Papers by Samantha Herrera
Frontiers in Pediatrics
BackgroundNeonatal deaths contribute to nearly half (47%) of under-five mortality globally and 67... more BackgroundNeonatal deaths contribute to nearly half (47%) of under-five mortality globally and 67% in Bangladesh. Despite high neonatal mortality, care-seeking from qualified providers for newborn danger signs remains low. Identification of direct and indirect factors and their pathways affecting care-seeking will help to design a well-targeted intervention. This study assessed the direct, indirect, and total effect of the predictive factors on neonatal care-seeking in Bangladesh.Materials and methodsThis was a cross-sectional baseline household survey conducted in 14 districts of Bangladesh in 2019 with 17,251 recently delivered women (RDW) with a live birth outcome in the preceding 15 months. We used a two-stage stratified cluster sampling process to select the samples from 14 districts. We investigated the inter-relationship of maternal background characteristics, maternal health utilizations, child/neonate factors, health service delivery-related factors and newborn danger sign ...
Additional file 1 of Evaluating malaria programmes in moderate- and low-transmission settings: practical ways to generate robust evidence
Additional file 1: Table S1. Monitoring and evaluation core indicator reference guide.
MOESM1 of Are new national malaria strategic plans informed by the previous ones? A comprehensive assessment of sub-Saharan African countries from 2001 to present
Additional file 1. Extracted country challenges and solutions.
MOESM1 of A systematic review and synthesis of the strengths and limitations of measuring malaria mortality through verbal autopsy
Additional file 1. Summary of selected publications on malaria mortality and verbal autopsy.
BMC Pregnancy and Childbirth, 2021
Background Skin-to-skin contact (SSC) practice improves newborn survival and child development th... more Background Skin-to-skin contact (SSC) practice improves newborn survival and child development through preventing hypothermia in newborns, improving early initiation of breastfeeding practice, and strengthening mother-child bonding. Despite having numerous benefits, it is one of the least practiced interventions in low and middle-income countries (1 to 74%). In Bangladesh, the prevalence of SSC was 26% in 2014. In this study, we aimed to estimate the prevalence of SSC in the study districts and identify factors that facilitate or inhibit SSC practice so that context-specific recommendations can be made to advance the use of this intervention. Methods We used baseline household survey data of USAID’s MaMoni MNCSP project conducted in 10 districts of Bangladesh in 2019. Our analysis included 13,695 recently delivered women (RDW) with a live birth outcome. Our primary outcome was the mother’s reported practice of SSC. We examined various antepartum, intrapartum, newborn, and sociodemog...
Psychiatric Quarterly, 2020
The Collaborative Care Model (CoCM), in which social workers, primary care physicians, and a cons... more The Collaborative Care Model (CoCM), in which social workers, primary care physicians, and a consulting psychiatrist work as a team, is an established approach to the treatment of common mental health conditions in primary care settings. Following implementation of a CoCM depression care program at our hospital-based academic primary care practice, we observed a low rate of retention with the use of problem solving therapy/behavioral activation (PST/BA). Our aim in this study was to evaluate the effectiveness of interpersonal psychotherapy (IPT), an evidence-based, flexible strategy that focuses on the relationship between depression and interpersonal challenges, compared to PST/BA. In 2015, most patients enrolled in our CoCM received PST/BA. In 2016, most patients received IPT. Patients who were enrolled and discharged from our CoCM depression care program in the years 2015 and 2016 and received either PST/BA or IPT, were included. Our primary measure was the difference in change in PHQ-9 score between the PST/BA and the IPT groups. Secondary outcomes included the difference in the change in GAD-7 score and measures of glycemic and blood pressure control between the two groups. Two hundred thirty four patients were included in our analysis. One hundred sixty five received PST/BA and 69 received IPT. There was no difference between groups in baseline demographics or measures of depression, anxiety, presence of hypertension, or presence of prediabetes/diabetes. Our primary analysis demonstrated a greater decrease in PHQ-9 score in patients receiving IPT (9.93) compared to those receiving PST/BA (5.41) (p < 0.0001). The proportion of patients achieving a clinical response (PHQ-9 < 10) was also greater in the IPT group (71%) compared to the PST/BA group (44%). In a CoCM depression care program, IPT was a more effective strategy in improving depression symptoms as measured by PHQ-9 scores than PST/BA.
