Systematic mapping of gender equality and social inclusion in WASH interventions: knowledge clusters and gaps

Introduction: Poor access to water, sanitation and hygiene (WASH) services threatens population health and contributes to gender and social inequalities, especially in low-resource settings. Despite awareness in the WASH sector of the importance of promoting gender equality and social inclusion (GESI) to address these inequalities, evaluations of interventions focus largely on health outcomes, while gender equality and other social outcomes are rarely included. This review aimed to collate and describe available research evidence of GESI outcomes evaluated in WASH intervention studies. Methods: We applied a systematic mapping methodology and searched for both academic and grey literature published between 2010 and 2020 in 16 bibliographic databases and 53 specialist websites. Eligibility screening (with consistency checking) was conducted according to predetermined criteria, followed by metadata coding and narrative synthesis. Results: Our evidence base comprises 463 intervention studies. Only 42% of studies measured transformative GESI outcomes of WASH interventions, referring to those that seek to transform gender relations and power imbalances to promote equality. A majority of studies disaggregated outcome data by sex, but other forms of data disaggregation were limited. Most included studies (78%) lacked a specific GESI mainstreaming component in their intervention design. Of the interventions with GESI mainstreaming, the majority targeted women and girls, with very few focused on other social groups or intersectional considerations. Conclusion: The review points to various areas for future primary and secondary research. Given the potential contribution of WASH to GESI, GESI considerations should be incorporated into the evaluation of WASH interventions. Regular collection of data and monitoring of GESI outcomes is needed as well as developing new and testing existing methods for monitoring and evaluation of such data

Implementation of the Afya conditional cash transfer intervention to retain women in the continuum of care : a mixed-methods process evaluation

Objectives: We report the results of a mixed-methods process evaluation that aimed to provide insight on the Afya conditional cash transfer (CCT) intervention fidelity and acceptability. Intervention, setting and participants: The Afya CCT intervention aimed to retain women in the continuum of maternal healthcare including antenatal care (ANC), delivery at facility and postnatal care (PNC) in Siaya County, Kenya. The cash transfers were delivered using an electronic card reader system at health facilities. It was evaluated in a trial that randomised 48 health facilities to intervention or control, and which found modest increases in attendance for ANC and immunisation appointments, but little effect on delivery at facility and PNC visits. Design: A mixed-methods process evaluation was conducted. We used the Afya electronic portal with recorded visits and payments, and reports on use of the electronic card reader system from each healthcare facility to assess fidelity. Focus group interviews with participants (N=5) and one-on-one interviews with participants (N=10) and healthcare staff (N=15) were conducted to assess the acceptability of the intervention. Data analyses were conducted using descriptive statistics and qualitative content analysis, as appropriate. Results: Delivery of the Afya CCT intervention was negatively affected by problems with the electronic card reader system and a decrease in adherence to its use over the intervention period by healthcare staff, resulting in low implementation fidelity. Acceptability of cash transfers in the form of mobile transfers was high for participants. Initially, the intervention was acceptable to healthcare staff, especially with respect to improvements in attaining facility targets for ANC visits. However, acceptability was negatively affected by significant delays linked to the card reader system. Conclusions: The findings highlight operational challenges in delivering the Afya CCT intervention using the Afya electronic card reader system, and the need for greater technology readiness before further scale-up

Hegemonic approaches in disaster risk management associated with hydrometeorological events: analysis of the context of Latin America and the Caribbean

Todos los artículos publicados en REDER siguen una política de Acceso Abierto y se respaldan en una Licencia CreativeCommons Atribución-NoComercial 4.0 Internacional.De los 10 países más afectados por desastres de origen climático en el mundo, cinco se encuentran en la región de América Latina y el Caribe (LAC), donde han incorporado la Gestión del Riesgo de Desastres (GRD) en sus políticas de desarrollo. Dicha GRD está regida por directrices de política pública internacional que determinan enfoques de investigación. Por lo tanto, este estudio busca identificar cuáles son los enfoques de intervención (específicamente de arriba hacia abajo) que predominan en la literatura científica como reflexión sobre los discursos hegemónicos en la GRD de la región. Para lograr esto, fue realizada una caracterización regional de la literatura científica mediante una revisión sistemática de literatura académica, a través de una clasificación por tipo de enfoque de intervención usando el aplicativo web Rayyan y un formulario para el análisis de cada uno de los documentos. Los resultados muestran que la mayoría de los artículos se basan en el enfoque de arriba hacia abajo y muy pocos estudios consideraron un enfoque de abajo hacia arriba. Los países con mayores publicaciones en esta materia son Brasil, México y Chile. El enfoque predominante es el preventivo y las inundaciones el tipo de peligro más abordado.Five of the ten most affected countries by climate-related disasters worldwide are located in the Latin American and Caribbean (LAC) region, which has incorporated Disaster Risk Management (DRM) into its development policies. Such DRM is ruled by international public policy guidelines that state financing priorities and research approaches. Thus, this study aims to identify which of the intervention approaches (especially top-down) prevail in the scientific literature as a reflection of the hegemonic discourses in DRM of the LAC region. To achieve this, a regional characterization of scientific literature on DRM was carried out through a systematic review of academic literature making use of the web-tool Rayyan. The analysis of the literature responds to a classification by type of intervention approach. The results found that most papers are based on a top-down approach, while very few studies consider a bottom-up approach. The countries with the most publications on this matter are Brazil, Mexico, and Chile. The preventive approach is the predominant and floods are the most addressed type of threat.Coordinación para el Perfeccionamiento de Personal Nível Superior (CAPES): becas de doctorado n° 88887.340300/2019-00 y 88887.489556/2020-00. Fundación para la Ciencia y la Tecnología (FCT) de Portugal: beca de doctorado n° 2021.07982.BD