Innovate to eliminate: a prerequisite in NTD programmes

Innovation plays a critical role in progress towards achievement of the World Health Organization's road map for neglected tropical diseases 2021-2030. As disease prevalence decreases, the cost to identify and treat remaining cases goes up. Additionally, as programmes move to the surveillance phase, diagnostic tests need to be highly sensitive and affordable. Until the early end to the Ascend West and Central Africa programme, the Ascend Learning and Innovation Fund supported five projects from 2019 to 2021. Designed for innovation, the fund encompassed a range of activities, including operational research, product development and social behavioural change. This flexibility allowed innovation to bridge the gap between strategic policy and practical implementation, piloting and proving business models to respond to information found through Ascend

Effects of social capital building on social network formation among the rural poor: a case-study from Peru

Although building social capital through participatory interventions is widely recommended in the development literature, limited attention has been paid to the process of social network expansion taking place in such contexts. This article empirically examines Putnam- and Bourdieu-based approaches to examine actors’ investments in social relations. Beneficiaries of a full-participatory intervention were followed over a four-year period using mixed-methods data. Results showed that, despite the existence of substantive social cohesion and promising levels of trust, actors’ capacity to benefit from project-sponsored bonding, bridging and linking social capital activities were affected by their capital endowments, lifestyles and (non)material interests. Over time, social capital building efforts appeared to have mostly favoured the emergence of village-level network structures unfavourable to the poorest, female, and non-politically active residents. The theoretical and practical implications of the findings are also discussed

A comparison of the training needs of maternity and sexual health professionals in a London teaching hospital with regards to routine enquiry for domestic abuse.

OBJECTIVE: To identify maternity and sexual healthcare professionals' training needs regarding routine enquiry for domestic abuse. STUDY DESIGN: A cross-sectional survey, part of a theory-based evaluation of a routine enquiry for domestic abuse intervention in a South London teaching hospital. METHODS: Two hundred and twenty-eight maternity professionals (68% of staff) and 46 sexual health practitioners (45% of staff) attended a 1-day domestic abuse training session. Pre-training questionnaires were completed by 208 respondents (80% response rate). The questionnaire elicited information about previous training experiences, dealing with cases of abuse, general knowledge, attitudes towards victims of abuse and views on routine enquiry. Bivariate and multivariate analyses were conducted to identify differences according to healthcare setting, prior training, and practitioners' demographic and experiential traits. RESULTS: Maternity and sexual health professionals reported positive attitudes towards women affected by abuse, but had limited domestic abuse training. Previously trained health professionals had good general knowledge, but failed to question attendees about abuse. Sexual health professionals were more likely to enquire about domestic abuse, and were more confident about implementing routine enquiry than maternity staff. Views on routine enquiry were influenced by health setting, demographic, attitudinal and experiential factors. CONCLUSIONS: Domestic abuse training is necessary in maternity and sexual health services. Educational interventions for routine enquiry should include practice-enabling components in addition to awareness modules and pre-training assessment of individuals' training needs to provide content that is tailored to their clinical practice and working environments. Institutional guidelines are recommended to enhance and sustain the positive effects of training

Behaviour change interventions for the control and elimination of schistosomiasis: A systematic review of evidence from low- and middle-income countries.

