Journal Articles

JSI staff regularly publish their research and results from work in peer-reviewed journals. This section provides a brief abstract with a link to the journal where you can read more and either download or order the article, depending on the journal.

2014   |   2013   |   All Journal Articles

December 2014

Routine Monitoring Systems for Integrated Community Case Management Programs: Lesson from 18 Countries in sub-Saharan Africa in Journal of Global Health

Using data collected from recent reviews of integrated community case management (iCCM) in Africa,researchers, including JSI's Serge Raharison of the Maternal and Child Health Integrated Project (MCHIP), analyzed the development and implementation of systems for routine monitoring of large scale iCCM programs. This article presents a synthesis of lessons learned from program implementation in 18 countries in sub-Saharan Africa.

Making Products Available among Community Health Workers: Evidence for Improving Community Health Supply Chains from Ethiopia, Malawi, and Rwanda in Journal of Global Health

In 2009, the Supply Chain for Community Case Management (SC4CCM) project set out to research and identify proven, simple, affordable solutions to address the unique supply chain challenges faced by community health workers and demonstrate that supply chain constraints at the community level can be overcome. After five years of project implementation, project staff, led by project director Yasmin Chandani, share findings from SC4CCM interventions in Ethiopia, Malawi, and Rwanda.

The future of routine immunization in the developing world: challenges and opportunities in Global Health: Science and Practice

Vaccine costs in the developing world have grown from less than a dollar per child in 2001 to up to thirty-five dollars per child in 2014, as more and costlier vaccines are being introduced into national immunization programs. Researchers, including JSI's Rebecca Fields of the Maternal and Child Survival Program (MCSP), explore this and other challenges to routine immunization and call for the strengthening of eight critical components of routine immunization: (1) policy, standards, and guidelines; (2) governance, organization, and management; (3)human resources; (4) vaccine, cold chain, and logistics management; (5) service delivery; (6) communication and community partnerships; (7) data generation and use; (8) sustainable financing.

Availability, utilization, and quality of emergency obstetric care services in Bauchi State, Nigeria in International Journal of Gynecology Obstetrics,

Nigeria has one of the highest maternal mortality rates (545 deaths per 100,000 live births) in the world. With 70% of the country’s population living in rural areas, access to quality maternal and child healthcare services is extremely low: Only 35% of births occur in health facilitates and in the northwest region of Nigeria this number is as low as 8%.
Bauchi is one of the states in this region in which the Targeted States High Impact Project (TSHIP) works to build the capacity of health systems to provide emergency obstetric care (EmOC) in an effort to improve maternal health outcomes. In 2012, the project surveyed 20 hospitals and 39 primary healthcare centers in Bauchi to determine the availability, utilization, and quality of EmOC services. Survey results showed that nearly 90% of the health facilities did not meet UN requirements for EmOC centers, and only approximately 4% of the expected 35,990 obstetric complications were managed in EmOC facilities. Nearly half of the women with major direct obstetric complications treated at EmOC facilities during the surveyed period died. TSHIP used the survey data to inform program implementation in Bauchi.

Read the article abstract and download full text form the International Journal of Gynecology Obstetrics

Effectiveness of Scaling up the "Three Pillars" Approach to Accelerating MDG4 Progress in Ethiopia in Journal of Health, Population, and Nutrition Vol. 32, No. 4

This paper describes the integrated approach taken by the Government of Ethiopia with support from JSI's Essential Services for Health in Ethiopia (ESHE) Project and assesses its effect on the coverage of six child health practices associated with reducing child mortality. The ESHE Project contributed to reducing high child mortality rates at scale among 14.5 million people through this ‘three pillars’ approach that aimed to (i) strengthen health systems, (ii) improve health workers’ performance, and (iii) engage the community.

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November 2014

Monitoring coverage of fully immunized children in Vaccine, Vo. 32, Issue 52

Immunization programs monitor 3rd dose of DPT-containing vaccine coverage as a principal indicator; however, this does not inform about coverage with other vaccines.To determine whether and to what extent the status of fully immunized children (FIC) coverage is being monitored in East and Southern African countries, JSI's Asnakew Tsega and Robert Steinglass (of the Maternal and Child Integrated Program (MCHIP) and WHO's Fussum Daniel conducted a mini survey among 19 national program managers in March 2014. The survey showed that most countries monitor FIC coverage and understand the importance of monitoring FIC coverage as a national immunization indicator.

