| Global Health: Science and Practice (GHSP), a no-fee, peer-reviewed, open-access journal, is targeted to global health professionals, particularly program implementers, to validate their experiences and program results by peer reviewers and to share them with the greater global health community. August 2014 | Volume 2 | Issue 3 Here are highlights of the articles in the August 2014 issue: View a list of all articles by article type below, or read the entire current issue online. Visit the GHSP website to read and comment on the articles, and subscribe to receive alerts when new articles and issues are published. Evidence-based public health: not only whether it works, but how it can be made to work practicably at scale Because public health must operate at scale in widely diverse, complex situations, randomized controlled trials (RCTs) have limited utility for public health. Other methodologies are needed. A key conceptual backbone is a detailed ''theory of change'' to apply appropriate evidence for each operational component. Synthesizing patterns of findings across multiple methodologies provides key insights. Programs operating successfully across a variety of settings can provide some of the best evidence. Challenges include judging the quality of such evidence and assisting programs to apply it. WHO and others should shift emphasis from RCTs to more relevant evidence when assessing public health issues. James D Shelton Oxytocin: taking the heat Oxytocin-in-Uniject satisfied the standards of its temperature-time indicator (TTI) in severe home storage conditions, although that required resupply every 30 days—a logistically onerous programmatic standard. Possible advances include: (1) incorporating TTIs with packaged batches of less expensive and more widely used conventional vials of oxytocin; (2) using TTIs calibrated more closely to the actual temperature sensitivity of oxytocin; and (3) researching whether a lower dose of oxytocin would be equally efficacious in preventing postpartum hemorrhage. Stephen Hodgins Combating trafficking in persons: a call to action for global health professionals Health care professionals can help identify victims of human trafficking, who commonly come into contact with providers during captivity. Providers can also help restore the physical and mental health of trafficking survivors. Training should focus on recognizing trafficking signs, interviewing techniques, and recommended responses when a victim is identified. Luis CdeBaca, Jane Nady Sigmon Maximizing the benefits of improved cookstoves: moving from acquisition to correct and consistent use The adoption of clean cooking technologies goes beyond mere product acquisition and requires attention to issues of cooking traditions, user engagement, gender dynamics, culture, and religion to effect correct and consistent use. Anita Shankar, Michael Johnson, Ethan Kay, Raj Pannu, Theresa Beltramo, Elisa Derby, Stephen Harrell, Curt Davis, Helen Petach Are national policies and programs for prevention and management of postpartum hemorrhage and preeclampsia adequate? A key informant survey in 37 countries Most surveyed countries have many supportive policies and program elements, but issues remain that impede maternal health efforts, including: inconsistent availability of essential commodities, particularly misoprostol; limitations on midwives' scope of practice; incomplete or out-of-date service delivery guidelines; and weak reporting systems. Jeffrey Michael Smith, Sheena Currie, Tirza Cannon, Deborah Armbruster, Julia Perri Cumulative effects of heat exposure and storage conditions of Oxytocin-in-Uniject in rural Ghana: implications for scale up Oxytocin-in-Uniject devices could be stored 30 to 40 days without refrigeration under typical field conditions, with wastage levels below 10%, based on simulation studies. Luke C Mullany, Sam Newton, Samuel Afari-Asiedu, Edward Adiibokah, Charlotte T Agyemang, Patience Cofie, Steve Brooke, Seth Owusu-Agyei, Cynthia K Stanton Strategic contracting practices to improve procurement of health commodities Practices such as flexible, pre-established framework agreements can improve timeliness and cost of procurement and help improve commodity security. Addressing legislative barriers and building technical capacity in contract management may facilitate the use of such practices. Leslie Arney, Prashant Yadav, Roger Miller, Taylor Wilkerson Major challenges to scale up of visual inspection-based cervical cancer prevention programs: the experience of Guatemalan NGOs Scale up of visual inspection with acetic acid (VIA) in Guatemala encountered major challenges, including high attrition of people trained, didactic training without hands-on skills building, lack of continued supervision, and provision of VIA alone without immediate on-site provision of cryotherapy. Anita Nandkumar Chary, Peter J Rohloff Can traditional birth attendants be trained to accurately identify septic infants, initiate antibiotics, and refer in a rural African setting? Despite having limited training, these TBAs were able to accurately identify critically ill neonates, initiate treatment in the field, and refer for further care. Given their proximity to the mother/infant pair, and their role in rural communities, training and equipping TBAs in this role could be effective in reducing neonatal mortality. Christopher John Gill, William B MacLeod, Grace Phiri-Mazala, Nicholas G Guerina, Mark Mirochnick, Anna B Knapp, Davidson H Hamer Nationwide implementation of integrated community case management of childhood illness in Rwanda Between 2008 and 2011, Rwanda introduced iCCM of childhood illness nationwide. One year after iCCM rollout, community-based treatment for diarrhea and pneumonia had increased significantly, and under-5 mortality and overall health facility use had declined significantly. Catherine Mugeni,* Adam C Levine,* Richard M Munyaneza, Epiphanie Mulindahabi, Hannah C Cockrell, Justin Glavis-Bloom, Cameron T Nutt, Claire M Wagner, Erick Gaju, Alphonse Rukundo, Jean Pierre Habimana, Corine Karema, Fidele Ngabo, Agnes Binagwaho Plausible role for CHW peer support groups in increasing care-seeking in an integrated community case management project in Rwanda: a mixed methods evaluation During national scale up of iCCM in Rwanda, greater improvements in care-seeking were found in the districts where Kabeho Mwana implemented its model than in the rest of the country. Success was attributed to an emphasis on routine data, intensive monitoring, collaborative supervision, community mobilization and, in particular, CHW peer support groups. Anne Langston, Jennifer Weiss, Justine Landegger, Thomas Pullum, Melanie Morrow, Melene Kabadege, Catherine Mugeni, Eric Sarriot Exclusive breastfeeding: aligning the indicator with the goal While the global objective is exclusive breastfeeding (EBF) for a full 6 months duration, the standard indicator is a ''prevalence'' indicator, that is, the percentage of all children under age 6 months who are exclusively breastfed at a point in time. That yields a higher percentage than a more direct indicator of duration and can be easily misunderstood, exaggerating the amount of EBF. A measurement of actual percentage of children exclusively breastfeeding for a full 6 months can be easily calculated from standard DHS and MICS data. Thomas W Pullum Development and use of a master health facility list: Haiti's experience during the 2010 earthquake response Collaboration between the Haitian government and NGOs after the 2010 earthquake contributed to a more accurate and complete master health facility list, which helped coordinate emergency response operations as well as strengthen the routine health information system. Open data and social networks facilitated the collection and sharing of health facility information and in maintenance of the list over time. Alyson Rose-Wood, Nathan Heard, Roody Thermidor, Jessica Chan, Fanor Joseph, Gerald Lerebours, Antonio Zugaldia, Kimberly Konkel, Michael Edwards, Bill Lang, Carmen-Rosa Torres Reaching out to a community to improve maternal health in Ghana: the story of one midwife John Kuumuori Ganle GHSP is supported by the U.S. Agency for International Development and published by the Knowledge for Health project at the Johns Hopkins Bloomberg School of Public Health Center for Communication Programs in collaboration with the George Washington University School of Public Health and Health Services. Learn more about GHSP on its website: www.ghspjournal.org. | 
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