Scaling up Kudumbashree collective action for poverty alleviation and women's empowerment

"This paper discusses the factors that enabled and constrained the scaling up of a multisectoral poverty alleviation program called Kudumbashree, initiated by the government of Kerala (GOK), India, in 1998 to eradicate poverty by 2008. It also discusses some potential threats to and trade-offs of scaling up Kudumbashree. This report draws primarily upon the available literature and qualitative data collected during a five-day visit to Kudumbashree in March 2003....Our findings show that an enabling environment, especially decentralization and the concurrent devolution of finances to the local government bodies (LGBs), was critical in scaling up Kudumbashree. The CDS structures are now considered as a further step to decentralization. As the CDS structures are affiliated to the LGBs, their financial sustainability is ensured through various modalities, e.g., convergence, women's component plan, and earmarked assistance to women's self-help groups (SHG). The unique context of Kerala, coupled with leadership of a few motivated and innovative officials, was key in both the decentralization and scaling-up process." Authors' AbstractScaling-up ,Collective action ,

Scaling up HIV/AIDS interventions through expanded partnerships (STEPs) in Malawi

"This paper discusses enabling and constraining factors related to the scaling-up of the Scaling Up HIV/AIDS Interventions Through Expanded Partnerships (STEPs) initiative, supported by Save the Children U.S.A. (SC), to combat HIV/AIDS in Malawi. It also discusses potential threats to and contextual factors limiting scaling up of STEPs. The report draws primarily upon the available literature and qualitative data collected during a five-day visit to SC Malawi in December 2002. STEPs started in 1995 as Community-Based Options for Protection and Empowerment (COPE). COPE was a service-delivery program in Mangochi District to assist children affected by HIV/AIDS. Through evaluations, SC realized that such an approach was unsustainable, not cost-effective, and not scalable. Based on the recommendations of the evaluations and on field experience, the program changed course to mobilize collective action to combat the epidemic. Working in the Namwera community in Mangochi under the National AIDS Commission (NAC), STEPs revitalized the dormant decentralized AIDS committees and their technical subcommittees at the district, community, and village levels. Based on the positive experience in Namwera, the program changed its initial strategy to that of an external change agent, assisting communities with community mobilization and capacity building so that communities became empowered to act collectively to address their problems. Village AIDS committees (VACs) first identify the vulnerable. Then VACs plan responses on the basis of the nature and magnitude of vulnerability within the villages, needs of the vulnerable, and capacity within villages to respond. The committees also monitor activities and mobilize resources. As the needs of the most affected communities are crosscutting, the program has become truly multisectoral, with activities along the continuum of prevention, care, support, and mitigation. STEPs has also been influencing national policies related to HIV/AIDS and children." Authors' AbstractCapacity building ,HIV/AIDS Africa ,Collective action ,Community organizations ,Community mobilization ,Scaling up ,

Rethinking food aid to fight AIDS

"HIV/AIDS is a slow-moving, devastating shock that kills the most productive members of society, increases household dependency ratios, reduces household productivity and caring capacity, and impairs the intergenerational transfer of knowledge. It is socially invisible, complicated by silence, denial, stigma, and discrimination. While it affects both rich and poor, it is the poor who are most severely impacted. Though it affects both sexes, it is not gender neutral. Though AIDS is far more than just another health problem, many development organizations have yet to undertake thorough analyses of its impact on what they do and how they do it. Even fewer have actually changed their policies and procedures to adjust to the new realities. In the era of AIDS, food and nutrition security is becoming even more of a priority for many households and communities. We know that food and nutrition are fundamentally intertwined with HIV transmission and the impacts of AIDS. Evidence of the ways in which food insecurity and malnutrition may increase susceptibility to HIV as well as vulnerability to AIDS impacts, and how HIV/AIDS in turn exacerbates these conditions is increasingly well documented. Food and nutrition security is fundamentally relevant to all four of the conventional pillars of HIV/AIDS response prevention, care, treatment, and mitigation and food aid can be an important addition to the arsenal. This paper, based on a detailed review of the relevant literature and the findings of a mission to eastern and southern Africa, highlights the implications of the HIV/AIDS pandemic for food aid strategy and programming. By viewing food aid programs through an "HIV/AIDS lens" and in the context of a livelihoods approach, the authors argue that organizations can design effective interventions that reduce both susceptibility to HIV and vulnerability to AIDS impacts. Though there is little empirical evidence regarding the effectiveness of food aid in responding to HIV/AIDS, the authors argue this should not constrain action. Using past experience as a guide, organizations can learn by doing, documenting, and continuously reassessing their programs using the evolving HIV/AIDS lens. By doing so, they ensure maximal relevance and impact.." from Authors' AbstractHIV/AIDS Economic aspects ,HIV/AIDS Political aspects ,HIV/AIDS Social aspects ,Gender issues ,