Read the abstract and/or purchase the full article: "Monitoring coverage of dully immunized children."[/url

Immunization training needs in Malawi in East African Medical Journal, Vol. 91, no. 9

JSI's Asnakew Tsega, Robert Steinglass, and Hannah Hausi (Maternal and Child Health Integrated Program) review the current status of immunization training programs in Malawi’s health training institutions. Recommendations include updating training curricula and ensuring service providers are regularly trained.

Read the abstract and/or download the full article (subscription needed): "Immunization training needs in Malawi"

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October 2014

Barriers to Cervical Cancer Screening and Follow-up Care among Black Women in Massachusetts in Journal of Obstetric, Gynecologic & Neonatal Nursing

JSI conducted research at Boston, Massachuesetts-area hospitals, health centers, and community-based organizations to explore the factors that might lead to delays in appropriate cervical cancer screening and diagnosis among black women. The qualitative study involved six focus groups with a total of sixty-four participants, including black, non-Hispanic women from the general population and cervical cancer survivors, community leaders in women's health, and health care providers. Read the article abstract and/or download the full article at the Journal of Obstetric, Gynecologic & Neonatal Nursing.

A stewardship approach to shaping the future of public health supply chain systems in Journal of Global Health Science and Practice

JSI's Carolyn Hart and Chris Wright joined Alan Bornbusch of USAID and Todd Dickens of PATH offer insight into the changing role of government in public health supply chain management. The authors provide an overview of the changing dynamics in low- and middle-income countries, the opportunities for supply chain innovation and growth within this context, and how multiple stakeholders and a diversity of supply chain options contribute to public health outcomes. Within this complex supply chain ecosystem, the authors suggest that public agencies assume a stewardship role rather than an operational role. Read or download the article in Global Health: Science and Practice

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September 2014

Medical tourism and the code of medical ethics on advertisement in Nigeria in PanAfrican Medical Journal

JSI’s Olusesan Makinde, HMIS Advisor with the MEASURE Evaluation office in Nigeria and co-authors argue for the repeal or significant review of the code of ethics which bars healthcare providers and institutions from advertising the kind of services rendered at their medical practices. One outcome of this ban is the increase in medical tourism—travel to another country for the purpose of treatment. Because of the advertisement ban Nigerians are often unaware of quality medical services that are available in their own country for a more affordable price. An additional argument to repealing the ban is to reverse the “brain drain” to the “brain gain” by creating a more accepting environment for Nigerian medical specialists to remain in country and freely advertise their services. Read the article abstract or download the full article at the PanAfrican Medical Journal[/url0.

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August 2014

Development and use of a master health facility list: Haiti's experience during the 2010 earthquake response in Global Health: Science and Practice, Vol. 2, Issue 2

Following the 2010 earthquake in Haiti, the Haitian government received support from many international governments, organizations, and institutions to reconstruct the country's devastated health infrastructure. Part of the rebuilding effort was the development of a master health facility list (MHFL), which catalogs every public and privately-funded health facility in Haiti. MHFLs support an array of health systems functions and allow health officials to make decisions based on facility based data. The MEASURE Evaluation project was one of many organizations that came together to create and subsequently implement the MHFL to reconstruct Haiti's health system. This article details how and why the master list was created and how it has been utilized.

Read the article abstract.

Rethinking HIV prevalence determination in developing countries in AIDS Care, August 2014

To improve the accuracy of HIV prevalence rates in developing countries, JSI’s Olusesan Makinde and Kola Oyediran, members of the MEASURE Evaluation team, propose a data collection model that leverages the increasing adoption and penetration of the Internet and mobile technology to collect and archive routine data from HIV counseling and testing (HCT) client intake forms from all HCT centers and prevention of mother-to-child transmission (PMTCT) sites in a country. Read the article abstract or download the full article at

Evidence on access to medicines for chronic diseases from household surveys in five low- and middle-income countries in Oxford Journal of Health Policy and Planning, September 2014

JSI's Brian Serumaga of the USAID | DELIVER PROJECT contributed to this study into the accessibility of medicines for chronic, non-communicable diseases in five middle- and low-income countries: Ghana, Jordan, Uganda, Philippines, and Kenya. Researchers sought to quantify access to essential medicines for people with chronic conditions and to evaluate how household socioeconomic status and perceptions about medicines availability and affordability influence access. Read the article abstract or download the full text at

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July 2014

The association between quality of HIV care, loss to follow-up and mortality in pediatric and adolescent patients receiving antiretroviral therapy in Nigeria in PLOS One

Access to pediatric anitretroviral therapy (ART) in resource-limited settings has risen significantly over the last decade. However, access to treatment is not a guarantee of treatment success; to derive the full benefit of ART, children and adolescents must be provided with high quality care and treatment that addressed their multifaceted needs.

