Independent evaluation of the SMEPOL project : impact, lessons and options for replication

The Small and Medium Enterprise Policy Development (SMEPOL) project in Egypt (2000-2005) was successful, and the lessons learned may be replicable. The objective was to improve the policy environment for MSME development. The project enabled MSME issues to move up on the policy agenda, generated a range of policy-relevant research, enhanced capacity in key ministries, and improved policy development processes, meanwhile developing a cohesive Competitiveness Strategy for Egypt. Policy influence was mostly achieved at the ministerial level rather than across the government. Some key lessons are presented within the context of the literature and practical experience

Raising irrigation productivity and releasing water for intersectoral needs (RIPARWIN): RIPARWIN final technical report

River basinsHydrologyRiver basin managementRiver basin developmentDevelopment projectsWater allocationIrrigation waterProductivityIrrigation managementRiceTanzaniaGreat Ruaha River BasinUsangu River Basin

Memorias del taller : generación y transferencia de tecnologia agropecuaria; el papel de las ong y el sector publico

Taller organizado en Santa Cruz de la Sierra, Bolivia, 2-7 diciembre de 199

Modern Slavery, Environmental Degradation and Climate Change: Fisheries, Field, Forests and Factories

In this commentary paper, the current state of research on the tightly connected and bi-directional relationships among modern slavery, environmental degradation and climate change is critically assessed and reviewed. An emerging branch of research has begun to conceptualize linkages between slavery and environmental change. Responding to a gap in the extant literature, this paper synthesizes and makes sense of this emerging research base and proposes a future research agenda for exploring the slavery–environment nexus. Through an exploration of 19 key texts which explicitly examine the relationship between slavery and environmental change, spanning across diverse disciplines and spatial scales, we draw out two key arguments that can be adopted in proposing a future research agenda. Firstly, we identify the sectoral emergence of the nexus, forming primarily around four key sectors: (i) Fisheries, (ii) Fields, (iii) Forests and (iv) Factories. The review suggests that a sufficient exploration of slavery–environment linkages needs to transverse these sectoral boundaries. Secondly, the paper highlights the bi-directional interactions among modern slavery, climate change and environmental degradation. Accordingly, we argue for a holistic lens which explores how slavery practices and environmental change are continually shaping one another. Existing research has provided initial understandings of the relationship among modern slavery, environmental destruction and climate change. However, there remains considerable scope for the connections between the three to be further interrogated and unpacked. Based on the review, the paper sets out three key research agendas, highlighting the need to move beyond a spatially and sectorally confined exploration of slavery–environment interactions towards an integrated and sophisticated interrogation of the nexus. Additionally, we propose the future examination of the deep underlying drivers of slavery–environment interactions and to situate these within contemporary capitalist social and economic relations

Findings from a cluster randomised trial of unconditional cash transfers in Niger.

Unconditional cash transfers (UCTs) are used as a humanitarian intervention to prevent acute malnutrition, despite a lack of evidence about their effectiveness. In Niger, UCT and supplementary feeding are given during the June-September "lean season," although admissions of malnourished children to feeding programmes may rise from March/April. We hypothesised that earlier initiation of the UCT would reduce the prevalence of global acute malnutrition (GAM) in children 6-59 months old in beneficiary households and at population level. We conducted a 2-armed cluster-randomised controlled trial in which the poorest households received either the standard UCT (4 transfers between June and September) or a modified UCT (6 transfers from April); both providing 130,000 FCFA/£144 in total. Eligible individuals (pregnant and lactating women and children 6- 0.05), despite improved food security (p < 0.05), possibly driven by increased fever/malaria in children (p < 0.001). Nonfood related drivers of malnutrition, such as disease, may limit the effectiveness of UCTs plus supplementary feeding to prevent malnutrition in this context. Caution is required in applying the findings of this study to periods of severe food insecurity

Taking the Long View: What Does a Child Focus Add to Social Protection?

