A systematic review of the health, social and financial impacts of welfare rights advice delivered in healthcare settings

BACKGROUND: Socio-economic variations in health, including variations in health according to wealth and income, have been widely reported. A potential method of improving the health of the most deprived groups is to increase their income. State funded welfare programmes of financial benefits and benefits in kind are common in developed countries. However, there is evidence of widespread under claiming of welfare benefits by those eligible for them. One method of exploring the health effects of income supplementation is, therefore, to measure the health effects of welfare benefit maximisation programmes. We conducted a systematic review of the health, social and financial impacts of welfare rights advice delivered in healthcare settings. METHODS: Published and unpublished literature was accessed through searches of electronic databases, websites and an internet search engine; hand searches of journals; suggestions from experts; and reference lists of relevant publications. Data on the intervention delivered, evaluation performed, and outcome data on health, social and economic measures were abstracted and assessed by pairs of independent reviewers. Results are reported in narrative form. RESULTS: 55 studies were included in the review. Only seven studies included a comparison or control group. There was evidence that welfare rights advice delivered in healthcare settings results in financial benefits. There was little evidence that the advice resulted in measurable health or social benefits. This is primarily due to lack of good quality evidence, rather than evidence of an absence of effect. CONCLUSION: There are good theoretical reasons why income supplementation should improve health, but currently little evidence of adequate robustness and quality to indicate that the impact goes beyond increasing income

Capabilities for Uniqueness and Borrowing

An important application of unique object references is safe and efficient message passing in concurrent object-oriented programming. However, to prevent the ill effects of aliasing, practical systems often severely restrict the shape of messages passed by reference. Moreover, the problematic interplay between destructive reads--often used to implement unique references--and temporary aliasing through "borrowed" references is exacerbated in a concurrent setting, increasing the potential for unpredictable run-time errors. This paper introduces a new approach to uniqueness. The idea is to use capabilities for enforcing both at-most-once consumption of unique references, and a flexible notion of uniqueness. The main novelty of our approach is a model of uniqueness and borrowing based on simple, unstructured capabilities. The advantages are: first, it provides simple foundations for uniqueness and borrowing. Second, it can be formalized using a relatively simple type system, for which we provide a complete soundness proof. Third, it avoids common problems involving borrowing and destructive reads, since unique references subsume borrowed references. We have implemented our type system as an extension to Scala. Practical experience suggests that our system allows type checking real-world actor-based concurrent programs with only a small number of additional type annotations

Difficulties in managing innovation

The article, in a special issue on the Microelectronics Education Programme, reflected on the experience of MEP and of the Alvey Programme of Research and Development in Advanced Information Technology

Age, mobility, and knowledge: an action research approach

The article reports a pilot project at the Norwegian Employment Service, where an intervention enabled older workers to teach younger workers, using older technology. Older workers are regarded as a resource, not as a problem

Status and impacts of HIV/AIDS in agriculturel universities and colleges in Africa

The report looks into the status, impact and preventive actions taken by some of the partner universities and colleges in Africa of Agricultural University of Norway (NLH) against the spread of HIV/AIDS. Countries included in the study are Botswana, Ethiopia, Eritrea, Kenya, South Africa, Uganda, Malawi and Tanzania. Overall it showed that there is a growing recognition of the problem on campus, most universities have established special HIV/AIDS Committees and have information campaigns to new students. However, little is included in research and curriculum development. Neither are anyone making projections of what future losses of staff and students will mean for the university or the agricultural sector. Successful institutional and societal responses to HIV/AIDS require leadership. Universities play a role in the leadership of their communities. The key findings from the study are as follows: Status of and impact of HIV/AIDS: No one knows the status due to the nature of the pandemic and the structure of reporting and health systems. The perceived trend points to females as a vulnerable group. The impact is felt but the magnitude is hard to know due to the fact that no one knows the status except for some universities in Kenya. Overall, the study revealed that there is an impact, in varying degrees, amongst students and staff. The impact is felt either through leave of absence, effect on teaching quality, dropping out to take care of sick relatives, or students’ output being affected. Loss of skilled labour is proving to be a problem for the universities, as it would take more time to train new staff. Assessment of Present Programs by Agricultural Universities and Colleges: Most government programs in the study are promoted by the Ministry of Health, are in the start phase, targeting mainly students, with an emphasis on the biological-medical aspect. The social and psychological aspect is currently being included through peer education. The feedback on peer education is positive in that it is a powerful tool with a more holistic approach. A critique of the available information campaigns is that it is mostly from the top and western in its approach, neglecting important cultural elements. Ethical issues came up with keywords such as: discrimination, secrecy and denial, behaviour change, gender relations, exclusion from PhD grants, access to expensive medicines etc. Another issue was the role and responsibilities of the professors are important - especially in how they treat young vulnerable female students. Most universities are officially following a non-discrimination policy and most of the countries signed the UN Convention, but in practise this is a challenge. Based on the study we came up with the following recommendations: Expressed Needs from Universities and Colleges: The needs expressed by most universities are curriculum development and regional networking. Due to the nature of the problem, the universities were concerned in having interdisciplinary and multilevel research. NORAD on the other hand has a key role in helping to fight the pandemic. The involvement is basically facilitating, coordination and support of current and future programs through: integration of HIV/AIDS dimension in institutional collaboration agreements; contribute to research development by facilitating an interdisciplinary collaboration between Norwegian institutions and the African counterparts; support curriculum development initiatives, student peer education and outreaches, maintain current university operations through filling projected decrease in staff in students and lastly being instrumental in creating a node in Norway that coordinates and acts as a clearinghouse for HIV/AIDS and agriculture

