternal mortality, and improving human resources for health. The report details WHO's support for the government's 24-month health recovery plan and long-term health system strengthening in Sierra Le
2016 indicator reference guide at-risk infants tested for hiv#GOMOJO, INC.
This document defines the indicator "Percentage of infants born to HIV-positive women who had a virologic HIV test done within 12 months of birth". It provides details on the numerator, denominator, and disaggregation categories for this indicator, which measures how many exposed infants receive early testing to determine their HIV status. Early diagnosis is critical to ensure untreated infants receive necessary treatment. The document also describes how to calculate and interpret this indicator, and what types of PEPFAR support can be counted.
03 children's enhanced adherence couselling in zambia ssAlbert Mwango
This document provides an overview of children's enhanced adherence counselling in Zambia. It begins with definitions of viral suppression and treatment failure. It then reviews viral load testing and effective regimens in children, and how to manage suspected treatment failure. It discusses enhanced adherence counselling (EAC) and the process involved. EAC aims to identify reasons for non-adherence and improve adherence. The document also reviews second line antiretroviral regimens for children in Zambia.
This report provides an analysis of HIV and STI surveillance data from Papua New Guinea in 2012. Key findings include:
- A total of 200,711 HIV tests were conducted, of which 4,723 (2.35%) were positive. Testing was higher among females.
- Nine provinces had HIV positivity rates above 1% among antenatal clients, with the highest in Enga (6.12%), Western Highlands (4.28%), and National Capital District (4.14%).
- 2,857 new HIV-positive cases were reported nationally. Most cases originated from and resided in provinces in the Highlands and Southern regions, particularly Enga, Southern Highlands, and Eastern
Similar to Rapid Assessment of Ebola-Related Implications for RMNCH Service Delivery and Utilization in Guinea (20)
Managing missing values in routinely reported data: One approach from the Dem...MEASURE Evaluation
This Data for Impact webinar was held in December 2020. Access the recording and learn more at https://www.data4impactproject.org/resources/webinars/managing-missing-values-in-routinely-reported-data-one-approach-from-the-democratic-republic-of-the-congo/
This Data for Impact webinar took place October 29, 2020. Learn more at https://www.data4impactproject.org/resources/webinars/use-of-routine-data-for-economic-evaluations/
Data for Impact hosted a one-hour webinar sharing guidance for using routine data in evaluations. More: https://www.data4impactproject.org/resources/webinars/routine-data-use-in-evaluation-practical-guidance/
Tuberculosis/HIV Mobility Study: Objectives and BackgroundMEASURE Evaluation
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive function. Exercise causes chemical changes in the brain that may help protect against mental illness and improve symptoms for those who already suffer from conditions like anxiety and depression.
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive function. Exercise causes chemical changes in the brain that may help protect against mental illness and improve symptoms.
Understanding Referral Networks for Adolescent Girls and Young WomenMEASURE Evaluation
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A review of the growth of the Israel Genealogy Research Association Database Collection for the last 12 months. Our collection is now passed the 3 million mark and still growing. See which archives have contributed the most. See the different types of records we have, and which years have had records added. You can also see what we have for the future.
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ISO/IEC 27001, ISO/IEC 42001, and GDPR: Best Practices for Implementation and...PECB
Denis is a dynamic and results-driven Chief Information Officer (CIO) with a distinguished career spanning information systems analysis and technical project management. With a proven track record of spearheading the design and delivery of cutting-edge Information Management solutions, he has consistently elevated business operations, streamlined reporting functions, and maximized process efficiency.
Certified as an ISO/IEC 27001: Information Security Management Systems (ISMS) Lead Implementer, Data Protection Officer, and Cyber Risks Analyst, Denis brings a heightened focus on data security, privacy, and cyber resilience to every endeavor.
His expertise extends across a diverse spectrum of reporting, database, and web development applications, underpinned by an exceptional grasp of data storage and virtualization technologies. His proficiency in application testing, database administration, and data cleansing ensures seamless execution of complex projects.
