Making family planning accessible in resource-poor settings

Ndola Prata

It is imperative to make family planning more accessible in low resource settings. The poorest couples have the highest fertility, the lowest contraceptive use and the highest unmet need for contraception. It is also in the low resource settings where maternal and child mortality is the highest. Family planning can contribute to improvements in maternal and child health, especially in low resource settings where overall access to health services is limited. Four critical steps should be taken to increase access to family planning in resource-poor settings: (i) increase knowledge...

Tackling India’s HIV epidemic: lessons from Africa

Malcolm Potts
Julia Walsh

India stands on the brink of a major HIV epidemic. However, by examining where public health initiatives went wrong in Africa, the international community may be able to help India avoid the devastating effects seen in Africa

Published in BMJ, 6 21 2003, 326(7403):1389-92

Download PDF, click here.

Using the kanga to measure postpartum blood loss

N Prata
G Mbaruku
M Campbell

In rural African settings, the colorful fabric kanga is locally-made and inexpensive; every woman owns dozens for use as skirts and shawls. The kanga has become useful as a simple solution for the complicated problem of measuring blood loss after delivery. This commentary describes remarkable results when traditional birth attendants in Tanzania use the kanga to identify postpartum hemorrhage.

Published in International Journal of Gynecology and Obstetrics (2005) 89, 49—50

Download PDF,...

Private sector, human resources and health franchising in Africa

Ndola Prata
Dominic Montagu
Emma Jefferys

In much of the developing world, private health care providers and pharmacies are the most important sources of medicine and medical care and yet these providers are frequently not considered in planning for public health. This paper presents the available evidence, by socioeconomic status, on which strata of society benefit from publicly provided care and which strata use private health care. Using data from The World Bank’s Health Nutrition and Population Poverty Thematic Reports on 22 countries in Africa, an assessment was made of the use of public and private health services, by asset...

Lime Juice as a candidate for microbicide? An open-label safety trial of 10% and 20% lime juice used vaginally

A Hemmerling
M Potts
J Walsh
B Young-Holt
K Whaley
D Stefanski

Objective: Lime has a long history as a contraceptive and vaginal hygiene douche, and ongoing use in Africa is documented. We report on the first safety study on diluted lime juice to assess its potential as a candidate microbicide. Methods: Twenty-five sexually abstinent women were randomly assigned to apply a 10% or 20% concentration of lime juice or 0% (water-only) through a soaked tampon once daily for 14 consecutive days. Tests for genital infections, measurement of inflammatory biomarkers, and a colposcopy were performed before and after treatment. Results: No participant showed...

Response to letters re: “Reassessing HIV Prevention,”


Science, 2008

This article is a response to letters sent in to Science regarding the article “Reassessing HIV Prevention” by Potts M, Halperin DT, Kirby D, Swidler A, Marseille E, Klausner JD, Hearst N, Wamai RG, Kahn JG, Walsh J. 2008 May 9;320(5877):749-50. 2008;

The authors argue, “Population-level disease control efforts must be evidence-based, culturally acceptable, and feasible...

Crisis in the Sahel: Possible Solutions and the Consequences of Inaction

Malcolm Potts
Eliya Zulu
Michael Wehner
Federico Castillo
Courtney Henderson

The following report documents how, over the next 30 to 40 years in parts of sub- Saharan Africa, between 100 million and 200 million people are likely to be without sustainable food supplies. This was the conclusion of a multidisciplinary group of experts from Africa and North America, who asked what will happen in the Sahel when new projections of global warming are combined with rapid population growth. The meeting was not the first on the Sahel, but the breadth of expertise in agriculture, climatology, demography, family planning, the status of women, terrorism, and national security...

Meeting the need: youth and family planning in sub-Saharan Africa

Ndola Prata
Karen Weidert
Amita Sreenevas

Background: The need for a concerted effort to address the gaps in family planning services for youth in sub-Saharan Africa has been underreported and underexplored.

Study Design: Trends in fertility, childbearing, unmet need for family planning options and contraceptive prevalence (CP) among youth are described with data from six African countries with four consecutive Demographic and Health Surveys. Estimates of exposure to risk of pregnancy and number of new contraceptives users needed to maintain and double CP in 2015 are calculated using current CP and...

Big issues deserve bold responses: Population and climate change in the Sahel

Malcolm Potts
Alisha Graves

Parts of Africa have the most rapid population growth in the world. Recent studies by climatologists suggest that, in coming decades, ecologically vulnerable areas of Africa, including the Sahel will be exposed to the harshest adverse effects of global warming. The threat hanging over parts of sub-Saharan Africa is extreme. Fortunately, there are evidence-based achievable policies which can greatly ameliorate what would otherwise be a slowly unfolding catastrophe of stunning magnitude. But to succeed such measures must be taken immediately and on a large scale....