Importance of Health and Social Care Research into Gender and Sexual Minority Populations in Nepal

Despite progressive legislative developments and increased visibility of sexual and gender minority populations in the general population, mass media often report that this population face a wide range of discrimination and inequalities. LGBT (lesbian, gay, and bisexual, and transgender) populations have not been considered as priority research populations in Nepal. Research in other geographical settings has shown an increased risk of poor mental health, violence, and suicide and higher rates of smoking, as well as alcohol and drugs use among LGBT populations. They are also risk for lifestyle-related illness such as cancer, diabetes, and heart diseases. Currently, in Nepal, there is a lack of understanding of health and well-being, social exclusion, stigma, and discrimination as experienced by these populations. Good-quality public health research can help design and implement targeted interventions to the sexual and gender minority populations of Nepal

The analytical framework of water and armed conflict: a focus on the 2006 Summer War between Israel and Lebanon

This paper develops an analytical framework to investigate the relationship between water and armed conflict, and applies it to the ‘Summer War’ of 2006 between Israel and Lebanon (Hezbollah). The framework broadens and deepens existing classifications by assessing the impact of acts of war as indiscriminate or targeted, and evaluating them in terms of international norms and law, in particular International Humanitarian Law (IHL). In the case at hand, the relationship is characterised by extensive damage in Lebanon to drinking water infrastructure and resources. This is seen as a clear violation of the letter and the spirit of IHL, while the partial destruction of more than 50 public water towers compromises water rights and national development goals. The absence of pre-war environmental baselines makes it difficult to gauge the impact on water resources, suggesting a role for those with first-hand knowledge of the hostilities to develop a more effective response before, during, and after armed conflict

National discourses on women's empowerment in Bangladesh : continuities and change

As Bangladesh turns 40, improvements in women’s wellbeing and increased agency are claimed to be some of the most significant gains in the post-independence era. Various economic and social development indicators show that in the last 20 years, Bangladesh, a poor, Muslim-majority country in the classic patriarchal belt, has made substantial progress in increasing women’s access to education and healthcare (including increasing lifeexpectancy), and in improving women’s participation in the labour force. The actors implementing such programmes and policies and claiming to promote women’s empowerment are numerous, and they occupy a significant position within national political traditions and development discourses. In the 1970s and 1980s development ideas around women’s empowerment in Bangladesh were influenced by an overtly instrumentalist logic within the international donor sphere. This led to the women’s empowerment agenda being perceived as a donor driven project, which overlooks how domestic actors such as political parties, women’s organisations and national NGOs have influenced thinking and action around it. This paper explores how these perceptions and narratives around women’s empowerment have evolved in Bangladesh from 2000 to date. It studies the concepts of women’s empowerment in public discourse and reviews the meanings and uses of the term by selected women’s organisations, donor agencies, political parties and development NGOs. By reviewing the publicly available documents of these organisations, the paper analyses the multiple discourses on women’s empowerment, showing the different concepts associated with it and how notions such as power, domains and processes of empowerment are understood by these actors. It also highlights how these different discourses have influenced each other and where they have diverged, with an emphasis on what these divergences mean in terms of advancing women’s interests in Bangladesh. Keywords: Bangladesh; women’s empowerment; NGOs; political parties; women’s movement; international aid agencies

Livelihoods, conflict and aid programming: Is the evidence base good enough?

In conflict-affected situations, aid-funded livelihood interventions are often tasked with a dual imperative: to generate material welfare benefits and to contribute to peacebuilding outcomes. There may be some logic to such a transformative agenda, but does the reality square with the rhetoric? Through a review of the effectiveness of a range of livelihood promotion interventions—from job creation to microfinance—this paper finds that high quality empirical evidence is hard to come by in conflict-affected situations. Many evaluations appear to conflate outputs with impacts and numerous studies fail to include adequate information on their methodologies and datasets, making it difficult to appraise the reliability of their conclusions. Given the primary purpose of this literature—to provide policy guidance on effective ways to promote livelihoods— this silence is particularly concerning. As such, there is a strong case to be made for a restrained and nuanced handling of such interventions in conflict-affected settings.Department for International Development - PO511

Number and timing of antenatal HIV testing: Evidence from a community-based study in Northern Vietnam

