This paper implemented a qualitative analysis of wellbeing in life history interviews in Chiawa, rural Zambia. The enquiry goes beyond simply reading across methods, disciplines and contexts, to consider fundamental differences in constructions of the human subject, and how these relate to understandings of wellbeing. Field research took place in two periods, August–November, 2010 and 2012. Analysis drew on 46 individual case studies, conducted through open-ended interviews. These were identified through a survey with an average of 390 male and female household heads in each round, including 25% female headed households. As social determinants theory predicts, the interviews confirm elements of autonomy, competence and relatedness as vital to wellbeing. However, these are expressed in ways that highlight material and relational, rather than psychological, factors. The authors endorsed social determinants theory’s utility in interdisciplinary approaches to wellbeing, but only if it admits its own cultural grounding in the construction of socially and culturally distinctive questions on basic psychological needs.
Monitoring equity and research policy
An article published in the journal Nature on July 5 puts forward a new technique for the evaluation of research on development. It marks a departure from conventional approaches that, according to the author, have significant weaknesses. This new method for the evaluation of development research — known as RQ+ or Research Quality Plus — emphasises the crucial importance of context, local knowledge and the views of the populations whose lives the research aims to improve. Conventional approaches to evaluating scientific endeavours are argued by the author to have a number of inbuilt constraints. For example, they focus primarily on peer assessment or bibliometrics but don’t explicitly pass judgement on the originality or usefulness of the research, nor do they look at the degree of respect for local knowledge. The RQ+ approach goes beyond an evaluation focused solely on the scientific merit of research outputs and includes other dimensions that are essential to measuring the value and quality of research. RQ+ takes account of what evaluators have to say, but their views should be evidence-based, rather than a simple opinion. Those carrying out the evaluation should take into consideration external points of view — for example those of users targeted by the research or of the communities it is supposed to benefit — as well as the perspectives of other researchers working in the same field.
Community-based information systems (CBIS) are key to understanding how HIV programs are working to control the epidemic at the local level in countries with high burden. MEASURE Evaluation developed this collection of indicators to guide community-based HIV programs in monitoring their performance and thereby enhance informed decision making by governments, major donors, and implementing partners. The indicators cover the following themes: vulnerable children, prevention of mother-to-child transmission, key populations, HIV prevention, home-based care and data use cases. The site also provides useful resources and a summary list of indicators.
The authors report on conflicting figures for pregnancy and childbirth related deaths in Zimbabwe from 525 to 960 maternal deaths for every 100,000 live births. It would seem to be a relatively straightforward task to measure maternal mortality, but they note that in reality, that is not the case. Ideally, you would analyse death certificates, but even in countries with well-functioning birth and death registration systems, they report that the number of maternal deaths is routinely undercounted. This is because death certificates are not always complete and in some cases, the person signing a death certificate may not be aware that the woman was pregnant or that her pregnancy contributed in some way to her death. In some instances, health facilities have been known to try and conceal maternal mortalities because of political pressure to reduce the numbers. Zimbabwe is classified as a country with incomplete birth and death records by the UN. Researchers therefore rely on censuses and surveys to estimate maternal deaths. Household surveys reported 614 deaths / 100,000 live births for the period between 2007 and 2014, and 581 / 100 000 for 2009 to 2014, within the range of global organisations’ estimates.
Energy is crucial for achieving almost all of the sustainable development goals (SDGs), from eradication of poverty through advancements in health, education, water supply and industrialization to combating air pollution and climate change. This new report includes updated data from WHO on household air pollution showing that 3 billion people – or more than 40% of the world’s population – still do not have access to clean cooking fuels and technologies. Household air pollution from burning solid fuels and using kerosene for cooking alone are responsible for some 4 million deaths a year, with women and children being at greatest risk. The report provides a comprehensive summary of the world’s progress towards the global energy targets on access to electricity, clean cooking fuels, renewable energy and energy efficiency. It was launched at the Sustainable Energy for All forum held on 2 May 2018 in Lisbon, Portugal.