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Date: May 29, 2024
Tags: Information Security, ISO/IEC 27001, ISO/IEC 42001, Artificial Intelligence, GDPR
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This presentation was provided by Steph Pollock of The American Psychological Association’s Journals Program, and Damita Snow, of The American Society of Civil Engineers (ASCE), for the initial session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session One: 'Setting Expectations: a DEIA Primer,' was held June 6, 2024.
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Main Java[All of the Base Concepts}.docxadhitya5119
This is part 1 of my Java Learning Journey. This Contains Custom methods, classes, constructors, packages, multithreading , try- catch block, finally block and more.
it describes the bony anatomy including the femoral head , acetabulum, labrum . also discusses the capsule , ligaments . muscle that act on the hip joint and the range of motion are outlined. factors affecting hip joint stability and weight transmission through the joint are summarized.
LAND USE LAND COVER AND NDVI OF MIRZAPUR DISTRICT, UPRAHUL
This Dissertation explores the particular circumstances of Mirzapur, a region located in the
core of India. Mirzapur, with its varied terrains and abundant biodiversity, offers an optimal
environment for investigating the changes in vegetation cover dynamics. Our study utilizes
advanced technologies such as GIS (Geographic Information Systems) and Remote sensing to
analyze the transformations that have taken place over the course of a decade.
The complex relationship between human activities and the environment has been the focus
of extensive research and worry. As the global community grapples with swift urbanization,
population expansion, and economic progress, the effects on natural ecosystems are becoming
more evident. A crucial element of this impact is the alteration of vegetation cover, which plays a
significant role in maintaining the ecological equilibrium of our planet.Land serves as the foundation for all human activities and provides the necessary materials for
these activities. As the most crucial natural resource, its utilization by humans results in different
'Land uses,' which are determined by both human activities and the physical characteristics of the
land.
The utilization of land is impacted by human needs and environmental factors. In countries
like India, rapid population growth and the emphasis on extensive resource exploitation can lead
to significant land degradation, adversely affecting the region's land cover.
Therefore, human intervention has significantly influenced land use patterns over many
centuries, evolving its structure over time and space. In the present era, these changes have
accelerated due to factors such as agriculture and urbanization. Information regarding land use and
cover is essential for various planning and management tasks related to the Earth's surface,
providing crucial environmental data for scientific, resource management, policy purposes, and
diverse human activities.
Accurate understanding of land use and cover is imperative for the development planning
of any area. Consequently, a wide range of professionals, including earth system scientists, land
and water managers, and urban planners, are interested in obtaining data on land use and cover
changes, conversion trends, and other related patterns. The spatial dimensions of land use and
cover support policymakers and scientists in making well-informed decisions, as alterations in
these patterns indicate shifts in economic and social conditions. Monitoring such changes with the
help of Advanced technologies like Remote Sensing and Geographic Information Systems is
crucial for coordinated efforts across different administrative levels. Advanced technologies like
Remote Sensing and Geographic Information Systems
9
Changes in vegetation cover refer to variations in the distribution, composition, and overall
structure of plant communities across different temporal and spatial scales. These changes can
occur natural.
LAND USE LAND COVER AND NDVI OF MIRZAPUR DISTRICT, UP
Rapid Assessment of Ebola-Related Implications for RMNCH Service Delivery and Utilization in Guinea
1. Alimou Barry, Janine Barden-O’Fallon,
Jack Hazerjian, Paul Brodish
MEASURE Evaluation
24 June 2015
A Rapid Assessment
of Ebola-Related
Implications for
RMNCH Service
Delivery and
Utilization in
Guinea
2. WEEKLY INCIDENCE of CONFIRMED CASES of
EBOLA in GUINEA
Rapid assessment data collection period
http://apps.who.int/ebola/current-situation/ebola-situation-report-10-june-2015
0
20
40
60
80
100
120
140
160
180
Confirmed
Ebola Cases per
Week From
Start of 2015
Confirmed
Ebola Cases per
Week through
End of 2014
171
3. CASES of EBOLA in GUINEA
Cumulative Number
of Confirmed Cases
by Age Group‡
(per 100,000 population)
0-14 years 15-44 years 45+ years
Through
10 June, 2015
505
(11)
1846
(40)
838
(54)
Population figures are based on estimates from the United Nations Department of Economic and Social Affairs
‡Excludes cases for which data on age are not available.