<p>Abstract</p> <p>Background</p> <p>HIV testing for pregnant women is an important component for the success of prevention of mother-to-child transmission of HIV (PMTCT). A lack of antenatal HIV testing results in loss of benefits for HIV-infected mothers and their children. However, the provision of unnecessary repeat tests at a very late stage of pregnancy will reduce the beneficial effects of PMTCT and impose unnecessary costs for the individual woman as well as the health system. This study aims to assess the number and timing of antenatal HIV testing in a low-income setting where PMTCT programmes have been scaled up to reach first level health facilities.</p> <p>Methods</p> <p>A cross-sectional community-based study was conducted among 1108 recently delivered mothers through face-to-face interviews following a structured questionnaire that focused on socio-economic characteristics, experiences of antenatal care and HIV testing.</p> <p>Results</p> <p>The prevalence of women who lacked HIV testing among the study group was 10% while more than half of the women tested had had more than two tests during pregnancy. The following factors were associated with the lack of antenatal HIV test: having two children (aOR 2.1, 95% CI 1.3-3.4), living in a remote rural area (aOR 7.8, 95% CI 3.4-17.8), late antenatal care attendance (aOR 3.6, 95% CI 1.3-10.1) and not being informed about PMTCT at their first antenatal care visits (aOR 7.4, 95% CI 2.6-21.1). Among women who had multiple tests, 80% had the second test after 36 weeks of gestation. Women who had first ANC and first HIV testing at health facilities at primary level were more likely to be tested multiple times (OR 2.9 95% CI 1.9-4.3 and OR = 4.7 95% CI 3.5-6.4), respectively.</p> <p>Conclusions</p> <p>Not having an HIV test during pregnancy was associated with poor socio-economic characteristics among the women and with not receiving information about PMTCT at the first ANC visit. Multiple testing during pregnancy prevailed; the second tests were often provided at a late stage of gestation.</p

Sustainable Consumption Behavior in Sub-Saharan Africa: A Conceptual Framework

This paper develops a conceptual framework for investigating the adoption patterns, inhibitors, and facilitators ( PIF ) of sustainable consumption in sub-Sahara African ( SSA ) settings. Literature evidence shows paucity of empirical studies on sustainable consumption from SSA , which partly explains lack of suitable conceptual framework to guide research in this area. Also, the existing frameworks, which were developed outside SSA may not be suitable for constructing sustainable consumption behavior in SSA because of its peculiarities. The key signifi cance of this article is the potential of providing future researchers in this area with a framework to guide and manage their studies. As a conceptual article, insight was drawn from a plethora of scholarly articles in the domain of sustainable consumption and related areas. The framework is built on four key constructs—adoption patterns, inhibitors, facilitators ( PIF ), and intention. As a guide for studies from the SSA , the article includes an empirical section, which provides preliminary empirical validation for the proposed PIF conceptual framework based on a pilot test. The result from the pilot study, using structural equation modeling ( SEM ), led to positing the PIF Sustainable Consumption model, thus giving support for the PIF Conceptual Framework, which this article puts forward. In addition, the proposed PIF conceptual framework is capable of providing insight for crafting sustainability-related policies. © 2016 Wiley Periodicals, Inc

Geography, institutions and development: a review ofthe long-run impacts of climate change

The links between climate change, economic growth and economic development have gained increasing attention over recent years in both the academic and policy literature. However, most of the existing literature has tended to focus on direct, short run effects of climate change on the economy, for example due to extreme weather events and changes in agricultural growing conditions. In this paper we review potential effects of climate change on the prospects for long-run economic development. These effects might operate directly, via the role of geography (including climate) as a fundamental determinant of relative prosperity, or indirectly by modifying the environmental context in which political and economic institutions evolve. We consider potential mechanisms from climate change to long-run economic development that have been relatively neglected to date, including, for instance, effects on the distribution of income and political power. We conclude with some suggestions for areas of future research

Are health systems interventions gender blind? examining health system reconstruction in conflict affected states

Background Global health policy prioritizes improving the health of women and girls, as evident in the Sustainable Development Goals (SDGs), multiple women’s health initiatives, and the billions of dollars spent by international donors and national governments to improve health service delivery in low-income countries. Countries recovering from fragility and conflict often engage in wide-ranging institutional reforms, including within the health system, to address inequities. Research and policy do not sufficiently explore how health system interventions contribute to the broader goal of gender equity. Methods This paper utilizes a framework synthesis approach to examine if and how rebuilding health systems affected gender equity in the post-conflict contexts of Mozambique, Timor Leste, Sierra Leone, and Northern Uganda. To undertake this analysis, we utilized the WHO health systems building blocks to establish benchmarks of gender equity. We then identified and evaluated a broad range of available evidence on these building blocks within these four contexts. We reviewed the evidence to assess if and how health interventions during the post-conflict reconstruction period met these gender equity benchmarks. Findings Our analysis shows that the four countries did not meet gender equitable benchmarks in their health systems. Across all four contexts, health interventions did not adequately reflect on how gender norms are replicated by the health system, and conversely, how the health system can transform these gender norms and promote gender equity. Gender inequity undermined the ability of health systems to effectively improve health outcomes for women and girls. From our findings, we suggest the key attributes of gender equitable health systems to guide further research and policy. Conclusion The use of gender equitable benchmarks provides important insights into how health system interventions in the post-conflict period neglected the role of the health system in addressing or perpetuating gender inequities. Given the frequent contact made by individuals with health services, and the important role of the health system within societies, this gender blind nature of health system engagement missed an important opportunity to contribute to more equitable and peaceful societies