Jennifer Bryce
Biographic Data
| ID | 100824 |
|---|---|
| NAME | Jennifer Bryce |
| GIVEN NAMES | Jennifer |
| FAMILY NAME | Bryce |
| SIGNATURE | BRYCE J |
| AFFILIATIONS | Johns Hopkins University |
| VERIFIED | No |
| TOTAL WORKS | 38 |
| TOTAL CITATIONS | 193 |
| AUTHOR COUNT | 38 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 1983 |
| LATEST PUBLICATION YEAR | 2022 |
| H-INDEX | 8 |
Strengthening effectiveness evaluations to improve programs for women, children and adolescents
A full understanding of the pathways from efficacious interventions to population impact requires rigorous effectiveness evaluations conducted under realistic scale-up conditions at country level. In this paper, we introduce a deductive framework that underpins effectiveness evaluations. This framework forms the theoretical and conceptual basis for the 'Real Accountability: Data Analysis for Results' (RADAR) project, intended to address gaps in g…
Feasibility of engaging “Village Doctors” in the Community-based Integrated Management of Childhood Illness (C-IMCI)
BACKGROUND: Informal health care providers particularly "village doctors" are the first point of care for under-five childhood illnesses in rural Bangladesh. We engaged village doctors as part of the Multi-Country Evaluation (MCE) of Integrated Management of Childhood Illness (IMCI) and assessed their management of sick under-five children before and after a modified IMCI training, supplemented with ongoing monitoring and supportive supervision. …
Improving coverage measurement for reproductive, maternal, neonatal and child health
BACKGROUND: Regular monitoring of coverage for reproductive, maternal, neonatal, and child health (RMNCH) is central to assessing progress toward health goals. The objectives of this review were to describe the current state of coverage measurement for RMNCH, assess the extent to which current approaches to coverage measurement cover the spectrum of RMNCH interventions, and prioritize interventions for a novel approach to coverage measurement lin…
Countdown to 2015
Patterns and determinants of antenatal care utilization
BACKGROUND: Antenatal care (ANC) is critical for improving maternal and newborn health. WHO recommends that pregnant women complete at least four ANC visits. Countdown and other global monitoring efforts track the proportions of women who receive one or more visits by a skilled provider (ANC1+) and four or more visits by any provider (ANC4+). This study investigates patterns of drop-off in use between ANC1+ and ANC4+, and explores inequalities in…
Improved measurement for mothers, newborns and children in the era of the Sustainable Development Goals
BACKGROUND: An urgent priority in maternal, newborn and child health is to accelerate the scale-up of cost-effective essential interventions, especially during labor, the immediate postnatal period and for the treatment of serious infectious diseases and acute malnutrition. Tracking intervention coverage is a key activity to support scale-up and in this paper we examine priorities in coverage measurement, distinguishing between essential interven…
Assessment of the impact of quality improvement interventions on the quality of sick child care provided by Health Extension Workers in Ethiopia
BACKGROUND: Ethiopia has scaled up integrated community case management of childhood illness (iCCM), including several interventions to improve the performance of Health Extension Workers (HEWs). We assessed associations between interventions to improve iCCM quality of care and the observed quality of care among HEWs. METHODS: We assessed iCCM implementation strength and quality of care provided by HEWs in Ethiopia. Multivariate logistic regressi…
Diarrhea management in children under five in sub-Saharan Africa
Many children's lives can be saved with correct management of childhood diarrhea. Too many children are not receiving adequate care for diarrhea in high-burden sub-Saharan African countries, even among those seen in health facilities. Redoubling efforts to increase careseeking and improve quality of care for childhood diarrhea in both health facilities and at community level is an urgent priority
Access to integrated community case management of childhood illnesses services in rural Ethiopia
BACKGROUND: In 2010, Ethiopia began scaling up the integrated community case management (iCCM) of childhood illness strategy throughout the country allowing health extension workers (HEWs) to treat children in rural health posts. After 2 years of iCCM scale up, utilization of HEWs remains low. Little is known about factors related to the use of health services in this setting. This research aimed to elicit perceptions and experiences of caregiver…
Fluid curtailment during childhood diarrhea
