Child Marriage: Parents’ Lived Experience of Decision-Making Processes and Consequential Health Effects

Child or early marriage is increasingly recognized as a public health concern that poses significant health challenges for a young bride. This qualitative research explored child marriage among Hausa-Fulani ethnolinguistic communities in Northeastern Nigeria. Qualitative interviews were conducted with parents who married off their underage children. The central research questions relied on a theoretical foundation of social values theory and interpretative phenomenological analysis. The study results provide an in-depth understanding of the child marriage phenomenon by exploring parents\u27 lived experiences and the role of a child bride\u27s health in the decision-making process and illustrates how social values and norms drive child marriage in the community. The role of shame and honor are particularly significant, and these feelings drive the practice in these communities. Contrary to the prevailing narrative in the literature, no direct evidence indicated that poverty was a factor in the parental decision-making process. The decision to marry off their children was the purview of male parents in Hausa-Fulani communities, and social values were a key symbol of community identity preserved by common sociocultural practices. The child bride\u27s good health was a necessary condition for the marriage, and minimal considerations were given to the girl\u27s abilities to bear marital responsibility and children. Effective reproductive health education and promotion interventions are required to curb and prevent child marriage

Child Marriage: Parents’ Lived Experience of Decision-Making Processes and Consequential Health Effects

Child or early marriage is increasingly recognized as a public health concern that poses significant health challenges for a young bride. This qualitative research explored child marriage among Hausa-Fulani ethnolinguistic communities in Northeastern Nigeria. Qualitative interviews were conducted with parents who married off their underage children. The central research questions relied on a theoretical foundation of social values theory and interpretative phenomenological analysis. The study results provide an in-depth understanding of the child marriage phenomenon by exploring parents\u27 lived experiences and the role of a child bride\u27s health in the decision-making process and illustrates how social values and norms drive child marriage in the community. The role of shame and honor are particularly significant, and these feelings drive the practice in these communities. Contrary to the prevailing narrative in the literature, no direct evidence indicated that poverty was a factor in the parental decision-making process. The decision to marry off their children was the purview of male parents in Hausa-Fulani communities, and social values were a key symbol of community identity preserved by common sociocultural practices. The child bride\u27s good health was a necessary condition for the marriage, and minimal considerations were given to the girl\u27s abilities to bear marital responsibility and children. Effective reproductive health education and promotion interventions are required to curb and prevent child marriage

Comparing and Contrasting a Program versus System Approach to Evaluation: The Example of a Cardiac Care System

This paper focuses on the application of systems thinking concepts to evaluate systems.  The terms systems and systems thinking concepts are first defined.  The use of systems thinking concepts in program and system evaluation are then highlighted.  It is noted that while there are methods available to assist evaluation practitioners in applying systems thinking concepts to program evaluation, there is a need for similar guidance in applying systems thinking concepts to evaluating systems.  System Evaluation Theory (SET) is then reviewed as one evaluation theory designed to apply systems thinking concepts to evaluating systems. A case illustration is presented to help teach practitioners how to apply SET’s three steps.  The discussion focuses on comparing the differences between evaluation questions answered by applying systems thinking concepts versus those using program logic models

Validation of Reconstructed Program Theory

Background: The focus of this dissertation is on methods associated with evaluating a program's merit and worth. There are many approaches documented in the literature for evaluating merit and worth. The focus is only on theory driven evaluation (TDE). The premise of TDE is the program theory (PT) must be understood before being able to evaluate the merit and worth of a program. One of the early limitations in the TDE literature was a lack of methods for deriving PT. Renger has recently published methodology describing how existing source documentation could be to develop a program theory. A key component of Renger's methodology is the validation of the PT. Renger suggested using subject matter experts (SME) and program staff to validate the PT. However, it is uncertain whether relying on SMEs to validate a PT is sufficient. Objectives/Methods: Thus the current work focuses on whether there is empirical (i.e., research) and/or statistical (i.e., correlation analyses) support for a PT generated by SMEs. Results: Findings of the correlation analysis provide some evidence of the effectiveness of SMEs validation process. Specifically, weak or very weak statistical support was found for 56.25% (N=9) of relationships between mechanisms of change depicted in the model from Aim 5 (N=16). The results of targeted literature review indicate a strong relationship between the PT generated by SMEs and targeted literature search. Specifically, research evidence was found for 13 (81%) relationships between mechanisms of change identified in the model from Aim 5. Conclusion: PT can be reconstructed from source documentation. Reconstructed PT should be validated. Validation by SME appears to be time a fast, cost-effective way of getting feedback on the initial draft of PT. However, due to the limited scope of targeted literature search and correlational analysis, it is not possible to conclusively determine whether relying on subject matter experts is sufficient to validate reconstructed Program Theory. More research on TDE validation methods is needed

