13,011 research outputs found

    Tackling Ultra-Poverty Through the Graduation Approach: Situating Sustainable Livelihoods in the Landscape of Social Protection and Safety Nets

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    BRAC was founded in Bangladesh in 1972 and now works in nine other countries with very impoverished populations: Afghanistan, Pakistan, Myanmar, Philippines, Uganda, Tanzania, South Sudan, Sierra Leone and Liberia. From its years of experience designing and implementing microfinance and other programs, BRAC gained the insight that a unique set of interventions is required to bring out of extreme poverty those who they, and now others, call the "ultra-poor": people living on half or less of a US $1.25-a-day poverty threshold. BRAC pioneered the approach in 2002 by combining social safety nets with support for income-generating, and named it the Graduation approach, or Targeting the Ultra Poor (TUP) program. Graduation programs complement small cash stipends and in-kind asset transfers with several other sequenced interventions including savings, training, social integration and health care services. Over the last decade the Consultative Group to Assist the Poor (CGAP), the Ford Foundation, and other donors have supported ten pilots across different continents which have been carefully analyzed, and in which over 75% of participants have met Graduation requirements. This paper summarizes the landscape and institutional context within which the Targeting the Ultra-poor program sits, in order to help BRAC and other organizations to expand its scale and encourage others to support and adopt this approach, thereby helping an additional one million families graduate from ultra-poverty by 2020

    Evaluating the impact of physical activity apps and wearables: interdisciplinary review

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    Background: Although many smartphone apps and wearables have been designed to improve physical activity, their rapidly evolving nature and complexity present challenges for evaluating their impact. Traditional methodologies, such as randomized controlled trials (RCTs), can be slow. To keep pace with rapid technological development, evaluations of mobile health technologies must be efficient. Rapid alternative research designs have been proposed, and efficient in-app data collection methods, including in-device sensors and device-generated logs, are available. Along with effectiveness, it is important to measure engagement (ie, users’ interaction and usage behavior) and acceptability (ie, users’ subjective perceptions and experiences) to help explain how and why apps and wearables work. Objectives: This study aimed to (1) explore the extent to which evaluations of physical activity apps and wearables: employ rapid research designs; assess engagement, acceptability, as well as effectiveness; use efficient data collection methods; and (2) describe which dimensions of engagement and acceptability are assessed. Method: An interdisciplinary scoping review using 8 databases from health and computing sciences. Included studies measured physical activity, and evaluated physical activity apps or wearables that provided sensor-based feedback. Results were analyzed using descriptive numerical summaries, chi-square testing, and qualitative thematic analysis. Results: A total of 1829 abstracts were screened, and 858 articles read in full. Of 111 included studies, 61 (55.0%) were published between 2015 and 2017. Most (55.0%, 61/111) were RCTs, and only 2 studies (1.8%) used rapid research designs: 1 single-case design and 1 multiphase optimization strategy. Other research designs included 23 (22.5%) repeated measures designs, 11 (9.9%) nonrandomized group designs, 10 (9.0%) case studies, and 4 (3.6%) observational studies. Less than one-third of the studies (32.0%, 35/111) investigated effectiveness, engagement, and acceptability together. To measure physical activity, most studies (90.1%, 101/111) employed sensors (either in-device [67.6%, 75/111] or external [23.4%, 26/111]). RCTs were more likely to employ external sensors (accelerometers: P=.005). Studies that assessed engagement (52.3%, 58/111) mostly used device-generated logs (91%, 53/58) to measure the frequency, depth, and length of engagement. Studies that assessed acceptability (57.7%, 64/111) most often used questionnaires (64%, 42/64) and/or qualitative methods (53%, 34/64) to explore appreciation, perceived effectiveness and usefulness, satisfaction, intention to continue use, and social acceptability. Some studies (14.4%, 16/111) assessed dimensions more closely related to usability (ie, burden of sensor wear and use, interface complexity, and perceived technical performance). Conclusions: The rapid increase of research into the impact of physical activity apps and wearables means that evaluation guidelines are urgently needed to promote efficiency through the use of rapid research designs, in-device sensors and user-logs to assess effectiveness, engagement, and acceptability. Screening articles was time-consuming because reporting across health and computing sciences lacked standardization. Reporting guidelines are therefore needed to facilitate the synthesis of evidence across disciplines

    A Roadmap for Promoting Women's Economic Empowerment

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    This document summarizes findings of 18 research studies commissioned across 4 categories (entrepreneurship, farming, wage employment, young women's employment) to find out what works to empower women, for whom (categories of women), and where (country scenarios). The Roadmap is designed to guide investments from private sector and public-private partnerships, and highlights 9 proven, 9 promising, and 6 high-potential interventions to increase women's productivity and earnings in developing countries