The harmful practice of curtailing fluids for a child with diarrhea is highly prevalent, representing an increased risk of dehydration and complications due to diarrhea, including death, especially for children in specific subgroups
Improving and sustaining quality of child health care through IMCI training and supervision
BACKGROUND: The Integrated Management of Childhood Illness (IMCI) strategy includes guidelines for the management of sick children at first-level facilities. These guidelines intend to improve quality of care by ensuring a complete assessment of the child's health and by providing algorithms that combine presenting symptoms into a set of illness classifications for management by IMCI-trained service providers at first-level facilities. OBJECTIVES…
Using LiST to model potential reduction in under-five mortality in Burkina Faso
These findings suggest that significant reductions in under-five mortality may be achieved through the scale-up of the Acceleration. The Ministry of Health and its partners in Burkina Faso should continue their efforts to scale up these proven interventions to achieve and even exceed target levels for coverage
Thank You to Reviewers 2012
Quality of sick child care delivered by Health Surveillance Assistants in Malawi
OBJECTIVE: To assess the quality of care provided by Health Surveillance Assistants (HSAs)-a cadre of community-based health workers-as part of a national scale-up of community case management of childhood illness (CCM) in Malawi. METHODS: Trained research teams visited a random sample of HSAs (n = 131) trained in CCM and provided with initial essential drug stocks in six districts, and observed the provision of sick child care. Trained clinician…
Equity in maternal, newborn, and child health interventions in Countdown to 2015
Countdown to 2015 decade report (2000–10)
Maternal and child undernutrition
Integrated Management of Childhood Illness
OBJECTIVE: The Integrated Management of Childhood Illness is a strategy designed to address major causes of child mortality. The aim of this study was to assess the impact of the strategy on the quality of child health care provided at primary facilities. METHODS: Child health quality of care and costs were compared in four states in Northeastern Brazil, in 2001. There were studied 48 health facilities considered to have had stable strategy imple…
WHO estimates of the causes of death in children
Ten methodological lessons from the Multi-Country Evaluation of Integrated Management of Childhood Illness
OBJECTIVE: To describe key methodological aspects of the Multi-Country Evaluation of the Integrated Management of Childhood Illness strategy (MCE-IMCI) and analyze their implications for other public health impact evaluations. DESIGN: The MCE-IMCI evaluation designs are based on an impact model that defined expectations in the late 1990s about how IMCI would be implemented at country level and below, and the outcomes and impact it would have on c…
Implementation of the Integrated Management of Childhood Illness strategy in Peru and its association with health indicators
The Multi-Country Evaluation of Integrated Management of Childhood Illness (IMCI) Effectiveness, Cost and Impact (MCE) was launched to assess the global effectiveness of this strategy. Impact evaluations were started in five countries. The objectives of the Peru MCE were: (1) to document trends in IMCI implementation in the 24 departments of Peru from 1996 to 2000; (2) to document trends in indicators of health services coverage and impact (morta…
Improving quality and efficiency of facility-based child health care through Integrated Management of Childhood Illness in Tanzania
IMCI improved the quality and efficiency of child health care relative to routine child health care in the study districts. Previous study results indicated that the introduction of IMCI in these Tanzanian districts was associated with mortality levels that were 13% lower than in comparison districts. We can therefore conclude that IMCI is also more cost-effective than routine care for improving child health outcomes. The dissemination strategy f…
Out-of-pocket payments for under-five health care in rural southern Tanzania
Catastrophic payments and fairness in financial contributions for health care are becoming increasing concerns for many governments. Out-of-pocket financing for health care is common in many developing countries, including Tanzania. As part of the Multi-Country Evaluation of the Integrated Management of Childhood Illness (MCE-IMCI), the objective of this paper is to explore the determinants of variation and the level of out-of-pocket payments for…
Scaling up Integrated Management of Childhood Illness to the national level
