The objective of this project was to achieve high, sustainable levels of net coverage in a village in rural Tanzania by combining free distribution of long-lasting insecticide-impregnated nets (LLINs) with community-tailored education. Community leaders held an educational session for two members of every household addressing these practice and attitudes, demonstrating proper LLIN use, and emphasizing behaviour modification. Attendees received one or two LLINs per household. Baseline interviews and surveys revealed incorrect practices and attitudes regarding: use of nets in dry season, need to retreat LLINs, children napping under nets, need to repair nets and net procurement as a priority, with 53- 88.6% incorrect responses. A three-week follow-up demonstrated 83-95% correct responses. Results suggest that addressing community-specific practices and attitudes prior to LLIN distribution promotes consistent and correct use, and helps change attitudes towards bed nets as a preventative health measure. Future LLIN distributions can learn from the paradigm established in this project.
Governance and participation in health
This book builds on eight case studies, all loosely involving financial networks such as the G20, several written by network insiders, to try and sort out whether networks are a blessing or a curse for developing countries. The contributors ask a number of questions: Are networks exciting new avenues for poor country governments and civil society to influence the big decisions, or sneaky ways to get round accountability and exclude the population through a 21st century version of invitation-only gentleman’s clubs? Will they replace or strengthen formal international institutions like the United Nations or the International Monetary Fund? Are North-South networks different from South-South ones? (both are proliferating). The book sets out five functions of networks: agenda setting; consensus building; policy coordination; knowledge exchange and production and norm-setting and diffusion. It identifies two categories of network. Advocacy networks aim to mobilise support for a cause and concentrate on the agenda-setting, norm-setting and consensus-building functions, while ‘self-help’ or ‘problem-sharing’ networks focus on improving members’ capacities through knowledge production and exchange and policy coordination.
This case study describes a multisectoral adolescent sexual and reproductive health (ASRH) programme with three main components: clinical youth-friendly health services (YFHS), inschool interventions and community-based outreach. It has been written for programme and project managers at national, district and local levels interested in the implementation and scale-up of multisectoral programmes that encompass YFHS. It outlines the process used to design, implement, monitor and evaluate the Geração Biz programme in Mozambique. The steps taken during the pilot phase and subsequent scale-up of the programme are described, as well as key lessons learned. This case study is intended to provide an example of how to design and implement a multisectoral programme that is intended to be scaled up from the beginning. Although other countries have different political, social and cultural contexts, the experience and lessons learned here could be adapted and applied to help other countries that wish to establish or scale up YFHS within multisectoral programmes.
Despite several years of implementation, prevention of mother-to-child transmission (PMTCT) programmes in many resource poor settings are failing to reach the majority of HIV positive women. This study reports on a data-driven participatory quality improvement intervention implemented in a high HIV prevalence district in South Africa. The intervention consisted of an initial assessment undertaken by a team of district supervisors, workshops to assess results, identify weaknesses and set improvement targets and continuous monitoring to support changes. Routine data revealed poor coverage of all programme indicators except HIV testing. One year following the intervention, large improvements in programme indicators were observed. Coverage of CD4 testing increased from 40 to 97%, uptake of maternal nevirapine from 57 to 96%, uptake of infant nevirapine from 15 to 68% and six week polymerase chain reaction (PCR) testing from 24 to 68%. It is estimated that these improvements in coverage could avert 580 new infant infections per year in this district.
The University of Oxford's Global Economic Governance Programme has launched an independent Expert Taskforce on Global Knowledge Governance to propose a set of principles and options for the future of global knowledge governance. The Taskforce's Honorary Advisors emphasised the scope of global knowledge governance challenges at hand. The Taskforce will be led by a small, core team of experts participating in a personal capacity, supported by several distinguished Honorary Advisors. The Taskforce will consult widely, interviewing a diversity of academics, policy experts, and stakeholder communities around the world. The report will be peer-reviewed by a group of leading international scholars working on the intersection of issues covered in the study. The findings of the Taskforce will be published in late 2010 and presented to governments, relevant international organisations, stakeholders and academics working to shape how the future of global knowledge governance unfolds.