BackgroundFor the last two decades, schistosomiasis control efforts have focussed on preventive treatment. The disease, however, still affects over 200 million people worldwide. Behaviour change (BC) interventions can strengthen control by interrupting transmission through modifying exposure behaviour (water contact) or transmission practices (open urination/defaecation); or through fostering treatment seeking or acceptance. This review examines these interventions to assess their effectiveness in modifying risk practices and affecting epidemiological trends.Methodology/principal findingsA systematic multi-database literature search (PROSPERO CRD42021252368) was conducted for peer-reviewed publications released at any time before June 2021 assessing BC interventions for schistosomiasis control in low- and middle-income countries. 2,593 unique abstracts were identified, 66 were assigned to full text review, and 32 met all inclusion criteria. A typology of intervention models was outlined according to their use of behaviour change techniques and overarching rationale: health education (HEIs), social-environmental (SEIs), physical-environmental (PEIs), and incentives-centred interventions (ICIs). Available evidence does not allow to identify which BC approach is most effective in controlling risk behaviour to prevent schistosomiasis transmission. HEIs' impacts were observed to be limited by structural considerations, like infrastructure underdevelopment, economic obligations, socio-cultural traditions, and the natural environment. SEIs may address those challenges through participatory planning and implementation activities, which enable social structures, like governance and norms, to support BC. Their effects, however, appear context-sensitive. The importance of infrastructure investments was highlighted by intervention models. To adequately support BC, however, they require users' inputs and complementary services. Whilst ICIs reported positive impacts on treatment uptake, there are cost-effectiveness and sustainability concerns. Evaluation studies yielded limited evidence of independent epidemiological impacts from BC, due to limited use of suitable indicators and comparators. There was indicative evidence, however, that BC projects could sustain gains through treatment campaigns.Conclusions/significanceThere is a need for integrated interventions combining information provision, community-based planning, and infrastructure investments to support BC for schistosomiasis control. Programmes should carefully assess local conditions before implementation and consider that long-term support is likely needed. Available evidence indicates that BC interventions may contribute towards schistosomiasis control when accompanied by treatment activities. Further methodologically robust evidence is needed to ascertain the direct epidemiological benefits of BC

Evaluation of a domestic violence intervention in the maternity and sexual health services of a UK hospital.

This paper reports on an evaluation of a domestic violence intervention in the maternity and sexual health services of a UK hospital. The intervention encompassed guidelines, staff training, inclusion of routine enquiry for domestic violence with all patients, and referral of women disclosing violence to an on-site advocacy service. An "assumption querying" approach was applied to evaluate the intervention. Programmatic assumptions were identified and tested using interviews with service providers and patients, review of patient records, and pre- and post-training questionnaires. Domestic violence training resulted in changes in health professionals' knowledge and practice in the short-term, but universal routine enquiry was not achieved even in a context of organisational support, guidelines, training and advocacy. Potential and actual harm occurred, including breaches of confidentiality and failure to document evidence, limiting women's ability to access civil and legal remedies. Advocacy support led to positive outcomes for many women, as long as support to maintain positive changes, whether women stayed with or left the violent partner, continued to be given. Maternity and sexual health services were found to be opportune points of intervention for domestic violence services that combine routine enquiry by clinicians, support after disclosure and attention to harm reduction

Attaining Sustainable Services from Ecosystems through Trade-off Scenarios, Malawi, 2012-2016

Research for ASSETS was conducted in Peru, Colombia, and Malawi. This collection contains the data collected in Malawi. The objectives were: • To obtain information on the nutritional condition of children under five years of age that permit estimating stunting rates in the region. • To obtain socio-demographic indicators for rural households inhabiting the Amazon Basin. • Generate information on material living conditions among poor rural settings in the Amazon Basin. • Obtain information that allows assessing food (in)security conditions among poor rural households in the Amazon Basin. • Provide data that helps generating rural income estimates among rural households of the Amazon Basin. • Provide information that helps generating expenditure estimates for rural households in the Amazon region. • Generate quantitative information stating nature’s contributions to rural residents’ basic needs and income generation activities. • Provide socioeconomic and environmental indicators comparable to government’s’ nationwide living standards measurement studies and parallel surveys taking place in Colombia and Malawi. The household survey was divided into different modules covering various topics, including: • Socio-demographic characteristics of household members • Education • Health and maternity • Time use and employment • Housing and material living conditions • Food consumption and food security • Subjective wellbeing • Anthropometric measures (children under 5) • Farm characteristics: agriculture and livestock • Extractive activities: fishing, hunting, and wood-extractionFood security in poor rural communities often relies significantly on flows of ecosystem services from 'natural' environments. For millennia mankind has engaged in thinking and learning experiences which have shaped the processes underpinning the production of food and the management of land, addressing multiple factors and tradeoffs. However, many food production systems require intensive management and are prone to failure outside of the range of their optimal environmental conditions. Concerns are growing about the ability of current agricultural systems to support rising human populations without further degrading critical ecosystem services (such as water provisioning, pollination). During extreme events, such as drought, or other shocks or crises (environmental, social or economic), the dependence of rural communities on ecosystem services to meet their nutritional and livelihood needs often increases. This highlights the importance of minimising the impacts of agricultural systems on ecosystems and the services they provide. Strategies for coping with food insecurity may, in turn, have an impact on the capacity of ecosystems to deliver ecosystem services as the spatial and temporal nature of feedbacks between socio-economic and ecological systems can be complex. This project aimed to explicitly quantify the linkages between ecosystem services that affect - and are affected by - food security and nutritional health for the rural poor at the forest-agricultural interface. By integrating a suite of complexity tools and cutting edge models with more traditional participatory assessments in the field, the project aimed to identify how dynamic ecosystem services at the landscape scale translate to local-level nutritional diets and health and to inform policy makers on how future land use and climate change will affect both food security and the ecosystem services associated with it. Addressing the sustainability of natural resource management and rural livelihoods requires integrated thinking across disciplines. The complex transformations which can, or have already occurred from natural forest to managed landscapes must be fully understood so that systems can be adopted which promote sustainable transformations and/or can mitigate any negative impacts. This project therefore brought together expertise in social sciences, economics, ecology, risk management, spatial planning, climate change and complexity sciences to design and integrate a suite of models and methods to analyse how dynamic stocks and flows of ecosystem services translate to local-level food security and nutritional health. The project examined the multiple (and multi-directional) links between ecosystem services, food security and maternal and child health outcomes in poor rural communities, addressing three main themes: (1) Drivers, pressures and linkages between food security, nutritional health and ecosystem services; (2) Crises and tipping points: Past, present and future interactions between food insecurity and ecosystem services at the forest-agricultural interface; (3) The science-policy interface: How can we manage ecosystem services to reduce food insecurity and increase nutritional health?</p