This paper presents the first published report of a national-level effort to implement the Integrated Management of Childhood Illness (IMCI) strategy at scale. IMCI was introduced in Peru in late 1996, the early implementation phase started in 1997, with the expansion phase starting in 1998. Here we report on a retrospective evaluation designed to describe and analyze the process of taking IMCI to scale in Peru, conducted as one of five studies w…
Context matters
Appropriate consideration of contextual factors is essential for ensuring internal and external validity of randomized and non-randomized evaluations. Contextual factors may confound the association between delivery of the intervention and its potential health impact. They may also modify the effect of the intervention or programme, thus affecting the generalizability of results. This is particularly true for large-scale health programmes, for wh…
Evidence-Based Public Health
Randomized controlled trials (RCTs) are essential for evaluating the efficacy of clinical interventions, where the causal chain between the agent and the outcome is relatively short and simple and where results may be safely extrapolated to other settings. However, causal chains in public health interventions are complex, making RCT results subject to effect modification in different populations. Both the internal and external validity of RCT fin…
Context matters
Appropriate consideration of contextual factors is essential for ensuring internal and external validity of randomized and non-randomized evaluations. Contextual factors may confound the association between delivery of the intervention and its potential health impact. They may also modify the effect of the intervention or programme, thus affecting the generalizability of results. This is particularly true for large-scale health programmes, for wh…
Programmatic pathways to child survival
OBJECTIVE: To summarize the expectations held by World Health Organization programme personnel about how the introduction of the Integrated Management of Childhood Illness (IMCI) strategy would lead to improvements in child health and nutrition, to compare these expectations with what was learned from the Multi-Country Evaluation of IMCI Effectiveness, Cost and Impact (MCE-IMCI), and to discuss the implications of these findings for child surviva…
Life experiences, response styles and mental health among mothers and children in Beirut, Lebanon
Effect of Integrated Management of Childhood Illness (IMCI) on health worker performance in Northeast-Brazil
A multi-country evaluation is being carried out in Brazil and four other countries to determine the effectiveness, cost, and impact of the Integrated Management of Childhood Illness (IMCI). We examine the effect of IMCI on the quality of health care provided to children under five visiting health facilities. A health facility survey was conducted at 24 facilities (12 with IMCI) in each of four States in the Northeast. We assessed the quality of c…
Improving facility-based care for sick children in Uganda
This study assessed the effects of scaling-up Integrated Management of Childhood Illness (IMCI) on the quality of care received by sick children in 10 districts in Uganda. Health workers trained in IMCI were found to deliver significantly better care than health workers who had not yet been trained, but absolute levels of service quality remained low. Achieving training coverage alone is not sufficient as a strategy to improve and sustain care qu…
Scaling up Integrated Management of Childhood Illness to the national level
This paper presents the first published report of a national-level effort to implement the Integrated Management of Childhood Illness (IMCI) strategy at scale. IMCI was introduced in Peru in late 1996, the early implementation phase started in 1997, with the expansion phase starting in 1998. Here we report on a retrospective evaluation designed to describe and analyze the process of taking IMCI to scale in Peru, conducted as one of five studies w…
Child Health
In most countries, rates of mortality and malnutrition among children continue to decline, but large inequalities between poor and better-off children exist, both between and within countries. These inequalities, which appear to be widening, call into question the strategies for child mortality reduction relied upon to date. We review (1) what is known about the causes of socioeconomic inequalities in child health and where programs aimed at redu…
The Multi-Country Evaluation of the Integrated Management of Childhood Illness Strategy
The Multi-Country Evaluation of the Integrated Management of Childhood Illness (IMCI) includes studies of the effectiveness, cost, and impact of the IMCI strategy in Bangladesh, Brazil, Peru, Tanzania, and Uganda. Seven questions were addressed when the evaluation was designed: who would be in charge, through what mechanisms IMCI could affect child health, whether the focus would be efficacy or effectiveness, what indicators would be measured, wh…