Policy briefs are a relatively new approach to packaging research evidence for policymakers. Drawing on available systematic reviews makes the process of mobilising evidence feasible in a way that would not otherwise be possible if individual relevant studies had to be identified and synthesised for every feature of the issue under consideration. This article suggests questions that can be used to guide those preparing and using policy briefs to support evidence-informed policymaking: Does the policy brief address a high-priority issue and describe the relevant context of the issue being addressed? Does the policy brief describe the problem, costs and consequences of options to address the problem, and the key implementation considerations? Does the policy brief employ systematic and transparent methods to identify, select, and assess synthesised research evidence? Does the policy brief take quality, local applicability, and equity considerations into account when discussing the synthesised research evidence? Does the policy brief employ a graded-entry format? Was the policy brief reviewed for both scientific quality and system relevance?
Increasing interest in the use of policy dialogues has been fuelled by a number of factors, such as recognition that: there is a need for locally contextualised 'decision support' for policymakers and other stakeholders; research evidence is only one input into the decision-making processes of policymakers and other stakeholders; having many stakeholders can add significant value to these processes; and many stakeholders can take action to address high-priority issues, and not just policymakers. This article suggests questions to guide those organising and using policy dialogues to support evidence-informed policymaking: Does the dialogue address a high-priority issue? Does the dialogue provide opportunities to discuss the problem, options to address the problem, and key implementation considerations? Is the dialogue informed by a pre-circulated policy brief and by a discussion about the full range of factors that can influence the policymaking process? Does the dialogue ensure fair representation among those who will be involved in, or affected by, future decisions related to the issue? Are outputs produced and follow-up activities undertaken to support action?
This article addresses strategies to inform and engage the public in policy development and implementation. The importance of engaging the public (both patients and citizens) at all levels of health systems is widely recognised. They are the ultimate recipients of the desirable and undesirable impacts of public policies, and many governments and organisations have acknowledged the value of engaging them in evidence-informed policy development. The potential benefits of doing this include the establishment of policies that include their ideas and address their concerns, the improved implementation of policies, improved health services, and better health. Public engagement can also be viewed as a goal in itself by encouraging participative democracy, public accountability and transparency. The article suggests three questions that can be considered with regard to public participation strategies: What strategies can be used when working with the mass media to inform the public about policy development and implementation? What strategies can be used when working with civil society groups to inform and engage them in policy development and implementation? What methods can be used to involve consumers in policy development and implementation?
This essay begins by describing various areas of volunteering, such as volunteering to build social capital and skills-based volunteering, where volunteers offers specific skills, such as medical skills. It goes on to outline the benefits of volunteering. Volunteering contributes to the development agenda by strengthening the voice of civil society organisations so they can influence policy, both at local and national levels, for the promotion of sustainable development and the improvement of livelihood security. Volunteering also helps to support communities to participate in development at local and national levels, as well as support communities to gain access to resources for local development and the improvement of essential services and to respond effectively to the HIV pandemic through programmes of prevention, care and support. Volunteering can support communities to realise their human rights, especially those of women and children.
In varying degrees, most developing regions have formally embraced the democracy and development agenda and recognised the ‘democratic advantage’ in terms of delivering development. In Africa, a stream of policy declarations have been issued, pointing to the positive links between democracy and development. Both the NEPAD and the Africa Peer Review Mechanism (APRM) are premised on this belief. This analysis confirms that there are few dissenting voices when it comes to formally recognising the potential added value of democracy for development. Yet do these high expectations resist the test of reality? How do democratic processes actually operate in third countries? Admittedly, the impact of democracy on development is not simple and straightforward. Challenges include the current trend for democracy to be on the defensive, doubts about the delivery capacity of democracy and the difficulty of initiating and continuing dialogue on democracy. This paper offers key insights on the link between democracy and development.