Rethinking food aid to fight AIDS

"HIV/AIDS is a slow-moving, devastating shock that kills the most productive members of society, increases household dependency ratios, reduces household productivity and caring capacity, and impairs the intergenerational transfer of knowledge. It is socially invisible, complicated by silence, denial, stigma, and discrimination. While it affects both rich and poor, it is the poor who are most severely impacted. Though it affects both sexes, it is not gender neutral. Though AIDS is far more than just another health problem, many development organizations have yet to undertake thorough analyses of its impact on what they do and how they do it. Even fewer have actually changed their policies and procedures to adjust to the new realities. In the era of AIDS, food and nutrition security is becoming even more of a priority for many households and communities. We know that food and nutrition are fundamentally intertwined with HIV transmission and the impacts of AIDS. Evidence of the ways in which food insecurity and malnutrition may increase susceptibility to HIV as well as vulnerability to AIDS impacts, and how HIV/AIDS in turn exacerbates these conditions is increasingly well documented. Food and nutrition security is fundamentally relevant to all four of the conventional pillars of HIV/AIDS response prevention, care, treatment, and mitigation and food aid can be an important addition to the arsenal. This paper, based on a detailed review of the relevant literature and the findings of a mission to eastern and southern Africa, highlights the implications of the HIV/AIDS pandemic for food aid strategy and programming. By viewing food aid programs through an "HIV/AIDS lens" and in the context of a livelihoods approach, the authors argue that organizations can design effective interventions that reduce both susceptibility to HIV and vulnerability to AIDS impacts. Though there is little empirical evidence regarding the effectiveness of food aid in responding to HIV/AIDS, the authors argue this should not constrain action. Using past experience as a guide, organizations can learn by doing, documenting, and continuously reassessing their programs using the evolving HIV/AIDS lens. By doing so, they ensure maximal relevance and impact.." from Authors' AbstractHIV/AIDS Economic aspects ,HIV/AIDS Political aspects ,HIV/AIDS Social aspects ,Gender issues ,

Rethinking food aid to fight AIDS

To fully realize the potential of food aid to reduce risk and to mitigate the impacts of HIV/AIDS, existing strategies and interventiuons need to be re-viewed using an HIV/AIDS lens.HIV/AIDS ,Human capital ,

Scaling up Kudumbashree collective action for poverty alleviation and women's empowerment

"This paper discusses the factors that enabled and constrained the scaling up of a multisectoral poverty alleviation program called Kudumbashree, initiated by the government of Kerala (GOK), India, in 1998 to eradicate poverty by 2008. It also discusses some potential threats to and trade-offs of scaling up Kudumbashree. This report draws primarily upon the available literature and qualitative data collected during a five-day visit to Kudumbashree in March 2003....Our findings show that an enabling environment, especially decentralization and the concurrent devolution of finances to the local government bodies (LGBs), was critical in scaling up Kudumbashree. The CDS structures are now considered as a further step to decentralization. As the CDS structures are affiliated to the LGBs, their financial sustainability is ensured through various modalities, e.g., convergence, women's component plan, and earmarked assistance to women's self-help groups (SHG). The unique context of Kerala, coupled with leadership of a few motivated and innovative officials, was key in both the decentralization and scaling-up process." Authors' AbstractScaling-up ,Collective action ,

Scaling up HIV/AIDS interventions through expanded partnerships (STEPs) in Malawi

