Paper - 'Women's voices in rural Malawi: antenatal care research and community learning'

Dear HIFA colleagues,

My friend, Ted Lankester, suggested I share my recently published research with this community.

The paper, published in PLOS Global Public Health, explores women’s perceptions of pregnancy and antenatal care in Chizenga village, Chikwawa, Malawi. It arose from my MSc dissertation at the Liverpool School of Tropical Medicine, with co-authors Deborah Nyirenda and Terry Kana.

Through interviews with 14 pregnant women, we explored how understanding of antenatal care interacts with transport costs, distance, nutritional constraints, gender dynamics and experiences of respectful and disrespectful care. Women also expressed a desire for more community-based education and outreach.

The full open-access paper is available here: https://doi.org/10.1371/journal.pgph.0005515

Layton H, Nyirenda D, Kana T (2026) A qualitative study to explore women’s perceptions of pregnancy and antenatal care in Chizenga village, Chikwawa, Malawi. PLOS Glob Public Health 6(9): e0005515. https://doi.org/10.1371/journal.pgph.0005515

Their accounts inspired me to develop the Sangalala Maternal Health Partnership Programme with local partners, through The Reach Foundation UK. Our first cohort (39 women and 1 man) has recently completed the programme in Uganda, and we are now learning from participants’ experiences to strengthen it.

I would welcome members’ experiences of making maternal health information accessible and useful in rural communities, particularly where information needs sit alongside practical barriers to accessing care.

I promised the women who participated that I would help raise their voices. Sharing their perspectives and learning from this community is one way I hope to honour that promise.

Best Wishes,

Helen

HIFA profile [and my source]: Helen Layton is a Nurse and Global Health Consultant; Founder & Clinical Director, The Marula Institute; Co-founder & Executive Director, The Reach Foundation UK/Spain. My professional interests include maternal and child health, global health equity, respectful maternity care, community-led health education, and translating research into practice. As Co-founder and Executive Director of The Reach Foundation UK and Founder and Clinical Director of The Marula Institute, I am particularly interested in strengthening health systems, workforce education, safe care for children with complex needs, and ensuring women’s and families’ voices inform care. 
Helen AT cathcom.org

c/o HIFA - Publications re. primary health care & community health

Dear [HIFA] friends and colleagues with an interest in primary health care and community health:

Since my last communication with you more than 6 months ago, the entire field of global health has continued to be upended by our US government, with unconscionable effects on millions of people around the world, on advancements in global health research and its ethical foundations, and on the careers of thousands and thousands of people working around the world in the field of global health. As I said before, and I repeat now the obvious, it will take decades to build back what has been destroyed and to regain respect from the rest of the world for the United States and the values that most of us hold dear.

William Foege, eminent global health leader and former Director of the Centers for Disease Control and Prevention wrote this biting editorial <https://www.statnews.com/2025/08/18/rfk-jr-public-health-threats-william-foege-smallpox/> in which he said, among other things, 

"We will live through this drought of values, principles and facts and again apply our talents to improving global health and happiness. Do not back down.”

Atul Gwande, now one of the foremost champions of primary health care and community health of our time (even though he is, like me, an erstwhile surgeon!) and former Director of the USAID Bureau of Global Health during the Biden administration, gave an eloquent presentation of his perspective on the aftermath of the destruction of USAID on 28 April 2025 at the Harvard School of Public Health.

You can watch this here:
<https://www.bing.com/videos/riverview/relatedvideo?q=Atul+Gwande+presentation+at+Harvard+School+of+Public+Health+April+28%2c+2025&mid=26DA144398CF1F613D0A26DA144398CF1F613D0A&FORM=VIRE>.

Here are a few items of possible interest:

The Fourth International Symposium on CHWs will be held virtually next week.

I was most fortunate to be able to attend the second International Conference on Primary Health Care was held in Addis Ababa, Ethiopia, from October 6-10. It was a glorious event, with 750 attendees, mostly from Africa but with strong representation from UNICEF, WHO, Africa CDC, and other international organizations. 

The conference was sponsored by the International Institute for Primary Health Care – Ethiopia. <https://iphce.org/> Directors of PHC from 45 different African countries were present along with at least 50 community health workers from across Africa. There was palpable enthusiasm for the growing momentum for PHC across Africa.

Abhay and Rani Bang are world-renowned champions of community-based primary health care through their work with SEARCH <https://www.searchforhealth.ngo/> (Society for Education, Action, and Research) in Gadchiroli, India, with tribal people. Their seminal publications on the effectiveness of community-based primary health care and community health workers as well as their contributions to India’s national program for reducing neonatal mortality through home-based neonatal care, among others, have gained for them global recognition. Attached is an English translation of an article about their life’s work that was published in April Der Spiegel in the leading German magazine, Der Spiegel.