Social Work in Health Care, 2018
Depression is common in patients attending primary care clinics especially for those in socioecon... more Depression is common in patients attending primary care clinics especially for those in socioeconomically disadvantaged urban neighborhoods. A number of behavioral health collaborative care models exist to screen, assess, and treat patients within primary care clinics. This paper discusses the implementation of a behavioral health care program using the Improving Mood Promoting Access to Collaborative Treatment (IMPACT) model within an urban primary care clinic setting in New York City, that serves a large population of ethnically diverse and socioeconomically disadvantaged patients. While elements of the structured IMPACT model in the clinic were effective, the therapeutic approaches did not always meet the needs of all the patients. Therefore, the article describes the challenges this program faced and highlights how the IMPACT model was modified to meet the specific needs of the patients by using an adapted version of Interpersonal Psychotherapy as an alternative psychosocial intervention to the traditional Problem Solving Treatment psychosocial treatment in IMPACT.
Malaria Journal, 2020
Background Many countries have made substantial progress in scaling-up and sustaining malaria int... more Background Many countries have made substantial progress in scaling-up and sustaining malaria intervention coverage, leading to more focalized and heterogeneous transmission in many settings. Evaluation provides valuable information for programmes to understand if interventions have been implemented as planned and with quality, if the programme had the intended impact on malaria burden, and to guide programmatic decision-making. Low-, moderate-, and heterogeneous-transmission settings present unique evaluation challenges because of dynamic and targeted intervention strategies. This paper provides illustration of evaluation approaches and methodologies for these transmission settings, and suggests how to answer evaluation questions specific to the local context. Methods The Roll Back Malaria Monitoring and Evaluation Reference Group formed a task force in October 2017 to lead development of this framework. The task force includes representatives from National Malaria Programmes, fund...
Malaria Journal, 2019
Background: New national malaria strategic plans (NMSPs) should build upon the achievements and c... more Background: New national malaria strategic plans (NMSPs) should build upon the achievements and challenges identified during the implementation of previous plans, but there is limited research on the transition process between NMSPs. This study aims to fill this gap through an assessment of NMSPs across sub-Saharan Africa. Methods: The study reviewed the two most recent NMSPs for selected sub-Saharan African countries. Targets for six core malaria indicators were extracted from each NMSP and compared to the coverage achieved according to corresponding population-based surveys completed near the end of the NMSP term. Implementation challenges and proposed solutions identified through the NMSP analysis were documented. The current NMSP was reviewed to determine whether proposed solutions had been integrated into the strategy. Results: Twenty-two countries in sub-Saharan Africa were included in the assessment. Of the 135 verified targets, only 4 were achieved. No country reached more than one of the six targets assessed in each NMSP. Despite this low success rate, only four of the 22 countries lowered a subsequent target, with most setting the next target at an equal or greater level. Most NMSPs identified solutions to address implementation challenges faced, but the solutions were not always fully incorporated in the new strategy. Conclusions: The results show a disconnect between NMSPs. Most targets were set according to global goals rather than the individual country's previous achievements and limitations. This indicates a need to revise the NMSP development process to guide programmes in defining targets based on their country context and incorporate strategies to address challenges identified in the previous NMSP. This will allow countries to set and meet achievable targets as they work toward global goals.
Journal of Global Health Reports, 2019
Back Background ground Studies have demonstrated that trained community health workers can improv... more Back Background ground Studies have demonstrated that trained community health workers can improve access to quality health services for under five children. Under the World Health Organization's Rapid Access Expansion Progamme, integrated community case management of childhood illnesses (iCCM) was introduced in Abia and Niger States, Nigeria in 2013. The objective of the program was to increase the number of children 2-59 months receiving quality life-saving treatment for malaria, pneumonia and diarrhoea by extending case management through community-oriented resource persons (CORPs). We present findings from household surveys comparing baseline and endline data to assess changes in sick child care-seeking, assessment, and treatment coverage provided over the project period in Abia State. Methods Methods A baseline household survey was conducted in May 2014 and an endline survey in February 2017. The surveys used multi-stage cluster sampling of primary caregivers of children aged 2-59 months who had been recently sick with diarrhoea, fever, or cough with difficult breathing. R Results esults Care-seeking from an appropriate provider improved significantly from 69% at baseline to 77% at endline (P<0.01). At baseline, patent and proprietary medicine vendors (PPMVs) (55%) and health centers (34%) were the main providers of care for iCCM services; by endline, CORPs became the main source (48%), followed by PPMVs (36%) and health centers (25%). C Conclusions onclusions Overall, the findings demonstrate improvements in care-seeking. Care-seeking practices shifted over the course of the project, with more caregivers seeking care from CORPs by the end of the project. The findings suggest that scaling up iCCM in Nigeria may improve access to appropriate treatment for under five children living in hard-to-reach areas.