Attaining Sustainable Services From Ecosystems Through Trade-Off Scenarios, Colombia, 2013-2014

Research for ASSETS was conducted in Peru, Colombia, and Malawi. This collection contains the data collected in Colombia. The objectives were: • To obtain information on the nutritional condition of children under five years of age that permit estimating stunting rates in the region. • To obtain socio-demographic indicators for rural households inhabiting the Amazon Basin. • Generate information on material living conditions among poor rural settings in the Amazon Basin. • Obtain information that allows assessing food (in)security conditions among poor rural households in the Amazon Basin. • Provide data that helps generating rural income estimates among rural households of the Amazon Basin. • Provide information that helps generating expenditure estimates for rural households in the Amazon region. • Generate quantitative information stating nature’s contributions to rural residents’ basic needs and income generation activities. • Provide socioeconomic and environmental indicators comparable to government’s’ nationwide living standards measurement studies and parallel surveys taking place in Colombia and Malawi. The household survey was divided into different modules covering various topics, including: • Socio-demographic characteristics of household members • Education • Health and maternity • Time use and employment • Housing and material living conditions • Food consumption and food security • Subjective wellbeing • Anthropometric measures (children under 5) • Farm characteristics: agriculture and livestock • Extractive activities: fishing, hunting, and wood-extractionFood security in poor rural communities often relies significantly on flows of ecosystem services from 'natural' environments. For millennia mankind has engaged in thinking and learning experiences which have shaped the processes underpinning the production of food and the management of land, addressing multiple factors and tradeoffs. However, many food production systems require intensive management and are prone to failure outside of the range of their optimal environmental conditions. Concerns are growing about the ability of current agricultural systems to support rising human populations without further degrading critical ecosystem services (such as water provisioning, pollination). During extreme events, such as drought, or other shocks or crises (environmental, social or economic), the dependence of rural communities on ecosystem services to meet their nutritional and livelihood needs often increases. This highlights the importance of minimising the impacts of agricultural systems on ecosystems and the services they provide. Strategies for coping with food insecurity may, in turn, have an impact on the capacity of ecosystems to deliver ecosystem services as the spatial and temporal nature of feedbacks between socio-economic and ecological systems can be complex. This project aimed to explicitly quantify the linkages between ecosystem services that affect - and are affected by - food security and nutritional health for the rural poor at the forest-agricultural interface. By integrating a suite of complexity tools and cutting edge models with more traditional participatory assessments in the field, the project aimed to identify how dynamic ecosystem services at the landscape scale translate to local-level nutritional diets and health and to inform policy makers on how future land use and climate change will affect both food security and the ecosystem services associated with it. Addressing the sustainability of natural resource management and rural livelihoods requires integrated thinking across disciplines. The complex transformations which can, or have already occurred from natural forest to managed landscapes must be fully understood so that systems can be adopted which promote sustainable transformations and/or can mitigate any negative impacts. This project therefore brought together expertise in social sciences, economics, ecology, risk management, spatial planning, climate change and complexity sciences to design and integrate a suite of models and methods to analyse how dynamic stocks and flows of ecosystem services translate to local-level food security and nutritional health. The project examined the multiple (and multi-directional) links between ecosystem services, food security and maternal and child health outcomes in poor rural communities, addressing three main themes: (1) Drivers, pressures and linkages between food security, nutritional health and ecosystem services; (2) Crises and tipping points: Past, present and future interactions between food insecurity and ecosystem services at the forest-agricultural interface; (3) The science-policy interface: How can we manage ecosystem services to reduce food insecurity and increase nutritional health?</p