The Family and Television
The potential of family members to serve as mediators of learning from television has received increasing amounts of attention in the literature. At the same time, the involvement of parents in their children's viewing has been found to be low. Using sample episodes from an ethnographic research study, this article describes several types of family mediation that have not been emphasized in the literature: contextual mediation, informal verbal me…
Integrated Management of Childhood Illness
OBJECTIVE: The Integrated Management of Childhood Illness is a strategy designed to address major causes of child mortality. The aim of this study was to assess the impact of the strategy on the quality of child health care provided at primary facilities. METHODS: Child health quality of care and costs were compared in four states in Northeastern Brazil, in 2001. There were studied 48 health facilities considered to have had stable strategy imple…
Ten methodological lessons from the Multi-Country Evaluation of Integrated Management of Childhood Illness
OBJECTIVE: To describe key methodological aspects of the Multi-Country Evaluation of the Integrated Management of Childhood Illness strategy (MCE-IMCI) and analyze their implications for other public health impact evaluations. DESIGN: The MCE-IMCI evaluation designs are based on an impact model that defined expectations in the late 1990s about how IMCI would be implemented at country level and below, and the outcomes and impact it would have on c…
Improving quality and efficiency of facility-based child health care through Integrated Management of Childhood Illness in Tanzania
IMCI improved the quality and efficiency of child health care relative to routine child health care in the study districts. Previous study results indicated that the introduction of IMCI in these Tanzanian districts was associated with mortality levels that were 13% lower than in comparison districts. We can therefore conclude that IMCI is also more cost-effective than routine care for improving child health outcomes. The dissemination strategy f…
Measuring the quality of child health care at first-level facilities
Assessing the quality of facility-based child survival services
The facility-based assessment (FBA) method is a co-ordinated set of data collection activities, designed to determine the extent to which children are properly diagnosed and effectively treated at health facilities. Eleven African countries have conducted facility-based assessments since 1986, with support from the African Child Survival Initiative-Combatting Childhood Communicable Diseases project. Components of the FBA include observations of h…
Out-of-pocket payments for under-five health care in rural southern Tanzania
Catastrophic payments and fairness in financial contributions for health care are becoming increasing concerns for many governments. Out-of-pocket financing for health care is common in many developing countries, including Tanzania. As part of the Multi-Country Evaluation of the Integrated Management of Childhood Illness (MCE-IMCI), the objective of this paper is to explore the determinants of variation and the level of out-of-pocket payments for…
Quality of sick child care delivered by Health Surveillance Assistants in Malawi
OBJECTIVE: To assess the quality of care provided by Health Surveillance Assistants (HSAs)-a cadre of community-based health workers-as part of a national scale-up of community case management of childhood illness (CCM) in Malawi. METHODS: Trained research teams visited a random sample of HSAs (n = 131) trained in CCM and provided with initial essential drug stocks in six districts, and observed the provision of sick child care. Trained clinician…
Implementation of the Integrated Management of Childhood Illness strategy in Peru and its association with health indicators
The Multi-Country Evaluation of Integrated Management of Childhood Illness (IMCI) Effectiveness, Cost and Impact (MCE) was launched to assess the global effectiveness of this strategy. Impact evaluations were started in five countries. The objectives of the Peru MCE were: (1) to document trends in IMCI implementation in the 24 departments of Peru from 1996 to 2000; (2) to document trends in indicators of health services coverage and impact (morta…
Access to integrated community case management of childhood illnesses services in rural Ethiopia
BACKGROUND: In 2010, Ethiopia began scaling up the integrated community case management (iCCM) of childhood illness strategy throughout the country allowing health extension workers (HEWs) to treat children in rural health posts. After 2 years of iCCM scale up, utilization of HEWs remains low. Little is known about factors related to the use of health services in this setting. This research aimed to elicit perceptions and experiences of caregiver…
