This is a rare case study of a pilot project to address the specific needs of children under 5 affected by HIV/AIDS who are typically ignored at the programming level and often miss the benefits of general HIV/AIDS interventions. The project operated in Western Kenya and the study contains evidence of the work carried out, a lessons learned catalogue of the processes and tools developed, and a set of suggestions of how the tools and processes might be adapted to other groups in other contexts. It is an excellent example of a community based response to the needs of very young children and addresses the key challenges faced in attempting to do so
This report covers the main dilemmas and debates around HIV/AIDS and infant feeding practices. There is some focus on antiretrovirals and prevention of mother to child transmission, but sessions featured in the report mainly cover technical and progammatic issues, and the sharing of field experiences. The key themes are the issues of if and how to breastfeed, and confusion over unclear messages about infant feeding practices. Increasing access to information and voluntary counselling and testing is covered as well as community involvement and the perspective and role of breastfeeding supportive NGOs. Lessons learned are drawn upon and details of each working group on various subjects are documented. Research, monitoring and evaluation priorities are looked at, and there is a presentation of knowledge gaps and challenges for the future
Describes a process for synthesizing lessons learned from programme implementation in six countries, and using those lessons learned to adapt a programmatic framework. The framework is intended to guide the development and implementation of reproductive health components in integrated programmes in order to maximize their effectiveness
Can people remain healthy in a world that is sick? Many ecological disasters can be directly traced to careless exploitation of the environment, with human beings as first perpetrator and then victim. Our health closely mirrors the health of our surroundings: this is the basis of the Ecohealth approach. It recognizes the links between humans and their biophysical, social, and economic environments, and that these links are reflected in the population's state of health. This is a new area of research, requiring input from scientists, community and interest groups, and decision-makers. This book describes this new approach, providing lessons and recommendations from various IDRC-supported research activities. It demonstrates how decision-makers, in particular, can use the ecohealth approach to formulate policies and solutions that are both immediately visible and sustainable over the long term
This book has been written as a tool for people involved or interested in communication and natural resource management who seek a better understanding of how different theories and strategic change principles relate to actual practise. It relates a variety of theories and change principles in simplified, almost schematic form, to a series of real initiatives in the field through interactive 'experiences'. Each 'experience' is organised around a theme, a learning objective, a description of an actual natural resource management and communication initiative, and one or two theoretical lenses through which to analyse the initiative. The idea is not to 'discover' the right approach but rather to create an interactive space that enables you to reflect on what might work in your own context and also on how different contexts may require different approaches, principles and theoretical frameworks. People working in development fields other than natural resource management will also find this book very useful
In program assessment, impact can refer to outcomes that are shown to be caused by a program, and which would not have occurred in the absence of the program. Evaluation of impact in this sense involves analysis of causal relationships. This has been most successfully accomplished when assessing empirical indicators, in comparison to other social and cultural indicators associated with development. Assessing causal relationships when evaluating community development programs remains very challenging. Evaluations often have credible conclusions about results, but only provide hints about impact, in this sense.
The concepts and principles in this paper apply more to long-term community based development programs rather than disaster response programs. They are written from the perspective of an NGO practitioner, where evaluation is seen as part of the overall program cycle and normal program activities
This research analyzes the impacts of ICT on poverty reduction in Latin America and the Caribbean and proposes strategies to plan policies for sustainable development and poverty reduction using IS, with a view to reduce social and gender inequalities. It presents a diagnosis of ICTs use in poverty reduction based on research developed from 1995 (year of introduction of Internet in most of the region) to June of 2003. A short version is available in English
The article describes the Tygerberg Children's Hospital and Rotary Telemedicine Project in South Africa which links specialists from Tygerberg Hospital to doctors at regional community or district hospitals to improve healthcare in rural areas. The initiative has assembled its own telemedicine system using off-the-shelf computer equipment and software that is more affordable than commercial telemedicine systems. It describes the local context, how the system was set up and how it works. It outlines the challenges faced by the project
This document pulls together what research and experience tell us about the peer education in promoting attitude and behaviour change in adolescents around sexual and reproductive health. It also offers guidelines for policy makers and programme implementers to learn from others and to adapt strategies that will be most effective in their setting. Chapter one defines peer education, and explains some of the theoretical models. Chapter two justifies using peer education and discusses advantages and benefits of this approach. Chapter three synthesizes research on the impact of peer education in the Asian region. Chapter four compiles lessons learned from many research studies, to show what makes a peer education programme work. Chapter five presents a series of guidelines for planning and implementing adolescent reproductive health interventions, including tips for working with youth and adults
This case study outlines and assesses the Khayelitha programme, which focused on ART provision and aimed to document the feasibility of low-cost treatment and primary health care provision in developing countries. The document details the clinical outcomes of the programmes, the strategy used to ensure adherence and the contribution made by Treatment Action Campaign (TAC) to raise awareness and pressurise the government to develop an adequate response to the epidemic. The provision of ART in Khayelitsha had also a positive impact on prevention, making more HIV-positive people aware of their status, reducing stigma, being the catalyst of educational initiatives, improving the morale of health workers and keeping families intact and less at risk. The case study concludes with a comprehensive list of lessons learned and with key recommendations for the future, which include consolidation of nurse-based care, more training activities, integration of HIV/AIDS and TB services, educational programmes aimed at improving adherence to ART and a greater focus on paediatric AIDS and ART provision in rural remote areas