Attaining Sustainable Services From Ecosystems Through Trade-Off Scenarios, Peru, 2015

Research for ASSETS was conducted in Peru, Colombia, and Malawi. This collection contains the data collected in Peru. The objectives were: • To obtain information on the nutritional condition of children under five years of age that permit estimating stunting rates in the region. • To obtain socio-demographic indicators for rural households inhabiting the Amazon Basin. • Generate information on material living conditions among poor rural settings in the Amazon Basin. • Obtain information that allows assessing food (in)security conditions among poor rural households in the Amazon Basin. • Provide data that helps generating rural income estimates among rural households of the Amazon Basin. • Provide information that helps generating expenditure estimates for rural households in the Amazon region. • Generate quantitative information stating nature’s contributions to rural residents’ basic needs and income generation activities. • Provide socioeconomic and environmental indicators comparable to government’s’ nationwide living standards measurement studies and parallel surveys taking place in Colombia and Malawi. The household survey was divided into different modules covering various topics, including: • Socio-demographic characteristics of household members • Education • Health and maternity • Time use and employment • Housing and material living conditions • Food consumption and food security • Subjective wellbeing • Anthropometric measures (children under 5) • Farm characteristics: agriculture and livestock • Extractive activities: fishing, hunting, and wood-extractionFood security in poor rural communities often relies significantly on flows of ecosystem services from 'natural' environments. For millennia mankind has engaged in thinking and learning experiences which have shaped the processes underpinning the production of food and the management of land, addressing multiple factors and tradeoffs. However, many food production systems require intensive management and are prone to failure outside of the range of their optimal environmental conditions. Concerns are growing about the ability of current agricultural systems to support rising human populations without further degrading critical ecosystem services (such as water provisioning, pollination). During extreme events, such as drought, or other shocks or crises (environmental, social or economic), the dependence of rural communities on ecosystem services to meet their nutritional and livelihood needs often increases. This highlights the importance of minimising the impacts of agricultural systems on ecosystems and the services they provide. Strategies for coping with food insecurity may, in turn, have an impact on the capacity of ecosystems to deliver ecosystem services as the spatial and temporal nature of feedbacks between socio-economic and ecological systems can be complex. This project aimed to explicitly quantify the linkages between ecosystem services that affect - and are affected by - food security and nutritional health for the rural poor at the forest-agricultural interface. By integrating a suite of complexity tools and cutting edge models with more traditional participatory assessments in the field, the project aimed to identify how dynamic ecosystem services at the landscape scale translate to local-level nutritional diets and health and to inform policy makers on how future land use and climate change will affect both food security and the ecosystem services associated with it. Addressing the sustainability of natural resource management and rural livelihoods requires integrated thinking across disciplines. The complex transformations which can, or have already occurred from natural forest to managed landscapes must be fully understood so that systems can be adopted which promote sustainable transformations and/or can mitigate any negative impacts. This project therefore brought together expertise in social sciences, economics, ecology, risk management, spatial planning, climate change and complexity sciences to design and integrate a suite of models and methods to analyse how dynamic stocks and flows of ecosystem services translate to local-level food security and nutritional health. The project examined the multiple (and multi-directional) links between ecosystem services, food security and maternal and child health outcomes in poor rural communities, addressing three main themes: (1) Drivers, pressures and linkages between food security, nutritional health and ecosystem services; (2) Crises and tipping points: Past, present and future interactions between food insecurity and ecosystem services at the forest-agricultural interface; (3) The science-policy interface: How can we manage ecosystem services to reduce food insecurity and increase nutritional health?</p