Service delivery interventions to increase uptake of voluntary medical male circumcision for HIV prevention: A systematic review.

BackgroundVoluntary medical male circumcision (VMMC) remains an essential component of combination HIV prevention services, particularly in priority countries in sub-Saharan Africa. As VMMC programs seek to maximize impact and efficiency, and to support World Health Organization guidance, specific uptake-enhancing strategies are critical to identify.MethodsWe systematically reviewed the literature to evaluate the impact of service delivery interventions (e.g., facility layout, service co-location, mobile outreach) on VMMC uptake among adolescent and adult men. For the main effectiveness review, we searched for publications or conference abstracts that measured VMMC uptake or uptake of HIV testing or risk reduction counselling within VMMC services. We synthesized data by coding categories and outcomes. We also reviewed studies assessing acceptability, values/preferences, costs, and feasibility.ResultsFour randomized controlled trials and five observational studies were included in the effectiveness review. Studies took place in South Africa, Tanzania, Uganda, Zambia, and Zimbabwe. They assessed a range of service delivery innovations, including community-, school-, and facility-based interventions. Overall, interventions increased VMMC uptake; some successfully improved uptake among age-specific subpopulations, but urban-rural stratification showed no clear trends. Interventions that increased adult men's uptake included mobile services (compared to static facilities), home-based testing with active referral follow-up, and facility-based HIV testing with enhanced comprehensive sexual education. Six acceptability studies suggested interventions were generally perceived to help men choose to get circumcised. Eleven cost studies suggested interventions create economies-of-scale and efficiencies. Three studies suggested such interventions were feasible, improving facility preparedness, service quality and quantity, and efficiencies.ConclusionsInnovative changes in male-centered VMMC services can improve adult men's and adolescent boys' VMMC uptake. Limited evidence on interventions that enhance access and acceptability show promising results, but evidence gaps persist due to inconsistent intervention definition and delivery, due in part to contextual relevance and limited age disaggregation

Moving from rabies research to rabies control: lessons from India

BACKGROUND: Despite the availability of effective interventions and public recognition of the severity of the problem, rabies continues to suffer neglect by programme planners in India and other low and middle income countries. We investigate whether this state of 'policy impasse' is due to, at least in part, the research community not catering to the information needs of the policy makers. METHODS & FINDINGS: Our objective was to review the research output on rabies from India and examine its alignment with national policy priorities. A systematic literature review of all rabies research articles published from India between 2001 and 2011 was conducted. The distribution of conducted research was compared to the findings of an earlier research prioritization exercise. It was found that a total of 93 research articles were published from India since 2001, out of which 61% consisted of laboratory based studies focussing on rabies virus. Animals were the least studied group, comprising only 8% of the research output. One third of the articles were published in three journals focussing on vaccines and infectious disease epidemiology and the top 4 institutions (2 each from the animal and human health sectors) collectively produced 49% of the national research output. Biomedical research related to development of new interventions dominated the total output as opposed to the identified priority domains of socio-politic-economic research, basic epidemiological research and research to improve existing interventions. CONCLUSION: The paper highlights the gaps between rabies research and policy needs, and makes the case for developing a strategic research agenda that focusses on rabies control as an expected outcome

Local Government planning: from data to action

Decentralisation is built on the assu mption that decentralized governme nts are more knowledgeable about and responsive to the needs of the poor. This article ex amines the role of local governments in Kenya and the ways in which they make their decisions about the allocation of resources to deliver water and sanitation services. Two major challenges are identified: i) lack of data that accurately reveal which areas are most in need; and ii) inadequate instruments for planning, monitoring and evaluation. In tackling previous shortcomings, this study i) adopts a new specific appr oach for data collection at community level, and ii) exploits these data through simple composite indicator s as policy tools that assist local government with decision-making. It concludes that accurate and compre hensive data are the basis of effective targeting and prioritization, which are fundamental to sector planning.Peer ReviewedPostprint (published version

GLAAS 2014 Findings: Special report for Africa

The UN-Water GLAAS Special Report for Africa, an initiative led by WHO in close collaboration with the African Ministers' Council on Water and the African Development Bank, provides data from 39 African countries to take stock on progress made during the MDG period and to set the scene for the upcoming SDGs. The report highlights progress made in governance and increased investments. Challenges remain in monitoring as well as targeting funds to reach vulnerable groups

Center-commissioned external review of International Water Management Institute: Consolidated report, 19-29 May 2003

Agricultural research / Research institutes / Research policy / Research priorities / Planning / Monitoring / Evaluation / Financial resources / Gender

Agricultural, food, and water nanotechnologies for the poor: Opportunities, constraints, and role of the Consultative Group on International Agricultural Research

CGIAR, Developing countries, nanotechnology, research and development priorities,

Banking on Nature's Assets: How Multilateral Development Banks Can Strengthen Development by Using Ecosystem Services

Outlines the benefits of integrating the management of ecosystem services and trade-offs into strategies to improve economic development outcomes, mitigate climate change effects, and reduce economic and human costs. Recommends tools and policy options