The effect of performance-based financing on illness, care-seeking and treatment among children: an impact evaluation in Rwanda.

Background: Performance-based financing (PBF) strategies are promoted as a supply-side, results-based financing mechanism to improve primary health care. This study estimated the effects of Rwanda's PBF program on less-incentivized child health services and examined the differential program impact by household poverty.

Methods: Districts were allocated to intervention and comparison for PBF implementation in Rwanda.

The effect of access to contraceptive services on injectable use and demand for family planning in Malawi.

Context: Previous studies have identified positive relationships between geographic proximity to family planning services and contraceptive use, but have not accounted for the effect of contraceptive supply reliability or the diminishing influence of facility access with increasing distance.

Methods: Kernel density estimation was used to geographically link Malawi women's use of injectable contraceptives and demand for birth spacing or limiting, as drawn from the 2010 Demographic and Health Survey, with contraceptive logistics data from family planning service delivery points. Linear probability models were run to identify associations between access to injectable services-measured by distance alone and by distance combined with supply reliability-and injectable use and family planning demand among rural and urban populations.

Minor consent and delivery of adolescent vaccines.

Purpose: To explore whether, and to what extent, minor consent influences adolescent vaccine delivery in the United States.

Methods: A telephone survey was completed by 263 professionals with responsibilities for adolescent health care and/or vaccination in 43 states. Measures included perceived frequency of unaccompanied minor visits and perceived likelihood of vaccine delivery to unaccompanied minors in hypothetical scenarios that varied by adolescent age, vaccine type, visit type, and clinical setting.

Geographically linking population and facility surveys: methodological considerations.

Background: The relationship between health services and population outcomes is an important area of public health research that requires bringing together data on outcomes and the relevant service environment. Linking independent, existing datasets geographically is potentially an efficient approach; however, it raises a number of methodological issues which have not been extensively explored. This sensitivity analysis explores the potential misclassification error introduced when a sample rather than a census of health facilities is used and when household survey clusters are geographically displaced for confidentiality.

Retail pharmacies and adolescent vaccination--an exploration of current issues.

Purpose: To describe adolescent immunization practices prevalent in retail pharmacies in the United States, where little is known about their potential for increasing adolescent immunizations.

Methods: State pharmacy association spokespersons with knowledge of statewide pharmacy practices were interviewed to assess pharmacy practices and vaccine-related attitudes. Descriptive frequencies and score-tested differences in attitudes, using the generalized estimating equation, are presented.

When the cat is out of the bag: a case study in public health rationing in Oregon during the 2004-2005 influenza vaccine shortage.

Whereas the annual influenza season in the United States is fairly predictable, the influenza vaccine supply is variable, leaving providers vulnerable to supply and demand fluctuations each season. During the 2004-2005 influenza vaccine shortage, Oregon invoked Oregon Revised Statute 433-030 to target vaccine supplies to protect persons at highest risk for complications from influenza. This case study describes Oregon's efforts to ration vaccine at the point of administration by limiting the number of individuals eligible for vaccination.