scholarly journals What works and why? Evaluation of a community nutrition programme in Kenya

2012 ◽  
Vol 16 (9) ◽  
pp. 1614-1621 ◽  
Author(s):  
Kirsten Havemann ◽  
Pat Pridmore ◽  
Andrew Tomkins ◽  
Kristine Dandanell Garn
Keyword(s):  
Child Survival ◽  
Intervention Programme ◽  
Community Based ◽  
Participatory Learning ◽  
Child Undernutrition ◽  
Participatory Learning And Action ◽  
Survival And Development ◽  
The Government ◽  
Nutritional Status Of Children ◽  
Nutrition Programme

AbstractObjectiveTo investigate the nutritional impact of a community-based programme that focused on social cohesion and action.DesignThe change in nutritional status of children aged 12–60 months was examined over a period of 3 years in Makueni District in Eastern Province of Kenya in six communities in which an intervention programme of Participatory Learning and Action was introduced and in ten communities in which only basic preparations were made but no intervention was started.SettingThe intervention was part of the Government of Kenya Community Based Nutrition Programme and was supported by the Government of Denmark.SubjectsChildren aged 12–60 months.ResultsAmong communities without intervention there were similar levels of underweight (mean Z-score: −1·63 v. −1·50 (NS); % with Z-score < –2: 36·6 % v. 34·5 % (NS)) and stunting (mean Z-score: −2·0 v. −1·99 (NS); % with Z-score < –2: 44·3 % and 47·4 % (NS)) at baseline and after 3 years. By contrast, among communities who had received interventions, there were significant improvements after 3 years in the levels of underweight (mean Z-score: −1·66 v. −1·37 (P < 0·02); % with Z-score < –2: 42·9 % v. 31·4 % (P < 0·035)) and stunting (mean Z-score: −2·05 v. −1·59 (P < 0·05); % with Z-score < –2: 52·7 % v. 39·7 % (P < 0·02)).ConclusionsThe results indicate considerable potential for using Participatory Learning and Action as a community-based approach to effectively address child undernutrition. It is suggested that these interventions are developed, implemented and evaluated more widely as a mean of tackling childhood undernutrition and improving child survival and development.

scholarly journals Sexual Reproductive Health: Improving Child Survival Initiatives in Botswana

2022 ◽  
Vol 05 (01) ◽  
Author(s):  
Ogar Rapinyana ◽  
Keyword(s):  
Growth And Development ◽  
Integrated Management ◽  
Child Survival ◽  
Childhood Illness ◽  
Sexual Reproductive Health ◽  
Survival And Development ◽  
Child Welfare Clinic ◽  
The Government ◽  
Children Under 5 ◽  
Strategic Goal

Improving maternal and child survival it’s an important integral part of health care. A large number of deaths in Africa emanate from preventable diseases and largely in the first month of life. Majority of deaths were from preventable causes such as pneumonia, diarrhea and malaria and all accounting to 14.9%, 9.2% and 7.3% respectively. In an endeavour to the prevent and promote healthcare system, the government of Botswana came up with a special programme geared toward protecting the locals against common diseases. The government of Botswana, through the Ministry of Health (MoH), introduced the Accelerated Child Survival and Development (ACSD) strategic plan intervention with a specific focus on reducing the ‘under five mortality rate’ (U5MR). One of the high-impact interventions for reducing the U5MR is the Integrated Management of Childhood Illness (IMCI) strategy. The strategic goal of IMCI is to reduce death, illness, and disability and to promote improved growth and development among children under 5 years of age. Child welfare clinic and Nutrition has been discovered as one of the strategy to promote child’s growth and development. This strategy can be effective if it is implemented with IMCI and Immunisation.

Community groups to increase Human papillomavirus (HPV) vaccination through Participatory Learning and Action, Reducing barriers and increasing community Mobilisation in Zambia (CHARMZ) project.

2020 ◽  
Author(s):  
Katarina Hoernke
Keyword(s):  
Cervical Cancer ◽  
Hpv Vaccination ◽  
Community Mobilisation ◽  
Structured Interviews ◽  
Community Based ◽  
Community Groups ◽  
Participatory Learning ◽  
Vaccination Uptake ◽  
Key Stakeholders ◽  
Participatory Learning And Action

Abstract Background Zambia has a high incidence of cervical cancer. Uptake of the human papillomavirus (HPV) vaccine has been low since it first became available in Zambia in 2013. Community mobilisation and engagement with civil society has been identified as a key component of HPV vaccination programs in low and middle-income countries. Of the evidence available on community-based interventions in the context of HPV, participatory approaches which work closely with local stakeholders to identify and overcome barriers to HPV vaccination uptake have shown promising results. This is a proposal for a community-based cluster randomised controlled trial to increase HPV vaccination uptake in Zambia through a participatory learning and action (PLA) cycle approach in community groups. PLA is an approach in which participants identify and prioritise problems, and subsequently develop, implement and evaluate solutions to improve the health needs of their community. Key stakeholders to be engaged in this project include government members, policymakers, healthcare, donors and relevant non-governmental organisations (NGO), religious leaders, and civil society members. Formative research will be carried out with key stakeholders through semi-structured interviews and focus group discussions. The community group intervention will be facilitated by local healthcare workers from the cervical cancer prevention program in Zambia (CCPPZ).Results Success will be indicated by an increase in HPV vaccination uptake. The primary outcome will be HPV vaccination rates measured quantitatively. Data will be gathered once at the start of the study, once midway through the PLA phase and once during the post-intervention phase. Questionnaires and semi-structured interviews will allow for measurement of secondary outcomes both quantitatively and qualitatively, including perceived (i) HPV vaccination and cervical cancer knowledge, (ii) acceptability, accessibility and equitability of the HPV vaccination, as well as (iii) attitudes of female group members towards other cervical cancer screening and treatment services.Conclusions There is a need to address the high cervical cancer disease burden in Zambia. This would be the first intervention aiming to increase HPV vaccination uptake in Zambia through a low-cost, sustainable and scalable community-based participatory learning and action cycle approach.