Improving and sustaining quality of child health care through IMCI training and supervision
BACKGROUND: The Integrated Management of Childhood Illness (IMCI) strategy includes guidelines for the management of sick children at first-level facilities. These guidelines intend to improve quality of care by ensuring a complete assessment of the child's health and by providing algorithms that combine presenting symptoms into a set of illness classifications for management by IMCI-trained service providers at first-level facilities. OBJECTIVES…
Life Experiences among Low-Income Mothers in Beirut
The Family and Television
The potential of family members to serve as mediators of learning from television has received increasing amounts of attention in the literature. At the same time, the involvement of parents in their children's viewing has been found to be low. Using sample episodes from an ethnographic research study, this article describes several types of family mediation that have not been emphasized in the literature: contextual mediation, informal verbal me…
Life Experiences among Low-Income Mothers in Beirut
Life experiences, response styles and mental health among mothers and children in Beirut, Lebanon
Assessing the quality of facility-based child survival services
The facility-based assessment (FBA) method is a co-ordinated set of data collection activities, designed to determine the extent to which children are properly diagnosed and effectively treated at health facilities. Eleven African countries have conducted facility-based assessments since 1986, with support from the African Child Survival Initiative-Combatting Childhood Communicable Diseases project. Components of the FBA include observations of h…
Inequities among the very poor
Where and why are 10 million children dying every year?
Child Health
In most countries, rates of mortality and malnutrition among children continue to decline, but large inequalities between poor and better-off children exist, both between and within countries. These inequalities, which appear to be widening, call into question the strategies for child mortality reduction relied upon to date. We review (1) what is known about the causes of socioeconomic inequalities in child health and where programs aimed at redu…
Evidence-Based Public Health
Randomized controlled trials (RCTs) are essential for evaluating the efficacy of clinical interventions, where the causal chain between the agent and the outcome is relatively short and simple and where results may be safely extrapolated to other settings. However, causal chains in public health interventions are complex, making RCT results subject to effect modification in different populations. Both the internal and external validity of RCT fin…
The Multi-Country Evaluation of the Integrated Management of Childhood Illness Strategy
The Multi-Country Evaluation of the Integrated Management of Childhood Illness (IMCI) includes studies of the effectiveness, cost, and impact of the IMCI strategy in Bangladesh, Brazil, Peru, Tanzania, and Uganda. Seven questions were addressed when the evaluation was designed: who would be in charge, through what mechanisms IMCI could affect child health, whether the focus would be efficacy or effectiveness, what indicators would be measured, wh…
Effect of Integrated Management of Childhood Illness (IMCI) on health worker performance in Northeast-Brazil
A multi-country evaluation is being carried out in Brazil and four other countries to determine the effectiveness, cost, and impact of the Integrated Management of Childhood Illness (IMCI). We examine the effect of IMCI on the quality of health care provided to children under five visiting health facilities. A health facility survey was conducted at 24 facilities (12 with IMCI) in each of four States in the Northeast. We assessed the quality of c…
WHO estimates of the causes of death in children
Ten methodological lessons from the Multi-Country Evaluation of Integrated Management of Childhood Illness
OBJECTIVE: To describe key methodological aspects of the Multi-Country Evaluation of the Integrated Management of Childhood Illness strategy (MCE-IMCI) and analyze their implications for other public health impact evaluations. DESIGN: The MCE-IMCI evaluation designs are based on an impact model that defined expectations in the late 1990s about how IMCI would be implemented at country level and below, and the outcomes and impact it would have on c…
Implementation of the Integrated Management of Childhood Illness strategy in Peru and its association with health indicators