    Combined Structural Interventions for Gender Equality and Livelihood Security: A Critical Review of the Evidence from Southern and Eastern Africa and the Implications for Young People

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    This document presents information on how young people in southern and eastern Africa remain disproportionately vulnerable to HIV with gender inequalities and livelihood insecurities being key drivers of this. Behavioural HIV prevention interventions have had weak outcomes and a new generation of structural interventions have emerged seeking to challenge the wider drivers of the HIV epidemic, including gender inequalities and livelihood insecurities. We searched key academic data bases to identify interventions that simultaneously sought to strengthen people's livelihoods and transform gender relationships that had been evaluated in southern and eastern Africa. Our initial search identified 468 articles. We manually reviewed these and identified nine interventions that met our criteria for inclusion. We clustered the nine interventions into three groups: microfinance and gender empowerment interventions; supporting greater participation of women and girls in primary and secondary education; and gender empowerment and financial literacy interventions. We summarise the strengths and limitations of these interventions, with a particular focus on what lessons may be learnt for young people

    Evaluating Innovative Health Programs: Lessons for Health Policy

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    The Global Development Network’s (GDN) project “Evaluating Innovative Health Programs” (EIHP), funded by the Bill & Melinda Gates Foundation, seeks to inform policy on the effectiveness of health solutions that have the potential to improve health outcomes in developing countries. It evaluates the impact of nineteen programs from across developing and transition countries that focus on the health-related Millennium Development Goals (MDGs) of reducing child and maternal mortality, and halting and reversing the trend of communicable diseases such as HIV/AIDS, malaria and other diseases. The policy implications of the diverse set of interventions are distinguished between programs that involved earmarking resources, changing incentives, and developing innovative methods of health care delivery.Millennium Development Goals; child and maternal health; communicable diseases; impact evaluation; capacity building; Asia; Africa; Latin America

    Socially-marketed rapid diagnostic tests and ACT in the private sector: ten years of experience in Cambodia.

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    Whilst some populations have recently experienced dramatic declines in malaria, the majority of those most at risk of Plasmodium falciparum malaria still lack access to effective treatment with artemisinin combination therapy (ACT) and others are already facing parasites resistant to artemisinins.In this context, there is a crucial need to improve both access to and targeting of ACT through greater availability of good quality ACT and parasitological diagnosis. This is an issue of increasing urgency notably in the private commercial sector, which, in many countries, plays an important role in the provision of malaria treatment. The Affordable Medicines Facility for malaria (AMFm) is a recent initiative that aims to increase the provision of affordable ACT in public, private and NGO sectors through a manufacturer-level subsidy. However, to date, there is little documented experience in the programmatic implementation of subsidized ACT in the private sector. Cambodia is in the unique position of having more than 10 years of experience not only in implementing subsidized ACT, but also rapid diagnostic tests (RDT) as part of a nationwide social marketing programme. The programme includes behaviour change communication and the training of private providers as well as the sale and distribution of Malarine, the recommended ACT, and Malacheck, the RDT. This paper describes and evaluates this experience by drawing on the results of household and provider surveys conducted since the start of the programme. The available evidence suggests that providers' and consumers' awareness of Malarine increased rapidly, but that of Malacheck much less so. In addition, improvements in ACT and RDT availability and uptake were relatively slow, particularly in more remote areas.The lack of standardization in the survey methods and the gaps in the data highlight the importance of establishing a clear system for monitoring and evaluation for similar initiatives. Despite these limitations, a number of important lessons can still be learnt. These include the importance of a comprehensive communications strategy and of a sustained and reliable supply of products, with attention to the geographical reach of both. Other important challenges relate to the difficulty in incentivising providers and consumers not only to choose the recommended drug, but to precede this with a confirmatory blood test and ensure that providers adhere to the test results and patients to the treatment regime. In Cambodia, this is particularly complicated due to problems inherent to the drug itself and the emergence of artemisinin resistance

    Public Service Delivery: Role of Information and Communication Technology in Improving Governance and Development Impact

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    The focus of this paper is on improving governance through the use of information and communication technology (ICT) in the delivery of services to the poor, i.e., improving efficiency, accountability, and transparency, and reducing bribery. A number of papers recognize the potential benefits but they also point out that it has not been easy to harness this potential. This paper presents an analysis of effective case studies from developing countries where the benefits have reached a large number of poor citizens. It also identifies the critical success factors for wide-scale deployment. The paper includes cases on the use of ICTs in the management of delivery of public services in health, education, and provision of subsidized food. Cases on electronic delivery of government services, such as providing certificates and licenses to rural populations, which in turn provide entitlements to the poor for subsidized food, fertilizer, and health services are also included. ICT-enabled provision of information to enhance rural income is also covered
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