Recognising that many indicators of vulnerability among children, such as malnutrition or poor educational performance, might reflect intergenerational problems has profound implications for the design and implementation of social protection programmes. Treating the symptoms of these problems is of course essential: a malnourished child needs immediate nutritional support and a child who is failing at school needs special attention. But the argument of this paper is that ‘taking the long view’ is imperative if the reasons why children are malnourished, or failing, are to be correctly identified and adequately addressed. Importantly, the analysis implies directing interventions not exclusively at the children who are at risk, but at others in society who are responsible for the care of children

A systematic review of frameworks for the interrelationships of mental health evidence and policy in low- and middle-income countries

Background: The interrelationships between research evidence and policy-making are complex. Different theoretical frameworks exist to explain general evidence–policy interactions. One largely unexplored element of these interrelationships is how evidence interrelates with, and influences, policy/political agenda-setting. This review aims to identify the elements and processes of theories, frameworks and models on interrelationships of research evidence and health policy-making, with a focus on actionability and agenda-setting in the context of mental health in low- and middle-income countries (LMICs). Methods: A systematic review of theories was conducted based on the BeHeMOTh search method, using a tested and refined search strategy. Nine electronic databases and other relevant sources were searched for peer-reviewed and grey literature. Two reviewers screened the abstracts, reviewed full-text articles, extracted data and performed quality assessments. Analysis was based on a thematic analysis. The included papers had to present an actionable theoretical framework/model on evidence and policy interrelationships, such as knowledge translation or evidence-based policy, specifically target the agenda-setting process, focus on mental health, be from LMICs and published in English. Results: From 236 publications included in the full text analysis, no studies fully complied with our inclusion criteria. Widening the focus by leaving out ‘agenda-setting’, we included ten studies, four of which had unique conceptual frameworks focusing on mental health and LMICs but not agenda-setting. The four analysed frameworks confirmed research gaps from LMICs and mental health, and a lack of focus on agenda-setting. Frameworks and models from other health and policy areas provide interesting conceptual approaches and lessons with regards to agenda-setting. Conclusion: Our systematic review identified frameworks on evidence and policy interrelations that differ in their elements and processes. No framework fulfilled all inclusion criteria. Four actionable frameworks are applicable to mental health and LMICs, but none specifically target agenda-setting. We have identified agenda-setting as a research theory gap in the context of mental health knowledge translation in LMICs. Frameworks from other health/policy areas could offer lessons on agenda-setting and new approaches for creating policy impact for mental health and to tackle the translational gap in LMICs

Inequities in maternal and child health outcomes and interventions in Ghana

<p>Abstract</p> <p>Background</p> <p>With the date for achieving the targets of the Millennium Development Goals (MDGs) approaching fast, there is a heightened concern about equity, as inequities hamper progress towards the MDGs. Equity-focused approaches have the potential to accelerate the progress towards achieving the health-related MDGs faster than the current pace in a more cost-effective and sustainable manner. Ghana's rate of progress towards MDGs 4 and 5 related to reducing child and maternal mortality respectively is less than what is required to achieve the targets. The objective of this paper is to examine the equity dimension of child and maternal health outcomes and interventions using Ghana as a case study.</p> <p>Methods</p> <p>Data from Ghana Demographic and Health Survey 2008 report is analyzed for inequities in selected maternal and child health outcomes and interventions using population-weighted, regression-based measures: slope index of inequality and relative index of inequality.</p> <p>Results</p> <p>No statistically significant inequities are observed in infant and under-five mortality, perinatal mortality, wasting and acute respiratory infection in children. However, stunting, underweight in under-five children, anaemia in children and women, childhood diarrhoea and underweight in women (BMI < 18.5) show inequities that are to the disadvantage of the poorest. The rates significantly decrease among the wealthiest quintile as compared to the poorest. In contrast, overweight (BMI 25-29.9) and obesity (BMI ≥ 30) among women reveals a different trend - there are inequities in favour of the poorest. In other words, in Ghana overweight and obesity increase significantly among women in the wealthiest quintile compared to the poorest. With respect to interventions: treatment of diarrhoea in children, receiving all basic vaccines among children and sleeping under ITN (children and pregnant women) have no wealth-related gradient. Skilled care at birth, deliveries in a health facility (both public and private), caesarean section, use of modern contraceptives and intermittent preventive treatment for malaria during pregnancy all indicate gradients that are in favour of the wealthiest. The poorest use less of these interventions. Not unexpectedly, there is more use of home delivery among women of the poorest quintile.</p> <p>Conclusion</p> <p>Significant Inequities are observed in many of the selected child and maternal health outcomes and interventions. Failure to address these inequities vigorously is likely to lead to non-achievement of the MDG targets related to improving child and maternal health (MDGs 4 and 5). The government should therefore give due attention to tackling inequities in health outcomes and use of interventions by implementing equity-enhancing measure both within and outside the health sector in line with the principles of Primary Health Care and the recommendations of the WHO Commission on Social Determinants of Health.</p