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BACKGROUND: Low birth weight (LBW) is associated with neonatal mortality and sequelae of lifelong health problems; prioritizing the most promising antenatal interventions may guide resource allocation and improve health outcomes. OBJECTIVE: We sought to identify the most promising interventions that are not yet included in the policy recommendations of the World Health Organization (WHO) but could complement antenatal care and reduce the prevalence of LBW and related adverse birth outcomes in low- and middle-income settings. METHODS: We utilized an adapted Child Health and Nutrition Research Initiative (CHNRI) prioritization method. RESULTS: In addition to procedures already recommended by WHO for the prevention of LBW, we identified six promising antenatal interventions that are not currently recommended by WHO with an indication for LBW prevention, namely: (1) provision of multiple micronutrients; (2) low-dose aspirin; (3) high-dose calcium; (4) prophylactic cervical cerclage; (5) psychosocial support for smoking cessation; and (6) other psychosocial support for targeted populations and settings. We also identified seven interventions for further implementation research and six interventions for efficacy research. CONCLUSION: These promising interventions, coupled with increasing coverage of currently recommended antenatal care, could accelerate progress toward the global target of a 30% reduction in the number of LBW infants born in 2025 compared to 2006-10.

Background: Low birth weight (LBW) is a significant public health concern given its association with early-life mortality and other adverse health consequences that can impact the entire life cycle. In many countries, accurate estimates of LBW prevalence are lacking due to inaccuracies in collection and gaps in available data. Our study aimed to determine LBW prevalence among facility-born infants in selected areas of Kenya and Tanzania and to assess whether the introduction of an intervention to improve the accuracy of birth weight measurement would result in a meaningfully different estimate of LBW prevalence than current practice. Methods: We carried out a historically controlled intervention study in 22 health facilities in Kenya and three health facilities in Tanzania. The intervention included: provision of high-quality digital scales, training of nursing staff on accurate birth weight measurement, recording and scale calibration practices, and quality maintenance support that consisted of enhanced supervision and feedback (prospective arm). The historically controlled data were birth weights from the same facilities recorded in maternity registers for the same calendar months from the previous year measured using routine practices and manual scales. We calculated mean birth weight (95% confidence interval CI), mean difference in LBW prevalence, and respective risk ratio (95% CI) between study arms. Results: Between October 2019 and February 2020, we prospectively collected birth weights from 8441 newborns in Kenya and 4294 in Tanzania. Historical data were available from 9318 newborns in Kenya and 12,007 in Tanzania. In the prospective sample, the prevalence of LBW was 12.6% (95% confidence intervals [CI]: 10.9%–14.4%) in Kenya and 18.2% (12.2%–24.2%) in Tanzania. In the historical sample, the corresponding prevalence estimates were 7.8% (6.5%–9.2%) and 10.0% (8.6%–11.4%). Compared to the retrospective sample, the LBW prevalence in the prospective sample was 4.8% points (3.2%–6.4%) higher in Kenya and 8.2% points (2.3%–14.0%) higher in Tanzania, corresponding to a risk ratio of 1.61 (1.38–1.88) in Kenya and 1.81 (1.30–2.52) in Tanzania. Conclusion: Routine birth weight records underestimate the risk of LBW among facility-born infants in Kenya and Tanzania. The quality of birth weight data can be improved by a simple intervention consisting of provision of digital scales and supportive training. [ABSTRACT FROM AUTHOR]

Background: Healthcare workers' eHealth competence is a significant, but often overlooked, factor for successful eHealth implementation. The implementation of eHealth has radically transformed health sector workforce's competency requirements, and has created challenges, especially in low- and middle-income countries. Aim: The aim of the study was to identify healthcare workers' existing eHealth competences in private health centres in urban Tanzania. Methods: The data were collected in private health care facilities by using both a survey questionnaire and semi-structured interviews. Data were analysed by SPSS and Atlas.ti software. Results: Tanzanian healthcare workers had several weaknesses in computer and informatics competences, and eHealth technology-related competences varied widely among the participants. However, generally participants had positive perceptions towards eHealth. The majority of the healthcare workers had quite limited training for and exposure to eHealth technologies, which consequently appeared to hinder the competency development. Conclusion: To increase the likelihood for successful eHealth implementations, findings emphasize the importance of identifying individuals' eHealth competences prior to eHealth implementation, providing eHealth trainings that are targeted at the specific needs of groups and individuals, and support the on-thejob use of eHealth technologies. The positive perceptions towards eHealth suggest that healthcare workers are ready to take on such technologies. Further studies to determine how to improve healthcare workers' eHealth competences and what kind of training should be provided would be useful in addressing the identified challenges and overcome the weaknesses. [ABSTRACT FROM AUTHOR]

South Africa is plagued by severe HIV and tuberculosis (TB) epidemics. Despite integration policies, health services' reporting follows largely disease-specific vertical patterns, resulting in parallel data flows. This qualitative case study investigated how the health information system (HIS) is engaged with and perceived by health system employees. We conducted in-depth interviews with individuals (n=28) working in key roles at different levels of the health system in Cape Town, South Africa. Data from direct observation and document review complemented the interviews. All data were coded and analysed using thematic analysis. The key challenges reported included large amount of reporting in general, duplication of data elements, health governance and tensions over data collection tools. The vast amount of collected data was not considered holistic or fit-for-purpose. In conclusion, the HIS in South Africa causes work duplication and waste of efforts in times of scarce resources, and does not sufficiently support integration policies. Holistic approaches to studying, developing and implementing HIS are needed. [ABSTRACT FROM AUTHOR]