Social and behavior change communication (SBCC), which uses communication to positively influence the social dimensions of health and well-being, is an important strategy for improving health services at the provider level. With much of the responsibility for providing health care services falling on a cadre of professional health care workers (HCWs), particularly those in lower-level facilities, SBCC strategies targeting this workforce can be an important tool for improving quality of care. To maximize the impact of SBCC activities among HCWs, program designers and implementers must first develop an awareness of factors that improve or impede HCW performance at the facility level. The purpose of this literature review is to identify the facilitators and barriers to HCW service provision in three areas: knowledge and competency barriers in which HCWs lack the skills and knowledge to provide services; structural and contextual barriers in which systemic and environmental factors affect HCWs ability to provide services; and attitudinal barriers in which attitudes and societal beliefs influence health workers’ willingness to provide services. The research confirms that HCWs experience significant barriers in all three areas, ranging from lack of training and poor management to inadequate equipment to stigma towards certain populations. The findings in this paper can be used to capitalize upon facilitators and anticipate and respond to potential barriers when using SBCC programs to improve the quality of care provided by HCWs.
United States – Global Strategy to Empower Adolescent Girls
Adolescence is a critical period in a girl’s life, when significant physical, emotional, and social changes shape her future. In too many parts of the world, adolescence is the most precarious time for girls. A quarter of a billion girls live in poverty. One in three girls in the developing world is married by the time she is 18, and one in nine is married by the age of 15. Every year, millions of girls undergo female genital mutilation/cutting. Millions more live in conflict settings that increase the risks of gender-based violence. Many girls continue to be infected with HIV/AIDS, and too few girls have the education or skills they need to participate fully in the economies of their countries.
Medical Hostages: Detention of Women and Babies in Hospitals
A disturbing but common practice in many developing countries is the detainment of women who have recently given birth and who cannot afford their hospital charges. Contrary to policies aimed at encouraging women to deliver in health facilities, this practice is an abuse of their rights and has implications for wider maternal and neonatal health.
Detention of women is a surprisingly common problem, with current and recent examples of this practice found in Burundi, Cameroon, the Democratic Republic of Congo, Ghana, Kenya, Nigeria, the Philippines and Zimbabwe.1 It is, however, very difficult to estimate the extent of the problem as there are no prevalence studies and in many situations these detentions are illegal with no official figures. Most of the information concerning this practice therefore comes from assessments of single hospitals or anecdotal reports.