Growth and health outcomes at school age in HIV-exposed, uninfected Zambian children: Follow-up of two cohorts studied in infancy
Background: Early growth and health of HIV-exposed, uninfected (HEU) children is poorer than that of their HIV-unexposed, uninfected (HUU) counterparts but there is little information about longer term effects of early HIV exposure. We previously recruited two cohorts of HEU and HUU Zambian infants and documented the poorer infant growth and health of the HEU […]
Increasing facility delivery through maternity waiting homes for women living far from a health facility in rural Zambia: a quasi-experimental study
Objective: To report on the effectiveness of a standardised core Maternity Waiting Home (MWH) model to increase facility deliveries among women living >10 km from a health facility. Design: Quasi-experimental design with partial randomisation at the cluster level. Setting: Seven rural districts in Zambia. Population: Women delivering at 40 health facilities between June 2016 and August […]
The long-term effects of free care on birth outcomes: Evidence from a national policy reform in Zambia
As women in many countries still fail to give birth in facilities due to financial barriers, many see the abolition of user fees as a key step on the path towards universal coverage. We exploited the staggered removal of user charges in Zambia from 2006 to estimate the effect of user fee removal up to […]
Active TB case finding in a high burden setting; comparison of community and facility-based strategies in Lusaka, Zambia
Introduction We conducted an implementation science study to increase TB case detection through a combination of interventions at health facility and community levels. We determined the impact of the study in terms of additional cases detected and notification rate and compared the yield of bacteriologically confirmed TB of facility based and community based case finding. […]
Promoting progress in child survival across four African countries: The role of strong health governance and leadership in maternal, neonatal and child health
Despite numerous international and national efforts, only 12 countries in the World Health Organization’s African Region met the Millennium Development Goal #4 (MDG#4) to reduce under-five mortality by two-thirds by 2015. Given the variability across sub-Saharan Africa, a four-country study was undertaken to examine barriers and facilitators of child survival prior to 2015. Liberia and […]
Birth weight and gestational age distributions in a rural Kenyan population
Background: With the increased availability of access to prenatal ultrasound in low/middle-income countries, there is opportunity to better characterize the association between fetal growth and birth weight across global settings. This is important, as fetal growth curves and birthweight charts are often used as proxy health indicators. As part of a randomized control trial, in […]
Fertility outcomes following obstetric fistula repair: A prospective cohort study
Background: Obstetric fistula (OF) is a maternal morbidity associated with high rates of stillbirth, amenorrhea, and sexual dysfunction. Limited data exists on the reproductive outcomes of women in the years following a fistula repair. The objective of this study is to describe the fertility outcomes and family planning practices in a population of Malawian women […]
Qualitative accounts of school-aged children’s diets during the covid-19 pandemic in rural, central, kenya
The COVID-19 pandemic has caused disruption to food security in many countries, including Kenya. However, the impact of this on food provision to children at an individual level is unknown. This small study aimed to provide a qualitative snapshot of the diets of children during the COVID-19 pandemic. During completion of 24-h food recalls, with […]
Increasing proportion of HIV-infected pregnant Zambian women attending antenatal care are already on antiretroviral therapy (2010-2015)
Introduction: Accurate estimates of coverage of prevention of mother-to-child (PMTCT) services among HIV-infected pregnant women are vital for monitoring progress toward HIV elimination targets. The achievement of high coverage and uptake of services along the PMTCT cascade is crucial for national and international mother-to child transmission (MTCT) elimination goals. In eastern and southern Africa, MTCT […]
Scaling-up access to antiretroviral therapy for children: A cohort study evaluating care and treatment at mobile and hospital-affiliated HIV clinics in rural Zambia
Background: Travel time and distance are barriers to care for HIV-infected children in rural sub-Saharan Africa. Decentralization of care is one strategy to scale-up access to antiretroviral therapy (ART), but few programs have been evaluated. We compared outcomes for children receiving care in mobile and hospital-affiliated HIV clinics in rural Zambia. Methods: Outcomes were measured […]