From: http://apps.who.int/ebola/current-situation/ebola-situation-report-10-june-2015
Disproportionally affected adults and individuals in certain regions of the country
4. DEATHS from EBOLA in GUINEA
Cumulative Number
of Confirmed Deaths
in Total Population
(case fatality rate)
among Health Care Workers
(case fatality rate)
Through
10 June, 2015
2018
(62.3%)
94
(50.3%)
Population figures are based on estimates from the United Nations Department of Economic and Social Affairs
From: http://apps.who.int/ebola/current-situation/ebola-situation-report-10-june-2015
5. INDIRECT EFFECTS of EBOLA
Reports of clinic closures, patients being turned
away from services, and patients avoiding health
facilities out of fear
o In Sierra Leone, median inpatient admissions
dropped 70% between May and October 2014
• Reports of suspension of services, such as
vaccinations
To what extent are routine RMNCH services
in Guinea affected by Ebola?
7. METHODS
Compile and analyze facility data on key routine
RMNCH services from October 2013 (pre-Ebola)
through December 2014
Conduct interviews with:
o directors of health districts
o directors of health facilities
o providers of RMNCH services
o traditional practitioners
Use convenience sample of government and
private clinics in locations throughout Guinea with
variable Ebola incidence
Koulewondy Health
Center, Conakry
9. SELECTED STUDY SITES CLASSIFIED‡ AS
« ACTIVE », « CHANGING STATUS», or « INACTIVE >>
ACTIVE
(throughout)
CHANGING
STATUS
INACTIVE
(throughout)
GUÈCKÈDOU
CONAKRY CITY
DISTRICTS:
DIXINN
MATAM
RATOMA
BOFA
COYAH
DABOLA
DALABA
FARANAH
FRIA
KISSIDOUGOU
N’ZÈRÈKORÈ
SIGUIRI
MAMOU
MANDIANA
13 FACILITIES 26 FACILITIES 6 FACILITIES
‡ Based on retrospective review of Ebola case incidence for the period March-December 2014
10. KEY RMNCH INDICATORS
REPRODUCTIVE HEALTH
o New and continuing accepters of modern contraceptive methods
o Months with incidence of stockouts of contraceptive pills,
injectables, and/or condoms
Health education
mural at Guèckèdou
Prefectoral Hospital
11. MATERNAL HEALTH
o Pregnant women tested for HIV
o Pregnant women seen at first and third
prenatal visits
o Cases of pregnancy complications
o Facility-based births
o Maternal deaths
o Outpatient services
Horoya Health Center,
N’Zèrèkorè
KEY RMNCH INDICATORS
12. CHILD HEALTH
o Children vaccinated with Penta 1 and
Penta 3
o Children under 5 years of age with acute
respiratory illness, moderate malnutrition,
and diarrhea
o Child outpatient services
o Months with incidence of stockouts of
oral rehydration salts and Cotrimoxazole
o Children under 5 years of age hospitalized
due to acute respiratory illness Pediatric Ward of
Guèckèdou Prefectoral
Hospital
KEY RMNCH INDICATORS
14. Questionnaire for Directors of Health Services at Health District
o (Ex: facility closings; staffing issues; Ebola training; reporting continuity)
Questionnaire for Directors of Health Facilities
o (Ex: Ebola triage and referral; Ebola risk management; medical stockouts; medical
and personal concerns related to Ebola; recommendations)
Questionnaire for Providers of RMNCH Services
o (Ex: service suspension; Ebola training; Ebola risk management; medical
complications; Ebola-related concerns; recommendations)
Questionnaire for Traditional Practitioners
o (Ex: changes in service delivery and procedures; Ebola risk management)
DATA COLLECTION INSTRUMENTS
15. ETHICAL CONSIDERATIONS
Informed consent received from all interviewees
No identifying information collected from respondents
No personally sensitive questions asked about health status
Exemption received from University of North Carolina’s Ethics
Committee and Guinea’s Ministry of Health
16. LOGISTICS and COORDINATION
Collaborated with StatView International for
data collection and data entry
Coordinated with Ministry of Health Office of
Strategic Development and Family Health
Department
Communicated with directors of health services
at each study site, before and during field work,