JSI's Bisola Ojikutu conducted a study into the correlation between quality of care, loss-to-follow-up, and mortality among children and adolescents enrolled in HIV care in Nigeria. Data from 1516 patients at 23 sites across 10 states in Nigeria was collected an analyzed. This article presents detailed research methodology and findings from the study.

Advance distribution of misoprostol for the prevention of postpartum hemorrhage in South Sudan in {i}International Journal of Gynecology Obstetrics, July, 2014

JSI’s Vikas Dwivedi of the Maternal and Child Health Integrated Program (MCHIP)contributed to a study to determine if high uterotonic coverage can be achieved in South Sudan through a facility- and community-focused postpartum hemorrhage (PPH) prevention program. During prenatal care and home visits, misoprostol was distributed to pregnant women for the prevention of postpartum hemorrhage at home births. Data on uterotonic coverage and other program outcomes were collected through facility registers, home visits, and postpartum interviews. Read the article abstract or download the article in full at the International Journal of Gynecology Obstetrics.

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June 2014

Sex and Gender in the US Health Surveillance System: A Call to Action in American Journal of Public Health, Vol. 104, No. 6

Youth Risk Behavior Survey (YRBS) data have exposed significant sexual orientation disparities in health. Interest in examining the health of transgender youths, whose gender identities or expressions are not fully congruent with their assigned sex at birth, highlights limitations of the YRBS and the broader US health surveillance system.

JSI Senior Consultant Stewart Landers contributed to the mixed-methods Massachusetts Gender Measures Project to develop and cognitively test measures for adolescent health surveillance survey that produced a promising measure of transgender status.

This commentary, co-authored by Landers and based on the aforementioned research, defines the need for sex and gender measurement research, and summarizes the data and conclusions drawn from the Massachusetts Gender Measures Project.

Patient-stated preferences regarding volume-related risk mitigation strategies for hemodialysis in Clinical Journal of the American Society of Nephrology, June 2014

JSI Senior Research Scientist Tom Mangione contributed to a study into patient preferences toward different strategies used to mitigate fluid-related symptoms following hemodialysis. The strategies compared included dietary restriction, treatment time extension, more frequent dialysis, and wearable ultrafiltration devices. Results from the 588-patient survey showed that, while those who were more bothered by fluid-related symptoms were willing to engage in more fluid-mitigating strategies, generally patients were reluctant to extend treatment time in order to reduce symptoms. Subscribe to the Clinical Journal of the American Society of Nephrology to view the abstract and full article.

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May 2014

Voluntary Medical Male Circumcision (VMMC) in Tanzania and Zimbabwe: Service Delivery Intensity and Modality and Their Influence on the Age of Clients in PLOS One

Scaling up voluntary medical male circumcision (VMMC) to 80% of men aged 15–49 within five years could avert 3.4 million new HIV infections in Eastern and Southern Africa by 2025. Since 2009, Tanzania and Zimbabwe have rapidly expanded VMMC services through different delivery (fixed, outreach or mobile) and intensity (routine services, campaign) models. Three JSI staff members, Amelia Rock, Natasha Kanagat, Sophia Magalona, contributed to a review that describes the modality and intensity of VMMC services and its influence on the number and age of clients. Read the article at PLOS-One.

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March 2014

Drivers of routine immunization coverage improvement in Africa: findings from district-level case studies in Health Policy and Planning 2014; 1-11

JSI staff and the ARISE project conducted in-depth case studies to gain a deeper understanding as to why routine immunization coverage improves in some settings in Africa and not in others. In-depth case studies were used to determine pathways to routine immunization coverage improvement by comparing immunization programme experience in 12 districts in three countries. Research was conducted in Ethiopia, Cameroon and Ghana. Findings emphasize the critical role of implementation strategies and the need for locally skilled managers that are capable of tailoring strategies to specific settings and community needs. The case studies are unique in their focus on the positive drivers of change and the identification of pathways to coverage improvement, an approach that should be considered in future studies and routine assessments of district-level immunization system performance.