Nicholas Kristof has continued to share with the world some of the heart wrenching effects of the collapse of the United States Agency for International Development. The New York Times opinion columnist wrote <https://www.nytimes.com/2025/09/20/opinion/trump-usaid-cuts.html> on 20 September 2025 on the human dimension of the shutdown of USAID, citing estimates that 690,000 will die in 2025 and 829,00 will die in 2026 as a result of cutbacks in USAID funding, and 3.1 million children will die during Trump’s second term from these cuts (a PDF is attached if the link doesn’t work for you [mod: HIFA does not carry attachments]).

Two recent publications on novel approaches to reducing child mortality have gained widespread attention.

One study <https://www.nber.org/system/files/working_papers/w34152/w34152.pdf> in Kenya provided a one-time transfer of $1,000 to poor families and observed a decline of nearly half in under-5 mortality as well as in infant mortality. Another study reported that wrapping

A recently reported study <https://pmc.ncbi.nlm.nih.gov/articles/PMC12462887/> from Uganda found that giving mothers fabric treated with permethrin, a long-acting insecticide to protect against mosquito-born illnesses, as a baby wrap dramatically reduced malaria infections in the infants carried in them. There were 66 percent fewer cases among those children compared with babies in the untreated wraps. By the end of the six-month study, only 16 percent of children in the treated wrap group had been sick with malaria, compared with 34 percent in the untreated wrap group, many of whom had multiple malaria episodes.

Now available for purchase on Amazon.com are several important publications related to community-based primary health care and community workers.

Feel free to share this email and these resources with anyone else or with any relevant listserve you may have access to.

You are receiving this email because of your interest in primary health care and community health.

If you know of anyone that you think would like to be included in the listserv, just send me the person’s name and email address.

Warm regards, Henry

Henry B. Perry, MD, PhD, MPH Senior Associate, Health Systems Program Department of International Health Johns Hopkins Bloomberg School of Public Health Baltimore, MD, USA 21205 Hperry2 AT jhu.edu

HIFA profile: Henry Perry is a Senior Scientist at the Johns Hopkins Bloomberg School of Public Health, USA. Professional interests: Community health and primary health care. hperry2 AT jhu.edu

FINAL CALL: Have your say about evidence-based implementation! c/o HIFA

PARTICIPATE TO WIN PRIZES

View this email in your browser <https://mailchi.mp/nest360/improve-health-worldwide-complete-this-short-survey-10147215?e=f1722a9293>

LAST CHANCE TO INPUT - CLOSING ON 27TH JUNE!

Do you work on improving health and equity in low-and middle-income countries (LMICs)?

Have YOUR chance to: -Democratise research and evidence for implementation! -Ensure your setting is represented! -Win a £50 voucher in the prize draw!

Palestine, Uganda, and Peru shared the most replies so far!

BETTER HEALTH WORLDWIDE!

Complete this 10 minute survey about evidence-based implementation

You could win a £50 voucher!

Click here <https://newborntoolkit.us5.list-manage.com/track/click?u=7a4ba8643fabeb1b06801b973&id=99accaa2ac&e=f1722a9293> and submit for a chance to win!

[content removed as not supported by HIFA]

English Do you work on improving health outcomes around the world?

Have your say! Why? To accelerate evidence-based implementation, with equity, for better health worldwide.

Who? People involved in any aspect of health service implementation and strengthening at any level of the system (e.g. health care provider, data analyst, policy maker).

How? Click here<https://newborntoolkit.us5.list-manage.com/track/click?u=7a4ba8643fabeb1b06801b973&id=a29ce2fd65&e=f1722a9293> to have your say!

What? Participant information<https://newborntoolkit.us5.list-manage.com/track/click?u=7a4ba8643fabeb1b06801b973&id=7579d3a077&e=f1722a9293> is attached to this message.

Evidence-based Implementation: Many life-saving interventions are not implemented effectively, with wide gaps between what is known and what is done, especially in low- and middle-income countries.

We are keen to hear perspectives and realities from implementers in all low- and middle-income contexts. 

We are seeking your insights to help close the gap from evidence to implementation!

We hope you will take a few minutes to complete this brief survey.<https://newborntoolkit.us5.list-manage.com/track/click?u=7a4ba8643fabeb1b06801b973&id=422f1a8283&e=f1722a9293>

Answers can be anonymous and there is no requirement to provide identifying information.