These four briefs (separately shown on this site) provide information on evaluation of social participation and power in health to support capacity and practice. They are intended primarily for those working directly with social participation and power in health systems, but also for managers, funders and others who engage with them. They intend to inform thinking and approaches and provide links to deeper resources and do not intend to prescribe or be a ’how to’ toolkit. The four briefs address:
BRIEF 1: The concepts and approaches applied in ‘monitoring and evaluation processes at www.tarsc.org/publications/documents/Shapinghealth%20eval%20brief%201%20May2018.pdf
BRIEF 2: Approaches to assessing change in social participation and power in health at www.tarsc.org/publications/documents/Shaping%20health%20eval%20brief%202%202018.pdf
BRIEF 3: The methods used for participatory evaluation at www.tarsc.org/publications/documents/Shaping%20health%20eval%20brief%203%202018.pdf
BRIEF 4: Engaging funders and formal systems on evaluations of social power in health at www.tarsc.org/publications/documents/Shaping%20health%20eval%20brief%204%202018.pdf
The authors propose that there are some underlying differences between the disciplines of epidemiology and economics how trials are used and conducted and how their results are reported and disseminated. They hypothesize that evidence-based public health could be strengthened by understanding these differences, harvesting best-practice across the disciplines and breaking down communication barriers between economists and epidemiologists who conduct trials of public health interventions. Differences between disciplines suggests that more can be done to incorporate behavioural theory into trials and to improve the reporting of trial results and share data. The authors hypothesize that evidence-based public health can be strengthened by understanding differences in how economists and epidemiologists conduct trials of public health interventions and harvesting best-practice across the disciplines.
This paper assessed, whether and how, two knowledge translation platforms housed in government-affiliated institutions in Cameroon and Uganda have influenced health system policy-making processes and decisions aiming at supporting achievement of the health millennium development goals and the general climate for evidence-informed health system policy-making. The authors conducted an embedded comparative case study of four policy processes in which Evidence Informed Policy Network Cameroon and Regional East African Community Health Policy Initiative Uganda were involved between 2009 and 2011. The authors combined a documentary review and semi structured interviews of 54 stakeholders. A framework-guided thematic analysis, inspired by scholarship in health policy analysis and knowledge utilization was used. The coproduction of evidence briefs combined with tacit knowledge gathered during inclusive evidence-informed stakeholder dialogues helped to reframe health system problems, unveil sources of conflicts, open grounds for consensus and align viable and affordable options for achieving the health millennium development goals thus leading to decisions. New policy issue networks have emerged. Knowledge translation platforms were perceived as change agents with positive impact on the understanding, acceptance and adoption of evidence-informed health system policy-making because of their complementary work in relation to capacity building, rapid evidence syntheses and clearinghouse of policy-relevant evidence. The authors indicate that this embedded case study illustrates how two knowledge translation platforms influenced policy decisions through pathways involving policy issue networks, interest groups interaction and evidence-supported ideas and how they influenced the general climate for evidence-informed health system policy.
This paper illustrates a case of applying the Urban Health Equity Assessment and Response Tool in Matsapha, Swaziland. A descriptive single-case study design using qualitative research methods was adopted to collect data from purposively selected respondents. The study revealed that residents of the Matsapha peri-urban informal settlements faced challenges with conditions of daily living which impacted negatively on their health. There were health equity gaps. The application of the tools was facilitated by the formation of an all-inclusive team, intersectoral collaboration and incorporating strategies for improving urban health equity into existing programmes and projects.
TDR Global has launched a 3-month mobilization initiative on gender equity in health research. The aim is to enhance women’s position in health research and to address the impact of gender on infectious diseases of poverty through research. The initiative will share experience and thoughts on gender equity in health research. Challenge-solving workshops are being planned to identify local challenges, create local teams and offer training. TDR Global talks are opportunities to share best practices and experiences on enhancing gender equity in health research. Working groups on specific issues are options for organizing webinars, training and sharing ideas.