Journal of Global Health, 2019
Journal of Global Health, 2019
iCCM data quality: an approach to assessing iCCM reporting systems and data quality in 5 African ... more iCCM data quality: an approach to assessing iCCM reporting systems and data quality in 5 African countries Background Ensuring the quality of health service data is critical for data-driven decision-making. Data quality assessments (DQAs) are used to determine if data are of sufficient quality to support their intended use. However, guidance on how to conduct DQAs specifically for community-based interventions, such as integrated community case management (iCCM) programs, is limited. As part of the World Health Organization' s (WHO) Rapid Access Expansion (RAcE) Programme, ICF conducted DQAs in a unique effort to characterize the quality of community health worker-generated data and to use DQA findings to strengthen reporting systems and decision-making. Methods We present our experience implementing assessments using standardized DQA tools in the six RAcE project sites in the Democratic Republic of Congo, Malawi, Mozambique, Niger, and Nigeria. We describe the process used to create the RAcE DQA tools, adapt the tools to country contexts, and develop the iCCM DQA Toolkit, which enables countries to carry out regular and rapid DQAs. We provide examples of how we used results to generate recommendations. Results The DQA tools were customized for each RAcE project to assess the iCCM data reporting system, trace iCCM indicators through this system, and to ensure that DQAs were efficient and generated useful recommendations. This experience led to creation of an iCCM DQA Toolkit comprised of simplified versions of RAcE DQA tools and a guidance document. It includes system assessment questions that elicit actionable responses and a simplified data tracing tool focused on one treatment indicator for each iCCM focus illness: diarrhea, malaria, and pneumonia. The toolkit is intended for use at the national or sub-national level for periodic data quality checks. Conclusions The iCCM DQA Toolkit was designed to be easily tailored to different data reporting system structures because iCCM data reporting tools and data flow vary substantially. The toolkit enables countries to identify points in the reporting system where data quality is compromised and areas of the reporting system that require strengthening, so that countries can make informed adjustments that improve data quality, strengthen reporting systems, and inform decision-making.
Journal of Global Health, 2019
Evidence of Impact: iCCM as a strategy to save lives of children under five Background In 2013, t... more Evidence of Impact: iCCM as a strategy to save lives of children under five Background In 2013, the World Health Organization (WHO) launched the Rapid Access Expansion (RAcE) programme in the Democratic Republic of the Congo, Malawi, Mozambique, Niger, and Nigeria to increase coverage of diagnostic, treatment, and referral services for malaria, pneumonia, and diarrhea among children ages 2-59 months. In 2017, a final evaluation of the six RAcE sites was conducted to determine whether the programme goal was reached. A key evaluation objective was to estimate the reduction in childhood mortality and the number of under-five lives saved over the project period in the RAcE project areas. Methods The Lives Saved Tool (LiST) was used to estimate reductions in all-cause child mortality due to changes in coverage of treatment for the integrated community case management (iCCM) illnesses-malaria, pneumonia, and diarrhea-while accounting for other changes in maternal and child health interventions in each RAcE project area. Data from RAcE baseline and endline household surveys, Demographic and Health Surveys, and routine health service data were used in each LiST model. The models yielded estimated change in under-five mortality rates, and estimated number of lives saved per year by malaria, pneumonia and diarrhea treatment. We adjusted the results to estimate the number of lives saved by community health workers (CHW)-provided treatment. Results The LiST model accounts for coverage changes in iCCM intervention coverage and other health trends in each project area to estimate mortality reduction and child lives saved. Under five mortality declined in all six RAcE sites, with an average decline of 10 percent. An estimated 6200 under-five lives were saved by malaria, pneumonia, and diarrhea treatment in the DRC, Malawi, Niger, and Nigeria, of which approximately 4940 (75 percent) were saved by treatment provided by CHWs. This total excludes Mozambique, where there were no estimated under-five lives saved likely due to widespread stockouts of key medications. In all other project areas, lives saved by CHW-provided treatment contributed substantially to the estimated decline in under-five mortality. Conclusions Our results suggest that iCCM is a strategy that can save lives and measurably decrease child mortality in settings where access to health facility services is low and adequate resources for iCCM implementation are provided for CHW services. Electronic supplementary material: The online version of this article contains supplementary material.