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February 2014

Spatial Patterns in Domestic Violence and HIV Prevalence in Nigeria in Journal of Therapy and Management in HIV Infection, Volume 2, Number 1, February 2014

Using the 2008 Demographic and Health Survey and the 2010 ANC Sentinel Surveillance survey, JSI Senior M&E Advisor Kola Azeez Oyediran and JSI GIS Advisor/Data Analyst Marc Cunningham explore the spatial patterns of domestic violence and HIV prevalence between states in Nigeria.

Oyediran and Cunningham both work on the USAID-funded, MEASURE Evaluation project. MEASURE Evaluation implements and facilitates state-of-the-art methods for and approaches to improving monitoring and evaluation and data use to improve global health and well-being.

In this article, Oyediran and Cunningham found women in states with a high HIV prevalence rate had either experienced physical and/or sexual violence from their spouses. They call for a concurrently addressing domestic violence and HIV prevention, as well as, a further exploration of the causal relationships between domestic violence and health outcomes, especially HIV infections, in Nigeria. Oyediran&Cunningham/2014.

The quality–coverage gap in antenatal care: toward better measurement of effective coverage in Journal of Global Health Science and Practice February 2014, Volume 2, Issue 1

Alexis D’Agostino, JSI Monitoring and Evaluation Analyst, collaborated with Save the Children’s Stephen Hodgins to analyze the indicators used to measure antenatal care coverage.

The proportion of pregnant women receiving 4 or more antenatal care visits (ANC 4+) is used prominently as a global benchmark indicator to track maternal health program performance. This has contributed to an inappropriate focus on the number of contacts rather than on the content and process of care.

Hodgins and D’Agostino analyzed data from forty-one countries to determine coverage of specific elements of antenatal care and calculate the gap between expected services received over four visits, and services actually received (the quality-coverage gap). The analysis uncovered significant gaps in the provision of several antenatal care services, most prominently malaria prevention.

Based on the results of their analysis, Hodgins and D’Agostino argue for the adoption of a summary indicator that better reflects the content of care in maternal health programs.

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January 2014

Factors influencing the selection of delivery with no one present in Northern Nigeria: implications for policy and programs in "International Journal of Women's Health Volume 2014:6 Pages 171 - 183"

Nigeria ranks among the nations with the highest mortality rates in the world. In this study, JSI's Bolaji M. Fapohunda and Nosa Orobaton, who work on the Nigeria Targeted States High Impact Project (TSHIP), examine the effects of demographic, socioeconomic and women’s autonomy factors on the utilization of delivery assistance in Sokoto State, Nigeria, through data obtained from the 2008 Demographic and Health Survey (DHS). The study revealed that delivery with no one present and with unskilled attendance accounted for roughly 95% of all births in Sokoto State.

This study demonstrates that expectant mothers are willing to obtain care from a provider, and their odds of using accessible, affordable, skilled delivery is high, should such an option be presented. Fapohunda and Orobaton share recommended solutions to improve access to, and increase the affordability of, skilled health attendants.

View the abstract and download the article in the International Journal of Women's Health

Changing life jacket wearing behavior: An evaluation of two approaches in The Journal of Public Health Policy

The majority of boating-related drowning fatalities in the U.S. result from capsizes and falls overboard. As these events unexpectedly place boaters in the water and allow little or no time for the victim to find, put on, and fasten a life jacket, it is important for boaters to not only carry life jackets on board, but also to wear them while boating. In the United States Coast Guard's (USCG) annual accident and fatality report, from 1999 to 2011, there were 9212 fatalities, of which 71 per cent resulted from drowning. On average, 87 per cent of the drowning victims were not wearing a life jacket.

In efforts to promote boating safety, USCG, administrators of state boating laws, and the United States Army Corps of Engineers (USACE) have supported strategies to increase life jacket/personal flotation device wear by recreational boaters. In this article, we report on the evaluation of two distinct approaches: a multi-strategy marketing campaign to promote voluntary life jacket wear in the Central California Delta region and a demonstration project to gauge the impact of mandatory life jacket wear regulations at USACE Mississippi lakes.

Before the campaign in the Delta, adult wear was 8.5 per cent, increasing to 12.1 per cent during the first year, dipping to 9.4 per cent during the second year, and rising slightly to 10.5 per cent 3 plus years after the campaign. Before mandatory regulations at USACE lakes, adult wear was 13.7 per cent, increasing to 75.6 per cent during the first year, 70.1 per cent during the second year, and remaining high at 68.1 per cent in the third year. Policymakers should consider these findings when choosing how to increase life jacket use. Thomas Mangione, Wendy Chow, Journal of Public Health Policy, 2014.

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2014   |   2013   |   All Journal Articles