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Paying for performance is a strategy to meet the unmet need for family planning in low and middle income countries; however, rigorous evidence on effectiveness is lacking. Scientific databases and grey literature were searched from 1994 to May 2016. Thirteen studies were included. Payments were linked to units of targeted services, usually modified by quality indicators. Ancillary components and payment indicators differed between studies. Results were mixed for family planning outcome measures. Paying for performance was associated with improved modern family planning use in one study, and increased user and coverage rates in two more. Paying for performance with conditional cash transfers increased family planning use in another. One study found increased use in the upper wealth group only. However, eight studies reported no impact on modern family planning use or prevalence. Secondary outcomes of equity, financial risk protection, satisfaction, quality, and service organization were mixed. Available evidence is inconclusive and limited by the scarcity of studies and by variation in intervention, study design, and outcome measures. Further studies are warranted. [ABSTRACT FROM AUTHOR]

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In 2002 Save the Children UK carried out a study of child poverty in Uganda, as part of the on-going Uganda Participatory Poverty Assessment Programme. Using participants from all regions of the country, the researchers asked children about their perceptions of poverty and anti-poverty strategies, as well as questioning adult key informants about trends in child poverty, vulnerable groups and the effectiveness of government policies in tackling child poverty. This article reports on one aspect of the study, looking at the different indicators that children use to assess poverty, and comparing these with official poverty monitoring indicators. It finds that while some areas—notably, health, education and water and sanitation—are well documented, others, which may be as, or more significant to children's welfare, such as child abuse or quality of parental care, are almost totally neglected. A more holistic framework for assessing child poverty is proposed. Copyright © 2003 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Sierra Leone was highly impacted by the 2014–2016 West Africa Ebola outbreak, with 3,955 recorded deaths. Already stressed maternal health services were deeply affected by the outbreak due to fears of viral transmission, reallocation of maternity staff, and broader policies to stop transmission including travel restrictions. This research sought to explore women's perspectives on delaying pregnancy during the Ebola outbreak using family planning methods. Qualitative data collection took place in Kambia District in 2018 and included 35 women participants, with women who were either family planning users or nonusers at the time of the outbreak. Women reported a variety of reasons for choosing to take or not to take family planning during the outbreak, which we categorized as proximal (directly related to the outbreak) or distal (not directly outbreak related). Proximal reasons to take family planning included to avoid interacting with health care spaces where Ebola could be transmitted, to avoid the economic burden of additional children in a time when economic activities were curtailed and to return to school when education resumed postoutbreak. Distal reasoning included gender roles affecting women's decision making to seek family planning, concerns related to the physiological side effects of family planning, and the economic burden of paying for family planning. Women's perspectives for choosing to take or not take family planning during the Sierra Leone Ebola crisis had not been explored prior to this paper. Using the lens of family planning to consider how women choose to access health care in an outbreak gives us a unique perspective into how all health care interactions are impacted by a generalized outbreak of Ebola, and how outbreak responses struggle to ensure such services remain a priority. [ABSTRACT FROM AUTHOR]

How do the politics of agenda setting and policy adoption operate in the arena of healthcare reform in the industrializing world? Literature on the twenty‐first‐century developmental state emphasizes the role of democratic competition and civil society in causing political parties to take up new agendas, while power resources theory stresses the role of left‐wing political parties and labor unions in policy adoption. Yet, core tenets of these theories have not been considered extensively in light of dynamics in the industrializing world. This article examines the politics of policy adoption in countries that have recently aimed to provide healthcare access and financial protection to the poor and people in the informal sector in Mexico and Turkey. In line with literature on the twenty‐first‐century developmental state, we find democratic competition to play an important role in causing political parties to take up new agendas. However, examination of the cases illuminates surprising dynamics that challenge important elements of sociological theory: right‐leaning political parties played important roles in adoption, while labor unions and left‐wing parties oppose reform in the cases. Public health‐minded physicians leading change teams played important roles in agenda setting and leading the process of implementation. [ABSTRACT FROM AUTHOR]

The increased demand for basic emergency obstetric and neonatal care (BEmONC) services in Sierra Leone since the launch of the nationwide free maternity care initiative in 2010 has strained the capacity of the system to provide high‐quality care. In 2014, members of our research team visited all 97 functioning primary health‐care facilities in Bombali district in the Northern Province of Sierra Leone to evaluate gaps in access to BEmONC. Although most facilities had the equipment necessary for maternal and neonatal care, these were often not in satisfactory condition. Most of the facilities did not stock all of the essential medicines for BEmONC, and less than 10 percent of the facilities had sufficient stocks of unexpired and properly stored medications. Stronger supply chains will be necessary to improve health system performance in Sierra Leone, reduce maternal mortality, increase neonatal survival, and achieve targets associated with the Sustainable Development Goals (SDGs). [ABSTRACT FROM AUTHOR]