Review of Agricultural Extension and Research Project - INTA 2001, Nicaragua

This Report is a review of the Norwegian support to INTA, the Nicaraguan Institute for Agricultural Technology. It was established in 1993 with major support from the World Bank but Swiss Aid, COSUDE, also played an important role. INTA is a public entity with a major mandate in agricultural extension and research. Norway has supported research and extensions activities since the 1980s and also a special project for female farmers. At the request of the Government of Nicaragua an agreement was signed with Norway in 1996. The Norwegian support to INTA consisted of two major components, namely: • Support for the Process of the Generation and Transfer of Agricultural Technology and Training; and • Training and Technical Assistance for Women Farmers. - PROCATEPA Although the first Project has specific objectives and activities over time Norwegian support became more of a core (budget) support to INTA as such. This was probably a positive development since it provided INTA with needed flexibility in allocating donor funding to priority activities. For this reason, instead of trying to analyse the NORAD support, a number of key issues was identified and analysed. The PROCATEPA project was primarily a NORAD supported project and was reviewed in some detail. NORAD support to INTA has been small compared to the over-all budget and the funding provided by the World Bank. Nevertheless, Norwegian support has been substantial. In total (1997-2000) about USD 3.8 million was provided. Of this sum about USD 1 million was for PROCATEPA. INTA has a well developed system for monitoring its activities. A large amount of information is collected yearly on the different aspects of INTA activities. Apart from regular reviews there has only been one evaluation and it was carried out by the National Agricultural University in 1997. The available information does not permit an assessment of the impact of INTA on technological innovations of the beneficiaries. Having said this, available data and the interviews with stakeholders suggest that INTA has had a positive impact on the technological development and the standard of living of the beneficiaries. Training of INTA staff, particularly upgrading extension agents to a university degree, has been a priority area. NORAD's support was particularly important in this respect. With the assistance of INTA staff some data processing was carried out. Between 1997 and 2001 the percentage of INTA staff members with a university degree actually declined from 34 to 28 percent. A significant number of INTA students was either fired our resigned. Moreover, there was a large number of un- or underemployed agronomists in Nicaragua. And only 13% of the scholarships were awarded to female students. There were good reasons to assign priority to extension and to secure that research activities supported extension. There was a positive interaction between research and extension within INTA. Nevertheless, the issue of research training has been virtually ignored by INTA and there is not one PhD holder within INTA. In summary, the benefits of INTA support (and NORAD's) to training do not seem to justify the costs and there was a strong gender imbalance. Although there was a strong gender imbalance with respect to the scholarships awarded there has been a slight improvement in the gender balance within INTA. While the share of women within INTA only increased slightly between 1997 and 2001, (from 27 to 28 percent), the share of women with university education increased from 19 to 23 percent. NORAD's support to PROCATEPA has been successful in many respects. While in the past the focus was on providing special support to women projects (WID - Women in Development) INTA has developed a framework for providing support to families with a focus on women priority areas. Significant methodological development and training have been carried out. In this way there has been a significant mainstreaming of gender issues within INTA. As of 2000 a new Program me for technological development was introduced. It has a long time horizon, 16 years. The lead donor has been the World Bank. But IFAD and Swiss Aid are contributing as well. During the planning phase, Norway explicitly stated its wish to participate in a Sector Wide Approach (SWAP). However, for several reason such as the weakness of the Ministry of Agriculture to take a strong co-ordinating role, the lack of interest of the World Bank to develop a jointly funded national programme, and the desire of INTA to continue to receive Norwegian bi-lateral funding Norway never became an active partner in the development of the new programme. In summary, since its creation in 1993, INTA has become an important institution in agricultural applied and adaptive research and extension. Norwegian support to INTA has been important in this respect and not least to gender mainstreaming. It is recommended, in line with SWAP policies, that in the future, Norway should not continue with bi-lateral funding. In this context, there are two basic options, either to conclude NORAD's present support to agricultural research and extension or to engage in a long term programme funding with other donors, not least the World Bank.NORA