58,799 research outputs found

    How do programs work to improve child nutrition?: Program impact pathways of three nongovernmental organization intervention projects in the Peruvian highlands

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    This paper examines the program logic of three nongovernmental, community-based programs with different intervention models to reduce childhood stunting. Two programs, Child Nutrition Program (PNI) and Good Start, focused directly on education and behavior change among caregivers, or the short routes to achieve impact, while one program, Sustainable Networks for Food Security (REDESA), focused on upstream factors, such as improving local governance and coordination, improving water and sanitation, and increasing family incomes, or the long routes to achieve impact. We compared the logic of each program as it was explicitly documented to the logic as perceived by the implementers. We elucidated the program impact pathways (PIPs) of key activities by actors at different operational levels in each program to identify congruencies and gaps in the perceptions of causal mechanisms between program activities and their intended outcomes, and analyzed them with the simple program models and logical frameworks to highlight the methodology and utility of PIPs. In a desire to move beyond static input-out models of the three programs, we designed and conducted data collection activities (document review, semi-structured interviews, and observations) with the intention of gaining insights about those aspects of the program that brought causal mechanisms of a given program into clearer focus. We propose that different methods for eliciting PIPs may be necessary at different operational levels. The interview method elicited more complete responses among those who are familiar with programmatic concepts, whereas actors at the local operational level provided sparse and fragmentary responses, even when simple, common language was used during the interviews. Group participatory processes, using visual aids, may be more effective for mapping the perceptions of those who are not accustomed to articulating information about programs. To reduce the length and frequency of interviews with program actors, initial PIPs could also be constructed from program documents, then discussed and revised iteratively with program actors. Although program logic models and the logical frameworks provide a succinct overview of the program (for communication, strategic planning, and management), we found that PIPs provide a better representation of the causal connections between program activities and results, particularly when both upstream and direct intervention activities were part of the same program. PIPs provide a visual tool for tracking how activities were perceived to work and make an impact, bringing into focus the different pathways of the activities and influences along the way. Beyond the logical sequence of program inputs, outputs, and outcomes, the conceptualization of impact pathways is a useful approach for understanding the causal connections required for impact and for identifying where attention and reinforcements may be required within program operation. The utility of this tool warrants its use not only during final evaluation but also during mid-program monitoring and relevant assessments. National- and regional-level program actors had good understanding of the overarching frameworks and principles of their respective programs as well as the program components and activities. They demonstrated a strong coherence to the program documents, provided similar cohesive responses, and were able to articulate the impact pathways. However, program actors at the national level identified fewer facilitators and barriers along the impact pathways than did the local actors, revealing that the practical dimensions of the impact pathways were not as evident to planners and managers farther from the communities. Although program actors at the local level were more apt to provide practical examples of influencing factors or incidents that occur during implementation, they had difficulty fully articulating their perceived PIPs and provided fragmented views of how the activities linked to their outcomes. Similar patterns were found across the three programs. This finding raises the question of desirability of a common understanding of the goals and pathways by which these outcomes are achieved or the acceptability of diversity of perspectives. It is still unclear whether program effectiveness may be improved through greater congruency in the PIPs. Future research should elucidate how congruency of PIPs among program actors across operational levels could be increased, and whether greater congruency would improve program implementation and effectiveness.program impact pathway, program logic model, logical framework, childhood stunting, child nutrition programs,

    Exploring the Potential of Developmental Work Research and Change Laboratory to Support Sustainability Transformations:A Case Study of Organic Agriculture in Zimbabwe

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    This paper explores the emergence of transgressive learning in CHAT-informed development work research in a networked organic agriculture case study in Zimbabwe, based on intervention research involving district organic associations tackling interconnected issues of climate change, water, food security and solidarity. The study established that We change laboratories can be used to support transgressive learning through: confronting unproductive local norms; collective reframing of problematic issues; stimulating expansive learning and sustainability transformations in minds, relationships and landscapes across time. The study also confirms the need for fourth generation CHAT to address the complex social-ecological problems of today

    The sociology of entrenchment: a cystic fibrosis test for everyone?

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    In this article we introduce the notion of entrenchment to conceptualize the processes in which new technological options, through the interactions between a variety of actors, become viable and established practices in society, both satisfying and modifying needs and interests. The notion of entrenchment we use as a framework for an analysis of developments and debates in the field of cystic fibrosis testing and screening in Denmark. On the one hand, it appears that the development and introduction of cystic fibrosis (CF) screening to some extent is predetermined both by existing networks of human genome researchers, clinical geneticist, patients (organizations),funding organizations, and regulatory agencies, and by existing practices like that of prenatal diagnosis. On the other hand, in Denmark, the content and future of CF screening is shaped in ongoing processes or articulation of demand for screening and of its cultural and political acceptability, processes which also involve political decision-making and which (may) result in new networks and regimes. Yet, what appears to be an inherent and undecided part of the process of entrenchment of CF screening in Denmark, is how to allocate responsibilities and authority to decide what is acceptable and what not

    Understanding safety-critical interactions with a home medical device through Distributed Cognition

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    As healthcare shifts from the hospital to the home, it is becoming increasingly important to understand how patients interact with home medical devices, to inform the safe and patient-friendly design of these devices. Distributed Cognition (DCog) has been a useful theoretical framework for understanding situated interactions in the healthcare domain. However, it has not previously been applied to study interactions with home medical devices. In this study, DCog was applied to understand renal patients’ interactions with Home Hemodialysis Technology (HHT), as an example of a home medical device. Data was gathered through ethnographic observations and interviews with 19 renal patients and interviews with seven professionals. Data was analyzed through the principles summarized in the Distributed Cognition for Teamwork methodology. In this paper we focus on the analysis of system activities, information flows, social structures, physical layouts, and artefacts. By explicitly considering different ways in which cognitive processes are distributed, the DCog approach helped to understand patients’ interaction strategies, and pointed to design opportunities that could improve patients’ experiences of using HHT. The findings highlight the need to design HHT taking into consideration likely scenarios of use in the home and of the broader home context. A setting such as home hemodialysis has the characteristics of a complex and safety-critical socio-technical system, and a DCog approach effectively helps to understand how safety is achieved or compromised in such a system

    The CGIAR at a Crossroads: Assessing the role of international agricultural research in poverty alleviation from an innovation systems perspective

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    Globalization, technical change and migration are changing the dynamics of poverty and food production. These factors, combined with a better understanding of the nature of complex processes, are also changing the nature of scientific research, the roles researchers can play in poverty alleviation and the niches in which the CGIAR can operate. While keeping strong breeding and research programs, the CGIAR should devote increasing resources to better characterize the dynamics of poverty, redefine the networks it will use to promote the use of scientific information to foster innovation, link local innovators and researchers with international scientific networks, and help to build innovative capabilities in developing countries. These capabilities should refer not only to scientific research but also to new ways to support innovation and to design and implement poverty-alleviation programs. Finally, CGIAR researchers should adopt new research methods to better integrate into local and international innovation networks.CGIAR, Innovation, agricultural research, Agricultural and Food Policy, Food Security and Poverty, Research and Development/Tech Change/Emerging Technologies,
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