Malaria Journal, 2019
Background: To reduce the malaria burden in Nigeria, the country is scaling up prevention and tre... more Background: To reduce the malaria burden in Nigeria, the country is scaling up prevention and treatment interventions, especially household ownership and use of insecticide-treated nets (ITNs). Nevertheless, large gaps remain to achieve the goals of the National Malaria Strategic Plan 2014-2020 of universal access to ITNs and their increased use. To inform the targeting of intervention strategies and to maximize impact, the authors conducted a sub-national profiling of household ITN ownership and use in the general population to identify key predictors of ITN ownership and use, and the subgroups that are at higher risk of low ITN coverage and use. Methods: The authors conducted a secondary analysis of data from the 2015 Nigeria Malaria Indicator Survey. Using the Chi square automatic interaction detector (CHAID) and multiple logistic regression analysis, the authors examined the key predictors of ITN ownership and use in the general population throughout Nigeria. Results: The CHAID models identified region of the country as the best predictor of household ownership of at least one ITN and its use in the general population, with higher ownership and use observed in the northern regions. The odds of a household owning an ITN were five times greater in the North West region compared with the North Central region (odds ratio [OR] = 5.47, 95% confidence interval [CI] 4.46-6.72, p < 0.001). The odds of ITN use were two times greater for those living in the North West region compared with the North Central region (OR = 2.04, 95% CI 1.73-2.41, p < 0.001). Other significant predictors were household size, head of household education level, household wealth quintile, and place of residence. The CHAID gain index results identified households in the South West, North Central and South Central regions with low ITN ownership, and the general population in the South South, South East and North Central regions with low ITN use. Conclusions: This study reveals regional differences in ITN ownership and use in Nigeria. Therefore, the findings from this analysis provide evidence that could inform the NMEP to better target future campaign and routine distribution of ITNs, to achieve universal access and increased use by 2020 in Nigeria.
Malaria Journal, 2019
Background: To reduce the malaria burden in Nigeria, the National Malaria Strategic Plan (NMSP) 2... more Background: To reduce the malaria burden in Nigeria, the National Malaria Strategic Plan (NMSP) 2014-2020 calls for the scale-up of prevention and treatment interventions, including social and behaviour change (SBC). SBC interventions can increase awareness and improve the demand for and uptake of malaria interventions. However, there is limited evidence supporting the implementation of SBC interventions to improve key malaria behaviours, such as insecticide-treated bed net (ITN) use, among children in Nigeria. Methods: Using data from 2015 Nigeria Malaria Indicator Survey, this study used multiple logistic regression to assess the relationship between caregiver exposure to malaria messages and ITN use among children under five. Results: Caregiver exposure to ITN-related messages was significantly associated with ITN use among children under five (odds ratio [OR] = 1.63, p < 0.001). Conclusions: The results suggest that caregiver exposure to topic-specific SBC messages improves the use of ITNs among children. Given these results, Nigeria should strive to scale up SBC interventions to help increase ITN use among children in line with the objectives of the NMSP. Further evidence is needed to determine which SBC interventions are the most effective and scalable in Nigeria.
The American journal of tropical medicine and hygiene, 2017
As funding for malaria control increased considerably over the past 10 years resulting in the exp... more As funding for malaria control increased considerably over the past 10 years resulting in the expanded coverage of malaria control interventions, so did the need to measure the impact of these investments on malaria morbidity and mortality. Members of the Roll Back Malaria (RBM) Partnership undertook impact evaluations of malaria control programs at a time when there was little guidance in terms of the process for conducting an impact evaluation of a national-level malaria control program. The President's Malaria Initiative (PMI), as a member of the RBM Partnership, has provided financial and technical support for impact evaluations in 13 countries to date. On the basis of these experiences, PMI and its partners have developed a streamlined process for conducting the evaluations with a set of lessons learned and recommendations. Chief among these are: to ensure country ownership and involvement in the evaluations; to engage stakeholders throughout the process; to coordinate eval...
