The State of Out-of-School Girls in Sierra Leone: Findings Across Six Districts

The Girls' Circles baseline survey affirmed what we know – that girls' lives in Sierra Leone, especially those who are out of school, are characterised by multiple hardships: little to no education; the ubiquity of transactional sex; teen pregnancy; and everyday violence. Whilst little of this will be new for those who know Sierra Leone, the scale of these issues (which are likely to be under reported) is shocking, as is their everyday nature – girls struggling, for example, to identify violence where it is simply part of the fabric of their daily lives.This report was born out of a recognition that all of this rich data is available and should be shared with the world, particularly given the relative rarity of girls' voices being foregrounded in the Sierra Leonean context. It presents an opportunity for a 'state of the nation' summary about the lives of girls who are often most marginalised in Sierra Leone, and the findings are grounded in what girls themselves and their mentors are telling us about their lives.The availability of this nuanced data and verbatim accounts has enabled the report to go beyond the simplified or binary narratives often presented about girls, to present the realities of their lives, in their words. We hope this provides deep insight into their experiences and what lies behind these, as well as the possibilities for positive change

The State of Out-of-School Girls in Sierra Leone: Findings Across Six Districts - Executive Summary

The Girls' Circles baseline survey affirmed what we know – that girls' lives in Sierra Leone, especially those who are out of school, are characterised by multiple hardships: little to no education; the ubiquity of transactional sex; teen pregnancy; and everyday violence. Whilst little of this will be new for those who know Sierra Leone, the scale of these issues (which are likely to be under reported) is shocking, as is their everyday nature – girls struggling, for example, to identify violence where it is simply part of the fabric of their daily lives.This report was born out of a recognition that all of this rich data is available and should be shared with the world, particularly given the relative rarity of girls' voices being foregrounded in the Sierra Leonean context. It presents an opportunity for a 'state of the nation' summary about the lives of girls who are often most marginalised in Sierra Leone, and the findings are grounded in what girls themselves and their mentors are telling us about their lives.The availability of this nuanced data and verbatim accounts has enabled the report to go beyond the simplified or binary narratives often presented about girls, to present the realities of their lives, in their words. We hope this provides deep insight into their experiences and what lies behind these, as well as the possibilities for positive change

Resourcing Disability Justice: Our feminist journey toward centering Disability Justice

People with disabilities face massive discrimination, segregation, violence, chronic poverty, continuous violations of their human rights, and in the midst of crisis – such as COVID-19 – are disproportionately impacted. For girls, women, and youth with disabilities, the compounding consequences of these injustices are disproportionately exacerbated. Yet, in spite of the extreme systemic violence faced by people with disabilities, they continue to fight against centuries of marginalisation, discrimination, and violence, and have organised a global Disability Rights movement. And, largely led by Black and Brown girls and youth Disability Rights activists, powered the second wave of the Disability Rights movement that, as Sins Invalid states, brings us to a "path and goal of Collective Liberation, in which we hold the question "How do we move together" - as people with mixed abilities, multiracial, multi-gendered, mixed class, across the orientation spectrum - where no body/mind is left behind."In this report, we reflect with honesty about our feminist journey toward learning how to centre Disability Justice in our resourcing, offering insight into the Disability Rights and Justice work we have resourced through our Funds. We highlight reflections and perspectives from the Disability Rights activist advisors that lead the resourcing (grantmaking) decisions, and share key learnings that have been woven through ecosystem and community conversations. In addition, our partners, the Disability Rights Fund and MADRE offer insights into their work

Evaluating the impact of an intervention to increase uptake of modern contraceptives among adolescent girls (15-19 years) in Nigeria, Ethiopia and Tanzania: the Adolescents 360 quasi-experimental study protocol.

INTRODUCTION: Nigeria, Ethiopia and Tanzania have some of the highest teenage pregnancy rates and lowest rates of modern contraceptive use among adolescents. The transdisciplinary Adolescents 360 (A360) initiative being rolled out across these three countries uses human-centred design to create context-specific multicomponent interventions with the aim of increasing voluntary modern contraceptive use among girls aged 15-19 years. METHODS: The primary objective of the outcome evaluation is to assess the impact of A360 on the modern contraceptive prevalence rate (mCPR) among sexually active girls aged 15-19 years. A360 targets different subpopulations of adolescent girls in the three countries. In Northern Nigeria and Ethiopia, the study population is married girls aged 15-19 years. In Southern Nigeria, the study population is unmarried girls aged 15-19 years. In Tanzania, both married and unmarried girls aged 15-19 years will be included in the study. In all settings, we will use a prepopulation and postpopulation-based cross-sectional survey design. In Nigeria, the study design will also include a comparison group. A one-stage sampling design will be used in Nigeria and Ethiopia. A two-stage sampling design will be used in Tanzania. Questionnaires will be administered face-to-face by female interviewers aged between 18 and 26 years. Study outcomes will be assessed before the start of A360 implementation in late 2017 and approximately 24 months after implementation in late 2019. ETHICS AND DISSEMINATION: Findings of this study will be widely disseminated through workshops, conference presentations, reports, briefings, factsheets and academic publications

Challenges and opportunities in evaluating programmes incorporating human-centred design: lessons learnt from the evaluation of Adolescents 360.