with request to have a designated official work
along field study team
17. DATA QUALITY CONSIDERATIONS
Six data collection teams, each with a
physician as lead
Three quality monitoring teams to
ensure that protocols and practices
were being observed and that forms
were completed correctly
Data inscription into Epi 7 checked
against the field study forms
18. TIME LINE
2015 DATES
12 January
19 – 24 January
25 – 27 January
28 January – 8 February
9 – 17 February
18 February
19 February – 28 April
29 April
30 April – 13 May
30 May
24 June
• ACTIVITIES
• Approval of protocols and instruments
• Training of field workers and data clerks
• Coordination meetings w/ Ministry of Health and Public Hygiene
• UNC Ethics Committee approval
• Data collection
• Data entry and quality checks
• Debriefing with USAID/Guinea on preliminary findings
• Data cleaning, data analysis and preparation of report
• Submission of draft report to USAID/Guinea
• Review and finalization of report
• Submission of final report in English and French translation
• Presentation to USAID/Guinea
21. COMPARISON‡
of MEDIAN NUMBER of OUTPATIENT SERVCES in
OCT-DEC 2013 and 2014 from 45 FACILITIES
Oct-Dec
2013
Oct-Dec
2014
% Change
** p<.01
Outpatients (adults and children)
Hospitals 1355 930 – 31**
Health Centers 1223 1147 – 6**
Pediatric Outpatient Ward,
Donka National Hospital,
Conakry
Gonia Market
Health Center,
N’Zèrèkorè
‡ Wilcoxon signed rank test with median values
of services provided in each of the 2 quarters
22. FINDINGS by EBOLA ZONE
OUTPATIENT SERVICES
0
500
1000
1500
2000
2500
1 2 3 4 5
Time (quarters)
changing active
inactive
Median
number of
outpatient
visits
at hospitals
HOSPITALS
• Median number of adult and child outpatients:
significantly declined across all Ebola status zones
increased in early 2014 in Ebola active zone before steady
decline thereafter
relatively flat in inactive and changing Ebola status zones
before large declines late in 2014
23. FINDINGS by EBOLA ZONE
OUTPATIENT SERVICES
Median
number of
outpatient
visits
at health
centers 0
1000
2000
3000
1 2 3 4 5
Time (quarters)
changing active
inactive
HEALTH CENTERS
• Median number of adult and child outpatients:
small decline across all Ebola status zones
increased Apr-Jun 2014 in Ebola active zone before steady
decline thereafter
gradual increases in inactive and changing Ebola status zones
before small declines in Oct-Dec 2014
25. COMPARISON‡
of MEDIAN NUMBER of SERVCES and STOCKOUTS
of MODERN CONTRACEPTIVES OCT-DEC 2013 and 2014
from 45 FACILITIES
Oct-Dec
2013
Oct-Dec
2014
% Change
New Acceptors: Modern Contraception
Hospitals 19 12 – 37
Health Centers 25 34 + 36
Continuing Acceptors: Modern Contraception
Hospitals 60 50 – 17
Health Centers 26 28 + 8
Number of Facilities
Reporting Stockout
Stockouts of Key Contraceptives
over
15-Month
Period
over
9-Month
Period
of Ebola
Injectables 10 3
Oral Contraceptive Pills 7 2
Condoms 11 2
‡ Wilcoxon signed rank test with median values
of services provided in each of the 2 quarters
27. COMPARISON‡
of MEDIAN NUMBER of SERVICES in
OCT-DEC 2013 and 2014 from 45 FACILITIES
Oct-Dec
2013
Oct-Dec
2014
% Change
* p<.05
Pregnant Women Tested for HIV
Hospitals 112 55 – 51*
Health Centers 255 246 – 4
Pregnancy Complications
Hospitals 10 8 – 20
Pregnant Women Seen for ANC 1
Health Centers 337 295 – 12
Pregnant Women Seen for ANC 3
Health Centers 245 205 – 16
Facility-Based Births
Hospitals 303 281 – 7
Health Centers 100 69 – 31
‡ Wilcoxon signed rank test with median values
of services provided in each of the 2 quarters
28. FINDINGS by EBOLA ZONE
MATERNAL HEALTH SERVICES
0
100
200
300
1 2 3 4 5
Time (quarters)
changing active
inactive
Median number of pregnant
women tested for HIV in hospitals
• Only HIV testing of pregnant
women at hospitals showed a
statistically significant decline
• Drop in HIV testing at hospitals in
Ebola active zone heavily
accounts for overall decline
30. COMPARISON‡
