Selective feeding centres in refugee settings: evaluation framework protocol

Selective feeding programs are centres for the treatment of persons suffering from acute malnutrition. Unlike chronic malnutrition, acute malnutrition reflects recent problems. In a crisis situation, wasting is preferred above other indicators because it is sensitive to rapid change, indicates present change, can be used to monitor the impact of interventions and is a good predictor of immediate mortality risk. This paper reviews the current approach being used in the field to evaluate the effectiveness of feeding programs. There is no comprehensive evaluation framework in place to assess the impact of feeding programs on mortality due to malnutrition. Some loose outcome measures, such as the number of children enrolled in a feeding centre, are being used to determine if a feeding centre should continue. In addition, malnutrition prevalence and crude mortality rates determined through nutritional and mortality surveys are used to assess the impact of feeding programs. This procedure does not take into account potential confounding factors that impact on malnutrition prevalence, including access to non-relief foods and the general food ration. Therefore, one could not confidently say that the reduction of malnutrition prevalence is a result of feeding programs. This paper presents an alternative approach to evaluating feeding centres.<br /

Prevention of alcohol and other drug problems in culturally and linguistically diverse communities

Australia has long been known as a multicultural society. In 2009 around one-quarter of Australia&rsquo;s population was born overseas and immigrants come from more than 200 countries. While most of Australia&rsquo;s migrants come from New Zealand, the United Kingdom, India or China, the fastest growing immigrant populations are from sub-Saharan and northern Africa, and the Middle East. Immigrants from a non-English speaking country, as well as their children and grandchildren, are commonly referred to as culturally and linguistically diverse (CLD) as a way of acknowledging differences in ethnic identity and affiliation, as well as cultural and language practices and preferences. Culturally and linguistically diverse groups in Australia face many health challenges, one of which is a potential vulnerability to alcohol and other drug (AOD) use.The primary aim of this paper is to identify and evaluate primary prevention programs and initiatives aimed at preventing AOD harms in CLD communities.<br /

Immigration and social exclusion : examining health inequalities of immigrants through acculturation lenses

Over the last three decades, the number of people migrating from developing to developed countries has been increasing in stepwise fashion as a result of insecurity, war and poverty. Such mass population movement has resulted in dramatic demographic transformations of most developed countries (Organisation for Economic Co-operation and Development 2007). The latest demographic data indicate that about 4 million new immigrants entered OECD countries on a permanent basis in 2005, an increase of 10 per cent from 2004 (Organisation for Economic Co-operation and Development 2007). In Australia, the 2006 census data indicate that more than one in five Australians (22.2 per cent) were born overseas, a pattern that has remained constant since 1996. The overseas-born population increased in number between 1996 and 2006 by 13 per cent, from around 3.9 million to 4.4 million (Australian Bureau of Statistics 2007d). Although a considerable proportion of Australian residents born overseas (including refugees and humanitarian entrants) come from countries recently affected by war and political unrest (Australian Bureau of Statistics 2007d), at a global level, migration for family reunion is the dominant reason for the inflows, and labour immigration is expanding, while humanitarian migration (including refugees and asylum seekers) has been declining (Organisation for Economic Co-operation and Development 2007)

The need for the right socio-economic and cultural fit in the COVID-19 response in sub-Saharan Africa : examining demographic, economic political, health, and socio-cultural differentials in COVID-19 morbidity and mortality

The coronavirus disease (COVID-19) has spread quickly across the globe with devastating effects on the global economy as well as the regional and societies’ socio-economic fabrics and the way of life for vast populations. The nonhomogeneous continent faces local contextual complexities that require locally relevant and culturally appropriate COVID-19 interventions. This paper examines demographic, economic, political, health, and socio-cultural differentials in COVID-19 morbidity and mortality. The health systems need to be strengthened through extending the health workforce by mobilizing and engaging the diaspora, and implementing the International Health Regulations (2005) core capacities. In the absence of adequate social protection and welfare programs targeting the poor during the pandemic, sub-Saharan African countries need to put in place flexible but effective policies and legislation approaches that harness and formalise the informal trade and remove supply chain barriers. This could include strengthening cross-border trade facilities such as adequate pro-poor, gender-sensitive, and streamlined cross-border customs, tax regimes, and information flow. The emphasis should be on cross-border infrastructure that not only facilitates trade through efficient border administration but can also effectively manage cross-border health threats. There is an urgent need to strengthen social protection systems to make them responsive to crises, and embed them within human rights-based approaches to better support vulnerable populations and enact health and social security benefits. The COVI-19 response needs to adhere to the well-established ‘do no harm’ principle to prevent further damage or suffering as a result of the pandemic and examined through local lenses to inform peace-building initiatives that may yield long-term gains in the post-COVID-19 recovery efforts

Is removing blood donation barriers a donation facilitator? Australian African migrants’ view

