Ghana has made great progress in meeting most Millennium Development Goals; 1 however, the country's reproductive health indicators continue to lag. Among married women, use of modern contraceptives is low (23%) and unmet need for family planning remains high (26%). 2 Similarly, the total fertility rate decreased only slightly between 1998 and 2008, from 4.4 to 4.0. 3 As a result, the Ghanaian government has identified increasing contraceptive prevalence as a priority. 4Among the reasons for low use of contraceptives in Ghana are barriers to access, stock-outs and a shortage of trained health staff.5 These problems are more acute in rural areas of the country, where health facilities tend to be few and the distribution chain is often weaker-conditions that contribute to an urban-rural disparity in contraceptive use and unmet need. 3 In addition, access to communitybased family planning services is limited outside of select hard-to-reach areas where nurses have been mandated to provide family planning as part of the Community-Based Health Planning and Services (CHPS) model. CHPS zones are currently being scaled up, but as of 2011, only 22% of the population was being served under CHPS. 6In many countries, private-sector drug shops are the first place people seek health care, especially in areas with few health facilities or pharmacies. [7][8][9][10] In Ghana, such shops are called licensed chemical sellers and are independent businesses operated by nonpharmacists who have a minimum of a secondary education and are licensed by the Pharmacy Council to sell some over-the-counter medicines. Shop operators sometimes receive training from the Licensed Chemical Seller Association and Pharmacy Council, but it is not required to obtain a license. As privately owned enterprises, licensed chemical seller shops are positioned to provide socially marketed family planning methods using their existing infrastructure, which is sustained by the sale of other health products. Most pill and condom users in Ghana (75% and 54%, respectively) receive their contraceptives from such shops; however, the country's most popular method-the threemonth injectable contraceptive, depot medroxyprogesterone acetate or DMPA-is a prescription drug and is available only from a qualified medical provider or for purchase, but not injection, from a pharmacy.3 Most injectable users (87%) rely on public-sector health facilities to receive their injections, even though these facilities often experience stock-outs of the method.

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Appreciative Leadership is unique among leadership theories both past and present. This uniqueness includes its strength-based practice, search for the positive in people and organizations, and the role this plays in organizational innovation and transformation. What follows is a summary of Appreciative Inquiry and the five main principles on which it is based. We then discuss Appreciative Leadership in terms of its place among leadership theories in general.Finally we look at the potential of Appreciative Leadership inK-12 contexts.

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Adolescent girls and young women (AGYW) are disproportionately affected by HIV, and oral pre-exposure prophylaxis (PrEP) can reduce HIV acquisition. The purpose of this scoping review was to synthesize results from interventions along the PrEP continuum for AGYW to inform research and programs. We searched electronic databases for studies published between January 2012–July 2021 and conducted secondary reference searching. Studies were included if they assessed interventions to increase PrEP interest, uptake, or continuation among AGYW. Results were synthesized narratively. Of 2168 citations identified, 50 studies were eligible for inclusion, and 20 contained AGYW-specific data. Among cisgender and transgender AGYW, studies overall demonstrated a positive impact on PrEP interest and uptake but generally attained suboptimal continuation rates. Results demonstrate feasibility of deploying PrEP across diverse settings—particularly when interventions are layered, tailored to AGYW, and include differentiated delivery—but also highlight knowledge gaps and the need for more holistic metrics of success.