of MEDIAN NUMBER of SERVICES in
OCT-DEC 2013 and 2014 from 45 FACILITIES
Oct-Dec
2013
Oct-Dec
2014
% Change
* p<.05
** p<.01
PENTA 1 Vaccinations Given
Hospitals 504 316 – 37
Health Centers 259 212 – 18**
PENTA 3 Vaccinations Given
Hospitals 353 320 – 9
Health Centers 244 167 – 32**
Watery/Bloody Diarrhea, Child < 5 Yrs of Age
Hospitals 34 14 – 59**
Health Centers 16 12 – 25**
Acute Respiratory Illness (ARI), Child < 5 Yrs
Hospitals 98 41 – 58**
Health Centers 108 83 – 23**
Hospitalization due to ARI, Child < 5 Yrs
Hospitals 18 16 – 11
‡ Wilcoxon signed rank test with median values
of services provided in each of the 2 quarters
31. Median number
of Penta 1
vaccinations
given at
health centers
FINDINGS by EBOLA ZONE
CHILD HEALTH SERVICES – PENTA VACCINATIONS
0
100
200
300
400
500
1 2 3 4 5
Time (quarters)
changing active
inactive
Median number
of Penta 3
vaccinations
given at health
centers
0
100
200
300
400
1 2 3 4 5
Time (quarters)
changing active
inactive
• Throughout all Ebola status
zones, significant declines in
vaccinations given at health
centers -- but not at hospitals
• Yet declines not constant:
Declining Pentavalent 1
vaccinations show some
increases during last quarter
of 2014
Pentavalent 3 vaccinations
started falling as Ebola
cases grew in detection,
especially in Ebola active
zone
32. Median number
of cases of
diarrhea in
children under
five years of
age
in hospitals
FINDINGS by EBOLA ZONE
CHILD HEALTH SERVICES –DIARRHEA
Median number
of cases of
diarrhea in
children under
five years of
age
in health
centers
0
50
100
150
1 2 3 4 5
Time (quarters)
changing active
inactive
0
50
100
150
1 2 3 4 5
Time (quarters)
changing active
inactive
• Cases of diarrhea in children
< 5 years significantly
decreased across all Ebola
status zones
• Declines were not constant
throughout 2014
33. Median
number of
cases of ARI
in children
under five
years of age
treated at
hospitals
FINDINGS by EBOLA ZONE
CHILD HEALTH SERVICES – TREATMENT of ARI
0
100
200
300
400
1 2 3 4 5
Time (quarters)
changing active
inactive
HOSPITALS
• Median number of children < 5 with ARI:
significantly decreased across all Ebola status zones
declines not constant in Ebola changing status zones
slight increase in final quarter of 2014 in Ebola active zone
34. Median
number of
cases of ARI
in children
under five
years of age
treated at
health centers 0
100
200
300
400
1 2 3 4 5
Time (quarters)
changing active
inactive
HEALTH CENTERS
• Median number of children <5 with ARI:
trended upwards in early 2014 in Ebola active and inactive zones
before declining
steepest declines are in final quarter of 2014 for Ebola inactive and
changing status zones
FINDINGS by EBOLA ZONE
CHILD HEALTH SERVICES – TREATMENT of ARI
35. Number of Facilities
Reporting Stockout‡
Stockouts of Key Child Medications
over
15-Month
Period
over
9-Month
Period
of Ebola
Oral Rehydration Salts 22 8
Cotrimoxazole (Antibiotic) 18 9
STOCKOUTS of 2 KEY MEDICATIONS
in 45 FACILITIES
‡Due to the small number of facilities reporting stockouts of key child medications and contraceptives, this
information was reported by total number recorded for the 15‐month period, and the number recorded only
after the start of the Ebola outbreak (April through December 2014)
37. %
Public
Facilities
N = 43*
%
Private
Facilities
N = 19
Chi-Square
Test
Results
Facility reduced hours due to Ebola crisis 5 32 p < 0.01
Facility suspended services due to Ebola concerns 7 26 p < 0.05
Manager / Director noticed increase in complications
among patients who delayed accessing
health services during Ebola crisis
28 0 p < 0.01
Director reported service providers at the facility have
received training on Ebola infection control
93 68 p < 0.05
Director feels community members have concerns about
the safety of services at the facility
84 58 p < 0.05
Facility has been able to maintain routine data collection
and reporting as usual during Ebola crisis
98 74** p < 0.01
DIRECTORS of HEALTH FACILITIES (n = 62)
