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Data-to-Action Workshop Report: Uganda Humanitarian Violence Against Children and Youth Survey (HVACS), 2022
Get PDFThe Government of Uganda, civil society organisations, and international partners participated in a Data-to-Action (D2A) workshop in Kampala, Uganda, June 14–16, 2023. The workshop was co-convened by the Office of the Prime Minister’s Department of Refugees and the Baobab Research Programme Consortium, with support from the Ministry of Gender, Labour and Social Development; UNHCR; and U.S. Centers for Disease Control and Prevention headquarters staff. The Humanitarian Violence Against Children and Youth Survey (HVACS) D2A workshop supports countries in creating violence prevention priorities directly informed by HVACS data. These priorities are created by linking HVACS data to the suite of evidenced-based and prudent practices using the “INSPIRE: Seven Strategies for Ending Violence Against Children” technical package. The 2022 Uganda HVACS is the first representative study to estimate the prevalence of sexual, physical, and emotional violence against children and youth in humanitarian settlements. Survey results can be used to identify risk and protective factors for violence and abuse and to develop effective prevention strategies, as well as to inform HIV epidemic control in refugee settings in Uganda
Preparing the ground to influence humanitarian sector policies, guidelines, and strategies in Uganda: Case Study Two
Get PDFThis case study describes the pathway by which the Baobab Research Programme Consortium\u27s efforts have created a platform that is primed for influencing humanitarian sector policies, guidelines, and strategies with evidence and evidence-based approaches
The limits of nudging: Results of a randomized trial of text messages to promote home-based caregiving and reduce perceptions of stigma for COVID-19 patients in Kenyan informal settlements
No full textDuring the early stages of the global COVID-19 pandemic, governments searched for effective means to rapidly disseminate information about how to prevent the disease and care for sick household members. In June 2020, the government of Kenya considered sending text messages, a behavioral nudging approach, to inform and persuade the public to practice home-based care for those who were infected. We conducted a randomized evaluation of simple informational messages compared to messages targeting personal and social benefits for those receiving the messages. We hypothesized that those that received messages tailored around social or personal benefit would be more likely to undertake the promoted behaviors of isolating if infected with COVID-19 and intending to care for an infected family member. While fear and perceptions of stigma were widespread, more than two-thirds of respondents in the control condition expressed an intention to care for an infected family member at home. Despite greater recall of the personal benefit message, which used reciprocity as its key behavioral lever, intentions to provide care at home and perceptions of stigma did not differ across study groups. Rather, capabilities such as wealth and having sufficient room at home were the key determinants. While text messages as behavioral nudges may be useful for some behaviors, policymakers should consider a broader range of tools for behaviors that are influenced by people’s capabilities, since even low-cost interventions may crowd out the time and energy needed for other responses during an emergency
Individual interventions, collective lessons: Developing mid-range theory on women’s groups to improve health
No full textBackground: Interventions with women’s groups have been widely implemented to improve health outcomes in low- and middle-income settings, particularly India. While there is a large evidence base on the effectiveness of single interventions, it is challenging to predict whether a women’s group intervention delivered in one setting can be expected to work in another. Methods: We applied realist principles to develop and refine a mid-range theory on the effectiveness of women’s groups interventions, summarised key lessons for implementation, and reflected on the process. We synthesised primary data from several interventions in India, a systematic review, and an analysis of behaviour change techniques. We developed mid-range theories across three areas: maternal and newborn health, nutrition, and violence against women, as well as an overarching mid-range theory on how women’s groups can improve health. Results: Our overarching mid-range theory suggested that effective interventions should: build group or community capabilities; focus on health outcomes relevant to group members; and approach health issues modifiable through women’s individual or collective actions. We identified four key lessons for future interventions with women’s groups, including the importance of skilled and remunerated facilitation, sufficient intensity, supply-side strengthening, and the need to adapt delivery during scale up while maintaining fidelity to intervention theory. Conclusions: Our experience demonstrated the feasibility of developing mid-range theory from a combination of evidence and insights from practice. It also underscored the importance of community engagement and ongoing research to ‘thicken’ mid-range theories to design effective and scalable women’s groups interventions in India and similar settings
Utilisation de sondages d’opinion et de vignettes pour générer des données solides afin de mesurer l’opinion/ les attitudes du public sur la mutilation génitale féminine dans le comté d’Isiolo au Kenya : une étude pilote
No full textAssessing feasibility and acceptability of increasing access to sexual and reproductive health and rights through pharmacy outlets and community health volunteers