"This paper discusses enabling and constraining factors related to the scaling-up of the Scaling Up HIV/AIDS Interventions Through Expanded Partnerships (STEPs) initiative, supported by Save the Children U.S.A. (SC), to combat HIV/AIDS in Malawi. It also discusses potential threats to and contextual factors limiting scaling up of STEPs. The report draws primarily upon the available literature and qualitative data collected during a five-day visit to SC Malawi in December 2002. STEPs started in 1995 as Community-Based Options for Protection and Empowerment (COPE). COPE was a service-delivery program in Mangochi District to assist children affected by HIV/AIDS. Through evaluations, SC realized that such an approach was unsustainable, not cost-effective, and not scalable. Based on the recommendations of the evaluations and on field experience, the program changed course to mobilize collective action to combat the epidemic. Working in the Namwera community in Mangochi under the National AIDS Commission (NAC), STEPs revitalized the dormant decentralized AIDS committees and their technical subcommittees at the district, community, and village levels. Based on the positive experience in Namwera, the program changed its initial strategy to that of an external change agent, assisting communities with community mobilization and capacity building so that communities became empowered to act collectively to address their problems. Village AIDS committees (VACs) first identify the vulnerable. Then VACs plan responses on the basis of the nature and magnitude of vulnerability within the villages, needs of the vulnerable, and capacity within villages to respond. The committees also monitor activities and mobilize resources. As the needs of the most affected communities are crosscutting, the program has become truly multisectoral, with activities along the continuum of prevention, care, support, and mitigation. STEPs has also been influencing national policies related to HIV/AIDS and children." Authors' AbstractCapacity building ,HIV/AIDS Africa ,Collective action ,Community organizations ,Community mobilization ,Scaling up ,

Poor diet quality is associated with low CD4 count and anemia and predicts mortality among antiretroviral therapy-naive HIV-positive adults in Uganda.

BACKGROUND: We assessed the association between dietary diversity and CD4 count, moderate anemia, and mortality among 876 antiretroviral therapy-naive people living with HIV/AIDS infection (PLHIV) in Uganda. METHODS: Participants were interviewed and followed for an average of 21.6 months. Dietary diversity was measured using the Individual Dietary Diversity Score (IDDS) (range, 0-12) and summarized into an overall measure and disaggregated into nutrient-rich food groups (range, 0-7), cereals, roots, and tubers (range, 0\x{2013} 2); and oils, fats, sugars, and condiments (range, 0\x{2013} 3). We determined the cross-sectional associations between dietary diversity and (1) immunosuppression (CD4 count ≤ 350 cells/μL) and (2) moderate anemia (hemoglobin 350 CD4 cells per microliter, but not those with CD4 count ≤350 cells per microliter, consumption of nutrient-rich food groups was associated with a lower odds of moderate anemia (adjusted odds ratio, 0.57; 95% CI: 0.34 to 0.96). During follow-up, 48 participants (5.6%) died (mortality rate of 3.1 per 100 person-years). IDDS was inversely associated with mortality [adjusted hazard ratio, 0.76; 95% CI: 0.63 to 0.91]. CONCLUSION: These results suggest that diet quality is an important determinant of HIV disease severity and mortality in antiretroviral therapy-naive PLHIV

Dietary Transition in India: Temporal and Regional Trends, 1993 to 2012.

BACKGROUND: Rapid economic growth, urbanization, and globalization have resulted in dietary transformation in India. Triple burden of malnutrition remains a significant concern, with high prevalence of undernutrition, widespread micronutrient deficiencies, and rising obesity. OBJECTIVE: This article reviews the dietary transition in India by analyzing trends in food consumption across time and space. METHODS: Household consumption survey data from 1993 to 2012 are analyzed to examine both national- and state-level trends to investigate how diets have changed and vary across the country. Typical Indian diets are characterized using k-mean cluster analysis and associated with socioeconomic and geographical aspects. RESULTS: The article finds that on average Indian household diets have diversified slowly but steadily since the 90s. Indians diets have shifted away from cereals to higher consumption of milk. However, progress on micronutrient-rich food groups such as fruits, vegetables, meat, and egg has been worryingly slow. Even by 2012, about a fifth of rural Indian households did not consume fruits or milk, while more than half of both urban and rural households did not consume any meat, fish, or eggs. Five predominant dietary types are identified. Sections of the Indian households do consume reasonably balanced diets, but large percentages consume cereal-focused, dairy-focused, or processed food heavy diets with high processed food content. CONCLUSIONS: Diets in India have not transformed sufficiently to overcome major gaps in intakes of micronutrient-rich foods. Large regional heterogeneities in diets call for regionally differentiated strategies to improve diets