This article discusses the implementation of a hospital information system in Limpopo Province, South Africa and describes how it failed because of inadequate infrastructure and problems with the functioning of the system itself. Furthermore, users were not made sufficiently aware of the purpose of a computerised system and failed to appreciate the complexity of implementation and of the healthcare process. The paper calls for a better understanding of the unique nature of hospital information systems and for well designed evaluation to be built into the contracts from the beginning
This book describes the approach of COMPAS, a network of partners that supports 'development from within', based on local knowledge and practices. The body of the book consists of case studies which illustrate how development can be based on locally available resources, knowledge, values and leadership institutions; how there can be genuinely local determination of development options; and how the benefits of development within local areas and communities can be fostered
This report argues that real progress in health depends on strengthening health systems, centred on the principles of primary health care. This requires effective use of existing knowledge and technologies and innovation to create new health tools, along with appropriate structures and strategies to apply them. Success will need new forms of cooperation between international health agencies, national health leaders, health workers and communities, and other relevant sectors. Chapter 1 of the report looks at the current state of global health, highlighting the gap between the poor and better-off everywhere. Chapter 2 reflects on the slow progress towards achieving the Millenium Development Goals. Chapter 3 looks at the HIV/AIDS pandemic, and demonstrates why HIV/AIDS control needs to drive the agenda for the global health community. Chapter 4 looks at the steps needed to achieve polio eradication within the next few years, and chapter 5 concentrates on the lessons learned from the SARS outbreak. The theme of chapter 6 is the the overlap between communicable and non-communicable diseases and injuries occurring throughout the developing world, leading to a crisis of priorities for health systems. The concluding chapter returns to the statement that stronger health systems are necessary, and that strengthening health systems should be based on the principles and practices of primary health care
[Publisher's abstract] This book is a product of the second phase of a DFID-funded KaR project that is aimed at increasing the impact of research through improved dissemination of the research process and findings. It develops the ideas from phase one of the project 'Spreading the Word: Practical guidelines for research dissemination strategies' (Saywell and Cotton, 1999) (Source record number 35244). Based on in-depth consultation with Southern agencies about appropriate methods and formats by which to share information and knowledge relating to development research projects, this book provides dissemination checklists and guidelines. It also provides a useful overview of the issues and more specific advise for anyone engaged in development-related research, whether as contractors, practitioners or donors, at all stages of the project cycle
This paper explores how culture can be used in various forms (theatre, music, dance, traditional medicine, and more) as a means to communicate and encourage behavior change for HIV/AIDS prevention. It highlights theater for development and collaboration with traditional healers as viable alternatives to more conventional communication and behavior change models. It presents several case studies, good practices from the field, and lessons learned. The authors' understanding of a cultural approach to HIV/AIDS prevention means understanding and using a community's cultural references as a framework for the design and implementation of prevention policies and programmes. Programmes that have employed this approach are characterized by their participatory approach that fosters community ownership and in turn, can result in both greater efficacy and sustainability within the community
This resource pack is a helpful tool aimed at services, organisations and health professionals involved in the voluntary counselling and testing (VCT) centres in Kenya. VCT services offer HIV testing to asymptomatic individuals, and pre- and post-testing counselling. Compliance with quality requirements in the provision of the service is crucial to the achievement of the objectives. The National Guidelines for VCT set minimum standards for the registration and accreditation of sites and the Liverpool School of Tropical Medicine has devised a comprehensive quality assurance system to accompany the upscaling of the VCT programme, with an emphasis on individual and community involvement. This resource outlines the lessons learned in the implementation of quality assurance in VCT, and includes useful training materials and tools such as self-assessment and service supervision survey forms for the monitoring and evaluation of service delivery quality
The CORE Initiative provides technical and financial assistance to community- and faith-based organisations working to increase advocacy, reduce stigma and discrimination, and improve care and support programs in developing countries. Support is provided through conferences, demonstration projects, empowerment grants, and an online resource center (www.coreinitiative.org). This report reviews some of the major activities completed and lessons learned during the first 18 months of the initiative
This paper reviews national policies and programmes, NGO projects and community-based initiatives in three African countries, exploring the link between HIV/AIDS and child labour. Emphasis is placed on examining what is working
Rural households are managing as best they can in a rapidly changing and often threatening world which makes them vulnerable to the risk of HIV infection and ill equipped to cope with the effects of AIDS. Their chances of managing can be improved if they function in a supportive environment. However, in many cases this supportive environment does not exist and communities have to build their own resilience if they are to prove effective allies for rural households. Despite the difficulties of such a task, as shown in this paper, it is feasible. Certain conditions have to be met and pitfalls avoided in order to set up processes leading to sustainability and benefit all households as stakeholders. Such awareness is important for the communities themselves, but also for those providing outside assistance in order to trigger the building of community resilience and sustainability for all households, including in HIV/AIDS prevention and mitigation. This paper also reviews from a South East Asian perspective some of the lessons to be drawn from the global and African experiences and highlights some of the specificities and challenges of the region
Drawing from a consultation process to examine how local content in developing countries is created, adapted, and exchanged, this report provides some answers to these questions. It is a synthesis of lessons; the case stories which are reproduced in an accompanying report provide details on actual experienses and lessons from the ground