No full textBackground: Both unintended pregnancy and unsafe abortion are major public health problems in Kenya. The World Health Organization recommends the use of medication abortion to stop unwanted pregnancies. However, the extent of provision and uptake of medication abortion through private pharmacies in Kenya is not well known. This study assessed the feasibility and acceptability of utilizing pharmacy outlets and community health volunteers to increase women’s and girls’ access to information, medication abortion and other sexual and reproductive health services and rights. Methods: The study utilized a single arm (intervention only) pre-test and post-test design that involved implementing a set of interventions and comparing the baseline and endline indicators using simple frequencies considering the number of respondents involved in the study. The study, referred to as Tembe Mkononi project, was conducted from 1st February 2021 to 31st December 2022, in Homa Bay County. Data collection involved baseline and endline interviews with 10 pharmacy staff (drawn from 9 pharmacy outlets) and 20 community health volunteers while program data was extracted from pharmacy sales records. Results: A total of 527 clients obtained medication abortion drugs from the 9 participating pharmacy outlets between April and December 2022. There was a steady increase in the number of clients served from 15 clients in April 2022 to 112 clients in December 2022. Out of the 527 clients, 523 of them obtained family planning methods. All the pharmacy staff and community health volunteers expressed satisfaction and positive attitude towards the services provided to clients. Conclusion: Results of the study show that the provision of medication abortion and other sexual and reproductive health services such as contraceptives to women and girls through private pharmacy outlets was feasible and acceptable. Building the capacity of community health volunteers to create awareness, strengthen referral and follow-up activities increased demand and uptake of sexual and reproductive health services including medication abortion over the project period. Overall, the interventions implemented in a rural county in Western Kenya have potential in addressing the problem of unsafe abortion which is one of the leading causes of maternal morbidity and mortality in Kenya and other developing countries
MTN-030/IPM-041: A Phase 1, Randomized, Double-Blind Pharmacokinetic and Safety Study of Dapivirine/Levonorgestrel Vaginal Rings
No full textThe International Partnership for Microbicides (IPM), which was acquired by the Population Council in 2022, is the developer of the dapivirine vaginal ring and a multipurpose prevention technology (MPT) vaginal ring containing dapivirine and levonorgestrel. Two Phase 1 trials, evaluating pharmacokinetics, safety, bleeding patterns, acceptability, adherence and the vaginal microenvironment of the dapivirine levonorgestrel ring were conducted at sites in the United States by the Microbicide Trials Network (MTN). These data sets support the bleeding and acceptability analyses from one of the clinical trials (MTN-030)
Comparison of the penile microbiome in infant male circumcision: Mogen clamp versus Shangring
No full textBackground: This study aimed to characterise the infant penile (coronal sulcus) microbiome and the effects of early infant male circumcision (EIMC), following a standard surgical method (Mogen Clamp) and a non-surgical alternative (ShangRing). Methods: We collected coronal sulcus swabs at baseline and on days 7 and 14 post-circumcision from infants assigned to receive EIMC by Mogen Clamp (n = 15) or ShangRing (n = 15), in a randomised trial in Rakai and Kakuuto, Uganda. We used 16S rRNA gene-based sequencing and broad-coverage qPCR to characterise the infant penile microbiome and assess the effects of EIMC in both study arms. Findings: Prior to EIMC, the infant penile microbiome had a mixture of facultative and strict anaerobes. In both study arms, EIMC caused penile microbiome proportional abundance changes characterised by decreases in penile anaerobes [ShangRing Prevotella: −15.0%, (SD = 19.1); Mogen clamp Prevotella: −3.6% (11.2); ShangRing Veillonella: −11.3% (17.2); Mogen clamp Veillonella: −2.6% (11.8)] and increases in skin-associated facultative anaerobes [ShangRing Corynebacterium: 24.9%, (22.4); Mogen clamp Corynebacterium: 4.7% (21.3); ShangRing Staphylococcus: 21.1% (20.5); Mogen clamp Staphylococcus: 18.1% (20.1)]. Clostridium tetani was not detected during the study. Interpretation: Mogen Clamp and ShangRing EIMC both changed the composition of the infant penile microbiome by reducing the proportional abundances of anaerobes and uropathogens, which is consistent with medical male circumcision findings in adults. C. tetani was not increased by either EIMC method
Building locally anchored implementation science capacity: The case of the adolescent HIV implementation science alliance-supported local iS alliances
No full textBackground: The Fogarty International Center-led Adolescent HIV Implementation Science Alliance (AHISA) supports region-/country-specific implementation science (IS) alliances that build collaborations between research, policy, and program partners that respond to local implementation challenges. AHISA supported the development of seven locally-led IS alliances: five country-specific (i.e., Kenya, South Africa, Tanzania, Uganda, and Zambia), one in Central and West Africa, and one with youth researchers. This article outlines the aims, activities, and outcomes of local alliances, demonstrating how they enhance sustainable IS activities to address local challenges. Methods: We conducted a desk review of each alliance\u27s funding applications, reports, and data from the initial findings of a larger AHISA evaluation. The review analyzes common approaches, highlights their local relevance, and summarizes initial outcomes. Results: The local alliances have a common goal: to expand implementation of successful interventions to improve adolescent HIV. We identified four overarching themes across the local alliances’ activities: capacity building, priority setting, stakeholder engagement, and knowledge dissemination. Research capacity building activities include long-term mentorship between junior and senior researchers and short-term training for non-research partners. Setting priorities with members identifies local research needs and streamlines activities. Alliances incorporate substantial engagement between partners, particularly youth, who may serve as leaders and co-create activities. Dissemination shares activities and results broadly. Conclusion: Local IS alliances play a key role in building sustainable IS learning and collaboration platforms, enabling improved uptake of evidence into policy and programs, increased IS research capacity, and shared approaches to addressing implementation challenges