Purpose &ndash; The aim of this study was to assess whether the removal of blood donation &ldquo;barriers&rdquo; facilitates blood donation intentions, using a sample of African migrants, and to identify the implications for social marketing. African migrants are currently under-represented as blood donors in Australia. Some members of the African community have unique donation needs that can only be served by this community. Design/methodology/approach &ndash; Interviews were conducted with 425 people from the African community in Victoria and South Australia. Factor analysis was performed on the barriers and the removal of barriers. Item groupings for both constructs differed, suggesting that barriers and their removal are not necessarily opposite constructs. Findings &ndash; The cultural society factor was negatively associated with blood donation intention (i.e. a barrier), whereas engagement and overcoming fear were positively associated with blood donation intention (i.e. facilitators). Cultural issues and lack of understanding were not seen to impede blood donation. Additionally, the removal of cultural barriers did not facilitate increases in blood donation intentions. Thus, the removal of barriers may not be sufficient on their own to encourage donation Research limitations/implications &ndash; This only examines the issue with regards to whether the removal of barriers is a facilitator of blood donation with one group of migrants, and relationships may vary across other migrant and non-migrant groups. Practical implications &ndash; Policymakers often use social marketing interventions to overcome barriers as a way of facilitating blood donation. This research suggests that removing barriers is indeed important because these barriers impede people considering becoming blood donors. However, the findings also suggest that the removal of barriers is insufficient on its own to motivate blood donations (i.e. the removal of barriers is a hygiene factor). If this is the case, social marketing campaigns need to be multifaceted, removing barriers as well as leveraging facilitators, simultaneously. Social implications &ndash; This work identified that the impact of barriers and their removal may facilitate effective social marketing campaigns in differing ways, in the context of blood donation. Originality/value &ndash; How barriers and their removal impact social marketing activities (i.e. blood donation behaviour) has generally not been explored in research

Food insecurity, malnutrition and mortality in Maewo and Ambae islands, Vanuatu

Context: This paper reports on findings from the ex-post evaluation of the Maewo Capacity Building project in Maewo Island, Vanuatu, which was funded by World Vision Australia.Objectives: To examine the extent to which the infrastructure and systems left behind by the project contributed to the improvement of household food security and health and nutritional outcomes in Maewo Island, using Ambae Island as a comparator.Setting: Two-stage cluster survey conducted from 6 to 20 July 2004, which included anthropometric measures and 4.5-year retrospective mortality data collection.Participants: A total of 406 households in Maewo comprising 1623 people and 411 households in Ambae comprising 1799 people.Main outcome measures: Household food insecurity, crude mortality rate (CMR), under-five mortality rate (U5MR) and malnutrition prevalence among children.Results: The prevalence of food insecurity without hunger was estimated at 15.3%(95% confidence interval (CI): 12.1, 19.2%) in Maewo versus 38.2% (95% CI: 33.6, 43.0%) in Ambae, while food insecurity with hunger in children did not vary by location. After controlling for the child&rsquo;s age and gender, children in Maewo had higher weight-for-age and height-for-age Z-scores than children of the same age in Ambae. The CMR was lower in Maewo (CMR &frac14; 0.47/10 000 per day, 95% CI: 0.39, 0.55) than in Ambae (CMR &frac14; 0.59/10 000 per day, 95% CI: 0.51, 0.67) but no difference existed in U5MR. The major causes of death were similar in both locations, with frequently reported causes being malaria, acute respiratory infection anddiarrhoeal disease.Conclusions: Project initiatives in Maewo Island have reduced the risks of mortality and malnutrition. Using a cross-sectional &lsquo;external control group&rsquo; design, this paper demonstrates that it is possible to draw conclusions about project effectiveness where baseline data are incomplete or absent. Shifting from donor-driven evaluations to impact evaluations has greater learning value for the organisation, and greater value when reporting back to the beneficiaries about project impact and transformationaldevelopment in their community. Public health nutritionists working in the field are well versed in the collection and interpretation of anthropometric data for evaluation of nutritional interventions such as emergency feeding programmes. These same skills can be used to conduct impact evaluations, even some time after project completion, and elucidate lessons to be learned and shared. These skills can also be applied more widely to projects which impact on the longer-term nutritional status ofcommunities and their food security.<br /

Good practice in microfinance: the challenges of a poverty focus in an evolving industry

The awarding of the 2006 Nobel Peace prize to Grameen Bank founder Muhammad Yunus has further highlighted how microfinance has come to be regarded as a significant and effective tool in making finance available to the poor. However, much debate still centres on both how microfmance should be delivered and its effectiveness measured. Microfinance funding is not something that should be undertaken lightly, and an awareness of all the cogent issues is essential for any donor looking to undertake effective microfinance programming. This chapter will outline some of the key arguments in the contested debate on effective microfinance programming. It will focus on a discussion of poverty and impact assessments and argues that the effective funding of microfinance is dependent on the ability of an NGO to recognise the many forms which micro finance can take and direct their funding accordingly.<br /