SIGNIFICANT DIFFERENCES‡ BY PUBLIC AND PRIVATE FACILITY
‡Chi-square test for equivalency was used
*While data was collected at a total of 45 public facilities, interviews with heads of such facilities could only be collected at
43 of them
**Percent for routine data collection only; reporting of health services data by private health care facilities not studied
38. RMNCH Providers (n = 117)
Views on Health Delivery Services and Use
o 28% cited increase in
complications
o 86% cited changes in use of
health services by those in
the community
o 96% reported to have
changed their own practices
in providing maternal and
child health services
o 97% reported regular wearing
gloves when offering services
o 70% received training in
Ebola prevention
Staff Bulletin Board, N’Zèrèkorè Hospital
39. o 63% cited concerns about
Ebola held by those in their
community
o 36% cited negative
reactions from family
members and friends about
Ebola
o 80% reported concerns
about their security when
offering health services
o 7% reported that health
services at their health
facility had been suspended
or stopped due to Ebola Ebola Treatment Center,
Donka National Hospital, Conakry
RMNCH Providers (n = 117)
Views on Health Delivery Services and Use
40. Significant Negative Findings
o Overall decline in services, found more greatly at hospitals than
at other facilities
o Child health services most affected by Ebola
especially vaccinations that require multiple visits, diarrhea
and ARI cases
possibly due to parental reluctance to visit a health facility
o Significant decline reported by hospitals of HIV testing of
pregnant women
o Stockouts of some basic medicines have continued to be an
ongoing concern
o One‐third of health care providers received no training in Ebola
infection control
o A sizeable percentage of interviewees felt that their position as
health care providers is stigmatized by those in their community
Summary Conclusions
41. Significant Positive Findings
o Despite Ebola, information system on routine health services
continued to function
o Ebola does not appear to have had a widespread negative
impact on the availability of health services
o Many improved infection control measures have been adopted,
including routine hand washing by both health care workers and
traditional healers
Summary Conclusions
45. ACKNOWLEDGEMENTS
We are deeply grateful to USAID/Guinea and the Ministry of Health and Public
Hygiene for their support and commitment to this rapid assessment
In particular, we would like to cite the valuable assistance provided by:
Dr. Younoussa Ballo, Secretary General, Ministry of Health and Public Hygiene
Dr. Sekou Condé, Deputy Coordinator of the Fight against Ebola
Dr. Mamady Kourouma, the Director of Family Health and Nutrition
Dr. Boubacar Sall, Acting Director, Office of Strategy and Development
We also acknowledge the meaningful support and cooperation of the dedicated
professionals we met in the field, most notably, all health staff at the Regional
Health Directorate and District Health Offices and the dedicated staff at the
hospitals, health centers, and clinics we visited in Conakry and the 12
prefectures
Finally, we give our sincere thanks to StatView International for recruiting
excellent data collectors and providing tremendous logistical support to the field
work, without which this rapid assessment would not have been completed so
promptly
46. MEASURE Evaluation is funded by the U.S. Agency
for International Development (USAID) under terms
of Cooperative Agreement AID-OAA-L-14-00004
and implemented by the Carolina Population Center,
University of North Carolina at Chapel Hill in
partnership with Futures Group, ICF International,
John Snow, Inc., Management Sciences for Health,
and Tulane University. The views expressed in this
presentation do not necessarily reflect the views of
USAID or the United States government.
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