Malaria journal, Jan 23, 2017
Lack of valid and reliable data on malaria deaths continues to be a problem that plagues the glob... more Lack of valid and reliable data on malaria deaths continues to be a problem that plagues the global health community. To address this gap, the verbal autopsy (VA) method was developed to ascertain cause of death at the population level. Despite the adoption and wide use of VA, there are many recognized limitations of VA tools and methods, especially for measuring malaria mortality. This study synthesizes the strengths and limitations of existing VA tools and methods for measuring malaria mortality (MM) in low- and middle-income countries through a systematic literature review. The authors searched PubMed, Cochrane Library, Popline, WHOLIS, Google Scholar, and INDEPTH Network Health and Demographic Surveillance System sites' websites from 1 January 1990 to 15 January 2016 for articles and reports on MM measurement through VA. article presented results from a VA study where malaria was a cause of death; article discussed limitations/challenges related to measurement of MM through ...
En sus proprias palabras (in their own words): Latina women’s perspectives on enablers of HIV testing using freelisting
Health Education Journal, 2014
Objective: Comprehensive information on the facilitators of HIV testing in Latino women (Latinas)... more Objective: Comprehensive information on the facilitators of HIV testing in Latino women (Latinas) in the Southeastern USA is lacking. Efforts to rectify this should include Latina perspectives on the issue. This study aimed to (1) solicit Latina perspectives using qualitative methodology and (2) characterise enablers of HIV testing follow-through. Method: The study used the freelisting interview approach to document the perspectives of Latinas (18 years and older). The purposive sample included HIV-tested ( n = 21) and non-tested ( n = 10) women. The setting was Non-Traditional Counseling, Testing and Referral Sites in five counties in Central North Carolina, USA. The protocol was guided by the PEN-3 framework, which aims to take culture into account as part of health education. The focus was on the enablers (i.e. social groups, networks, information channels, systems and environments) of health behaviours. Results: While participants listed 66 enablers, 37 met the criteria for anal...
Malaria Journal, 2016
Background: Malaria control interventions in most endemic countries have intensified in recent ye... more Background: Malaria control interventions in most endemic countries have intensified in recent years and so there is a need for a robust monitoring and evaluation (M&E) system to measure progress and achievements. Providing programme and M&E officers with the appropriate skills is a way to strengthen malaria's M&E systems and enhance information use for programmes' implementation. This paper describes a recent effort in capacity strengthening for malaria M&E in sub-Saharan Africa (SSA). Methods: From 2010 to 2014, capacity-strengthening efforts consisted of organizing regional in-person workshops for M&E of malaria programmes for Anglophone and Francophone countries in SSA in collaboration with partners from Ghana and Burkina Faso. Open-sourced online courses were also available in English. A post-workshop assessment was conducted after 5 years to assess the effects of these regional workshops and identify gaps in capacity. Results: The regional workshops trained 181 participants from 28 countries from 2010 to 2014. Trained participants were from ministries of health, national malaria control and elimination programmes, non-governmental organizations, and development partners. The average score (%) for participants' knowledge tests increased from pretest to posttest for Anglophone workshops
¿Qué te parece?: Pretesting an HIV Testing Enablers Assessment Instrument Among Hispanic/Latino Immigrant Women
Hispanic health care international : the official journal of the National Association of Hispanic Nurses, 2015
This article describes the procedures used to determine the conceptual adequacy and cultural appr... more This article describes the procedures used to determine the conceptual adequacy and cultural appropriateness of a newly developed HIV Testing Enablers Assessment (H-TEA) instrument to be used with underserved Hispanic/Latino immigrant women. The aim was to create an appropriate format for women with similar language proficiencies and ethnic backgrounds. We discuss the feedback we received from the women in terms of cultural nuances we must pay attention to when creating items and organizing them into an assessment instrument. Women reported on the understandability, comfort level, likelihood of truthfulness, and cultural relevancy of questions and response options for the instrument. These are key factors in developing an instrument that is relevant, reliable, and culturally appropriate for our target population.
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Papers by Samantha Herrera