This survey is being conducted as part of the Lancet Commission on Evidence-Based Implementation in Global Health<https://newborntoolkit.us5.list-manage.com/track/click?u=7a4ba8643fabeb1b06801b973&id=ef480cd254&e=f1722a9293>. This study was funded by the Children’s Investment Fund Foundation.

A member of the study team can be contacted via ImplementersVoices AT gmail.com

Please share across your networks!! Let’s begin, click here!<https://newborntoolkit.us5.list-manage.com/track/click?u=7a4ba8643fabeb1b06801b973&id=63a8e4c758&e=f1722a9293>

[content removed as not supported by HIFA - and my source.]

From Harriet Ruysen - Harriet.Ruysen AT lshtm.ac.uk

South Sudan Medical Journal - #1 2022

Dear colleagues,

The first issue of the South Sudan Medical Journal for 2022 is on our website here and the contents are listed below.

In it, you will find articles covering seats for disabled people using pit latrines in Uganda, Neonatal Respiratory Distress Syndrome in Ethiopia, extra-pulmonary TB in South Sudan, case reports on the double uterus, ossifying fibroma of the mandible, and our second Back-to-Basics paper on fever.

See also the Appeal for the Al Sabah Children’s Hospital Resource Centre.

Please share this issue with your social networks; encourage colleagues to join our mailing list and to submit manuscripts to southsudanmedicaljournal AT gmail.com.

South Sudan Medical Journal

We thank everyone who contributes to SSMJ including our editors and, especially, our anonymous peer reviewers. Let us know if you are willing to review or edit articles.

Visit our website to get covid-19 updates for South Sudan and to see our new Guidelines for preparing tables for SSMJ manuscripts.

You can follow us on Twitter@SSMedJournal and our Facebook Group, and find previous SSMJ articles on our website and at  African Journals Online (AJOL) and the Directory of Open Access Journals (DOAJ)


EDITORIAL

• The unmet need of pit latrine use by disabled people: a practical solution Eluzai Hakim

RESEARCH ARTICLES

• Determinant factors of immediate outcomes of Neonatal Respiratory Distress Syndrome in Gondar, Ethiopia Yousif Abdalla Alzubair, Yohannes Hailu and Koku Sisay Tamirat
• One year’s experience of extra-pulmonary TB in a county/regional hospital in South Sudan Gadic Kot Apiu, Lina Sala, Rosario Iannetti, and J. Clarke McIntosh

MAIN ARTICLES

• Sanitation resources for disabled individuals in Uganda Harrison Schmachtenberger, Mei-Li Hey, and Mikaya LD Lumori
• Portable pit latrine seats to increase sanitation for disabled individuals in Lira, Uganda Mei-Li Hey, Harrison Schmachtenberger, and Mikaya LD Lumori

CASE REPORTS

• Double uterus in young women delivered by Caesarean Section: five cases from South Sudan and Ethiopia Jok Thikuiy Gang, Garang Dakjur Lueth and Onwar Otien Jwodh
• Giant ossifying fibroma of the mandible Ernesto Carmona Fernández

SUMMARY

• Back-to-basics: Fever is a syndrome and not just pyrexia Lucien Wasingya- Kasereka and John Kellett

SHORT ITEMS

• Gordon Memorial College Trust Fund (GMCTF) Applicants 2022/2023
• Snakebite cases on the rise as antivenom runs out in Warrap
• Al Sabah Children’s Hospital Resource Centre Appeal

BACK COVER

• The graphs showing South Sudan daily confirmed and cumulative COVID-19 deaths as of January 29, 2022

Kind regards,

The SSMJ team
Email: southsudanmedicaljournal AT gmail.com

n.b. I have reduced the number of links from the original email. PJ

People Fixing the World: c/o BBC World Service

The breath of life

"A clever invention is saving the lives of hundreds of children.

Pneumonia kills about 1.4 million children under five every year. Treatment with concentrated oxygen could save many of them, but the machines that make it need a reliable source of electricity. Some hospitals have frequent power cuts, though, which can be fatal.

So scientists in Australia and Uganda came up with an innovative way to produce oxygen by separating it from the rest of the air, using a vacuum created by running water.

Then they designed special bags that can store and deliver oxygen – even when the electricity cuts out. Their systems have provided oxygen for hundreds of sick children in Uganda.

People Fixing the World hears the story of these remarkable inventions."

individual

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INTERPERSONAL : SCIENCES

humanistic ----------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

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group - population

Creativity Innovation Problem solving	Pneumonia Concentrated Oxygen Storage Devices - Maintenance Life cycle management Repair in the field  Sustainability