The Multi-Country Evaluation of Integrated Management of Childhood Illness (IMCI) Effectiveness, Cost and Impact (MCE) was launched to assess the global effectiveness of this strategy. Impact evaluations were started in five countries. The objectives of the Peru MCE were: (1) to document trends in IMCI implementation in the 24 departments of Peru from 1996 to 2000; (2) to document trends in indicators of health services coverage and impact (morta…
Improving quality and efficiency of facility-based child health care through Integrated Management of Childhood Illness in Tanzania
IMCI improved the quality and efficiency of child health care relative to routine child health care in the study districts. Previous study results indicated that the introduction of IMCI in these Tanzanian districts was associated with mortality levels that were 13% lower than in comparison districts. We can therefore conclude that IMCI is also more cost-effective than routine care for improving child health outcomes. The dissemination strategy f…
Out-of-pocket payments for under-five health care in rural southern Tanzania
Catastrophic payments and fairness in financial contributions for health care are becoming increasing concerns for many governments. Out-of-pocket financing for health care is common in many developing countries, including Tanzania. As part of the Multi-Country Evaluation of the Integrated Management of Childhood Illness (MCE-IMCI), the objective of this paper is to explore the determinants of variation and the level of out-of-pocket payments for…
Scaling up Integrated Management of Childhood Illness to the national level
This paper presents the first published report of a national-level effort to implement the Integrated Management of Childhood Illness (IMCI) strategy at scale. IMCI was introduced in Peru in late 1996, the early implementation phase started in 1997, with the expansion phase starting in 1998. Here we report on a retrospective evaluation designed to describe and analyze the process of taking IMCI to scale in Peru, conducted as one of five studies w…
Context matters
Appropriate consideration of contextual factors is essential for ensuring internal and external validity of randomized and non-randomized evaluations. Contextual factors may confound the association between delivery of the intervention and its potential health impact. They may also modify the effect of the intervention or programme, thus affecting the generalizability of results. This is particularly true for large-scale health programmes, for wh…
Improving facility-based care for sick children in Uganda
This study assessed the effects of scaling-up Integrated Management of Childhood Illness (IMCI) on the quality of care received by sick children in 10 districts in Uganda. Health workers trained in IMCI were found to deliver significantly better care than health workers who had not yet been trained, but absolute levels of service quality remained low. Achieving training coverage alone is not sufficient as a strategy to improve and sustain care qu…
Programmatic pathways to child survival
OBJECTIVE: To summarize the expectations held by World Health Organization programme personnel about how the introduction of the Integrated Management of Childhood Illness (IMCI) strategy would lead to improvements in child health and nutrition, to compare these expectations with what was learned from the Multi-Country Evaluation of IMCI Effectiveness, Cost and Impact (MCE-IMCI), and to discuss the implications of these findings for child surviva…
Measuring the quality of child health care at first-level facilities
Maternal and child undernutrition
Integrated Management of Childhood Illness
OBJECTIVE: The Integrated Management of Childhood Illness is a strategy designed to address major causes of child mortality. The aim of this study was to assess the impact of the strategy on the quality of child health care provided at primary facilities. METHODS: Child health quality of care and costs were compared in four states in Northeastern Brazil, in 2001. There were studied 48 health facilities considered to have had stable strategy imple…
Countdown to 2015 decade report (2000–10)
Equity in maternal, newborn, and child health interventions in Countdown to 2015
Using LiST to model potential reduction in under-five mortality in Burkina Faso
These findings suggest that significant reductions in under-five mortality may be achieved through the scale-up of the Acceleration. The Ministry of Health and its partners in Burkina Faso should continue their efforts to scale up these proven interventions to achieve and even exceed target levels for coverage
Medicine (34 works) · Environmental health (29 works) · Global Maternal and Child Health (29 works) · Child Nutrition and Water Access (23 works) · Nursing (23 works) · Economic growth (21 works) · Population (21 works) · Developing country (19 works) · Health services (16 works) · Integrated Management of Childhood Illness (14 works)