Adolescents 360 (A360) is a four-year initiative (2016-2020) to increase 15-19-year-old girls' use of modern contraception in Nigeria, Ethiopia and Tanzania. The innovative A360 approach is led by human-centred design (HCD), combined with social marketing, developmental neuroscience, public health, sociocultural anthropology and youth engagement 'lenses', and aims to create context-specific, youth-driven solutions that respond to the needs of adolescent girls. The A360 external evaluation includes a process evaluation, quasi-experimental outcome evaluation, and a cost-effectiveness study. We reflect on evaluation opportunities and challenges associated with measuring the application and impact of this novel HCD-led design approach. For the process evaluation, participant observations were key to capturing the depth of the fast-paced, highly-iterative HCD process, and to understand decision-making within the design process. The evaluation team had to be flexible and align closely with the work plan of the implementers. The HCD process meant that key information such as intervention components, settings, and eligible populations were unclear and changed over outcome evaluation and cost-effectiveness protocol development. This resulted in a more time-consuming and resource-intensive study design process. As much time and resources went into the creation of a new design approach, separating one-off "creation" costs versus those costs associated with actually implementing the programme was challenging. Opportunities included the potential to inform programmatic decision-making in real-time to ensure that interventions adequately met the contextualized needs in targeted areas. Robust evaluation of interventions designed using HCD, a promising and increasingly popular approach, is warranted yet challenging. Future HCD-based initiatives should consider a phased evaluation, focusing initially on programme theory refinement and process evaluation, and then, when the intervention program details are clearer, following with outcome evaluation and cost-effectiveness analysis. A phased approach would delay the availability of evaluation findings but would allow for a more appropriate and tailored evaluation design

Cultural adaptation of a children's weight management programme for Bangladeshi and Pakistani families in the UK. A cluster-randomised feasibility study

AbstractBackground: Group-based children’s weight management programmes are widely available in the UK and evidence shows that these are effective in the short-term. No programmes have been specifically developed to meet the cultural requirements of UK minority ethnic communities. South Asian children are a high-risk group for obesity and its consequences; therefore, the study aim is to adapt an existing weight management programme for children aged 4-11 years and their families to ensure cultural relevance to Pakistani and Bangladeshicommunities, and undertake a feasibility study of the adapted programme.Methods/design: Pakistani and Bangladeshi families of overweight children who have been offered the existing children’s weight management programme in Birmingham, UK, will be invited to interviews and focus groups to explore their experiences and views of the programme. These data, together with existing literature and service provider information, will inform adaptation of the programme to be more culturally relevant to these families.The feasibility study will employ a cluster-randomised design, and will assess success of programme adaptation and feasibility of programme delivery. Planned programmes will be randomised to be delivered as the adapted programme (intervention) or the standard programme (comparator) with a 2:1 ratio. The primary outcome will be the proportion of Pakistani and Bangladeshi families completing the adapted programme. To assess recruitment, retention and data collection methods to inform a future trial, we aim to recruit 80 participants. A range of assessments will be undertaken with participants pre-, post- and 6-months post-intervention.Discussion: This study addresses the identified need to provide children’s weight management programmes that are suitable for minority ethnic communities. Whilst the focus of the intervention adaptation is on Pakistani and Bangladeshi communities, the programme will be developed to be flexibly delivered to meetthe cultural needs of communities of all ethnic compositions. The feasibility study will directly compare the adapted and existing weight management programmes, and will enable a comprehensive evaluation of the success of the adaptation. Essential information will also be gathered to inform the design and sample size calculation of a future trial to evaluate intervention effectiveness.Trial registration: ISRCTN81798055, registered: 13/05/2014.Keywords: Obesity, Children, Treatment, Weight management, Pakistani, Bangladesh

Proceedings of Patient Reported Outcome Measure’s (PROMs) Conference Oxford 2017: Advances in Patient Reported Outcomes Research

A33-Effects of Out-of-Pocket (OOP) Payments and Financial Distress on Quality of Life (QoL) of People with Parkinson’s (PwP) and their Carer

Enhancing Supply Chain Sustainability and Supply Chain Resilience: Perceptions and Practices

Climate change and recent disruptions have led supply chain sustainability and supply chain resilience to emerge as relevant topics during recent years. These two areas have become important considerations for companies to compete in the modern business environment. This study aims to determine managerial practices that can simultaneously enhance the sustainability and resilience of supply chains. Secondary aims include better defining the relationship and influence between these two topics. A systematic literature review revealed that while sustainable supply chain management and supply chain resilience have been researched, their intersections have sparsely been studied. Empirical data for this study was collected through semi-structured interviews with nine supply chain and procurement professionals in Finland and the US. Interviewees came from a wide range of industries in order to better define the similarities and differences across companies and industries. The interviews revealed six practices (lean processes, nearshoring, supplier selection processes, supplier relationship management, supplier certificates, and supplier questionnaires) that can enhance both supply chain resilience and sustainability. The study also found that the relationship between supply chain sustainability and resilience is nuanced and that it has the potential for synergies, trade-offs, or no relationship. These results contribute to this nascent field of research while providing managers with clear actions and a better understanding of the complex relationship between these two topics

Enhancing Supply Chain Sustainability and Supply Chain Resilience: Perceptions and Practices

Climate change and recent disruptions have led supply chain sustainability and supply chain resilience to emerge as relevant topics during recent years. These two areas have become important considerations for companies to compete in the modern business environment. This study aims to determine managerial practices that can simultaneously enhance the sustainability and resilience of supply chains. Secondary aims include better defining the relationship and influence between these two topics. A systematic literature review revealed that while sustainable supply chain management and supply chain resilience have been researched, their intersections have sparsely been studied. Empirical data for this study was collected through semi-structured interviews with nine supply chain and procurement professionals in Finland and the US. Interviewees came from a wide range of industries in order to better define the similarities and differences across companies and industries. The interviews revealed six practices (lean processes, nearshoring, supplier selection processes, supplier relationship management, supplier certificates, and supplier questionnaires) that can enhance both supply chain resilience and sustainability. The study also found that the relationship between supply chain sustainability and resilience is nuanced and that it has the potential for synergies, trade-offs, or no relationship. These results contribute to this nascent field of research while providing managers with clear actions and a better understanding of the complex relationship between these two topics