Integrating Health Systems and Science to Respond to COVID-19 in a Model District of Rural Madagascar.

There are many outstanding questions about how to control the global COVID-19 pandemic. The information void has been especially stark in the World Health Organization Africa Region, which has low per capita reported cases, low testing rates, low access to therapeutic drugs, and has the longest wait for vaccines. As with all disease, the central challenge in responding to COVID-19 is that it requires integrating complex health systems that incorporate prevention, testing, front line health care, and reliable data to inform policies and their implementation within a relevant timeframe.

Networks of Care in Rural Madagascar for Achieving Universal Health Coverage in Ifanadiana District.

Health care is most effective when a patient's basic primary care needs are met as close to home as possible, with advanced care accessible when needed. In Ifanadiana District, Madagascar, a collaboration between the Ministry of Public Health (MoPH) and PIVOT, a non-governmental organization (NGO), fosters Networks of Care (NOC) to support high-quality, patient-centered care. The district's health system has three levels of care: community, health center, district hospital; a regional hospital is available for tertiary care services.

District-level health system strengthening for universal health coverage: evidence from a longitudinal cohort study in rural Madagascar, 2014-2018.

Introduction: Despite renewed commitment to universal health coverage and health system strengthening (HSS) to improve access to primary care, there is insufficient evidence to guide their design and implementation. To address this, we conducted an impact evaluation of an ongoing HSS initiative in rural Madagascar, combining data from a longitudinal cohort and primary health centres.

Methods: We carried out a district representative household survey at the start of the HSS intervention in 2014 in over 1500 households in Ifanadiana district, and conducted follow-up surveys at 2 and 4 years.

Outcomes and bleb-related complications of trabeculectomy.

Purpose: To determine rates of success and complications of trabeculectomy surgery.

Design: Case series.

Participants: Consecutive patients undergoing trabeculectomy by 2 surgeons between May 2000 and October 2008.

Comparison of limbus-based and fornix-based trabeculectomy: success, bleb-related complications, and bleb morphology.

Purpose: To compare the success and complications of trabeculectomy performed with limbus-based and fornix-based conjunctival approaches.

Design: Retrospective case series with some prospective data collection.

Participants: Consecutive patients undergoing trabeculectomy by 2 surgeons between May 2000 and October 2008.

Comparison of home and away-from-home physical activity using accelerometers and cellular network-based tracking devices.

Background: Measuring physical at home and away from home is essential for assessing health and well-being, and could help design interventions to increase physical activity. Here, we describe how physical activity at home and away from home can be quantified by combining information from cellular network-based tracking devices and accelerometers.

Methods: Thirty-five working adults wore a cellular network-based tracking device and an accelerometer for 6 consecutive days and logged their travel away from home.