The Power of the Context Map: Designing Realistic Outcome Evaluation Strategies and Other Unanticipated Benefits

Developing a feasible evaluation plan is challenging when multiple activities, often sponsored by multiple agencies, work together toward a common goal. Often, resources are limited and not every agency\u27s interest can be represented in the final evaluation plan. The article illustrates how the Antecedent Target Measurement (ATM) approach to logic modeling was adapted to meet this challenge. The key adaptation is the context map generated in the first step of the ATM approach. The context map makes visually explicit many of the underlying conditions contributing to a problem as possible. The article also shares how a prioritization matrix can assist the evaluator in filtering through the context map to prioritize the outcomes to be included in the final evaluation plan as well as creating realistic outcomes. This transparent prioritization process can be especially helpful in managing evaluation expectations of multiple agencies with competing interests. Additional strategic planning benefits of the context map include pinpointing redundancies caused by overlapping collaborative efforts, identifying gaps in coverage, and assisting the coordination of multiple stakeholders

The Power of the Context Map: Designing Realistic Outcome Evaluation Strategies and Other Unanticipated Benefits

Developing a feasible evaluation plan is challenging when multiple activities, often sponsored by multiple agencies, work together toward a common goal. Often, resources are limited and not every agency\u27s interest can be represented in the final evaluation plan. The article illustrates how the Antecedent Target Measurement (ATM) approach to logic modeling was adapted to meet this challenge. The key adaptation is the context map generated in the first step of the ATM approach. The context map makes visually explicit many of the underlying conditions contributing to a problem as possible. The article also shares how a prioritization matrix can assist the evaluator in filtering through the context map to prioritize the outcomes to be included in the final evaluation plan as well as creating realistic outcomes. This transparent prioritization process can be especially helpful in managing evaluation expectations of multiple agencies with competing interests. Additional strategic planning benefits of the context map include pinpointing redundancies caused by overlapping collaborative efforts, identifying gaps in coverage, and assisting the coordination of multiple stakeholders

Comparing and Contrasting a Program versus System Approach to Evaluation: The Example of a Cardiac Care System

This paper focuses on the application of systems thinking concepts to evaluate systems. The terms systems and systems thinking concepts are first defined. The use of systems thinking concepts in program and system evaluation are then highlighted. It is noted that while there are methods available to assist evaluation practitioners in applying systems thinking concepts to program evaluation, there is a need for similar guidance in applying systems thinking concepts to evaluating systems. System Evaluation Theory (SET) is then reviewed as one evaluation theory designed to apply systems thinking concepts to evaluating systems. A case illustration is presented to help teach practitioners how to apply SET’s three steps. The discussion focuses on comparing the differences between evaluation questions answered by applying systems thinking concepts versus those using program logic models

Lessons learned in evaluating the infrastructure of a Centre for Translational Research

This article shares lessons learned while evaluating the implementation of a Clinical and Translational Research Centre (CTR). To meet its overarching goals, the CTR consists of numerous research support units (e.g., biostatistics, community engagement, professional development) that are intended to work together collaboratively. It is then argued that an evaluation approach grounded in system thinking was the best fit to evaluate this key CTR design feature. The rationale for selecting systems evaluation theory (SET) as the evaluation framework best suited to evaluate the CTR infrastructure is then presented. The application of SET and the lessons learned are then shared. This article concludes that there are many similarly structured programmes worldwide to which the lessons learned can be applied and upfront investments in using a system approach are rewarded by providing meaningful and useful evaluation recommendations for system change