scholarly journals Using Participatory Learning and Action in a Community-Based Intervention to Prevent Violence Against Women and Girls in Mumbai’s Informal Settlements

2020 ◽  
Vol 19 ◽  
pp. 160940692097223
Author(s):  
Proshant Chakraborty ◽  
Nayreen Daruwalla ◽  
Apoorwa Deepak Gupta ◽  
Unnati Machchhar ◽  
Bhaskar Kakad ◽  
...  
Keyword(s):  
Violence Against Women ◽  
Informal Settlements ◽  
Development Programs ◽  
Access To Services ◽  
Community Based ◽  
Collaborative Process ◽  
Participatory Learning ◽  
Participatory Learning And Action ◽  
Women And Girls ◽  
Violence Prevalence

For over 3 decades, participatory learning and action (PLA) techniques have been prominent in formative and evaluative studies in community-based development programs in the Global South. In this paper, we describe and discuss the use of PLA approaches at the beginning of a community-based program for prevention of violence against women and girls in Mumbai’s urban informal settlements. We adapted six PLA techniques as part of a formative community mobilization and rapid needs assessment exercise, addressing perceptions of violence prevalence, sources of household conflict, experiences of safety and mobility, access to services, preferences for service and support, and visualization of an ideal community free from violence. We describe the collaborative process of developing and implementing PLA techniques and discuss its relevance in generating contextual and grounded understandings of violence as well as in identifying factors which can potentially enable and constrain interventions.

scholarly journals Sustainability of community-based women’s groups: reflections from a participatory intervention for newborn and maternal health in Nepal

2018 ◽  
Vol 54 (4) ◽  
pp. 731-749 ◽  
Author(s):  
Annemijn E C Sondaal ◽  
Kirti M Tumbahangphe ◽  
Rishi Neupane ◽  
Dharma S Manandhar ◽  
Anthony Costello ◽  
...  
Keyword(s):  
Leadership Capacity ◽  
External Support ◽  
Cross Sectional Survey ◽  
Community Based ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Participatory Learning ◽  
Participatory Learning And Action ◽  
Local Embeddedness ◽  
Group Members

Abstract Participatory community-based women’s group interventions have been successful in improving maternal and newborn survival. In rural Makwanpur, Nepal, exposure to these Participatory Learning and Action groups resulted in a thirty-percent reduction in neonatal mortality rate and significantly fewer maternal deaths. It is often theorised that participatory approaches are more likely to be sustained than top-down approaches, but this is rarely evaluated after the withdrawal of external support. We sought to understand how participatory learning and action (PLA) groups in Makwanpur fared after the supporting non-governmental organisation withdrew their support as well as factors affecting their sustainability. We used mixed methods, conducting a cross-sectional survey of 239 groups, thirty focus group discussions with group members and thirty key informant interviews within twelve–seventeen months after support was withdrawn. Eighty percent of groups were still active which suggests that PLA groups have a high chance of being sustained over time. Groups were more likely to be sustained if the group had local importance and members continued to acquire new knowledge. However, the participatory nature of the group and local embeddedness were not enough to sustain all groups. They also needed leadership capacity, a unifying activity such as a fund, and a strong belief in the value of their meeting to sustain. These key factors should be considered when seeking to enable sustainability of participatory interventions.

Sedition in Liberal Democracies

2018 ◽  
Author(s):  
Anushka Singh
Keyword(s):  
Freedom Of Expression ◽  
Legal Protection ◽  
Community Based ◽  
Political Speech ◽  
Liberal Democracies ◽  
Indian Experience ◽  
Judicial Discourse ◽  
The Law ◽  
The Government ◽  
The Right

Liberal democracies claim to give constitutional and legal protection of varying degrees to the right to free speech of which political speech and the right to dissent are extensions. Within the right to freedom of expression, however, some category of speeches do not enjoy protection as they are believed to be ‘injurious’ to society. One such unprotected form of political speech is sedition which is criminalized for the repercussions it may have on the authority of the government and the state. The cases registered in India in recent months under the law against sedition show that the law in its wide and diverse deployment was used against agitators in a community-based pro-reservation movement, a group of university students for their alleged ‘anti-national’ statements, anti-liquor activists, to name a few. Set against its contemporary use, this book has used sedition as a lens to probe the fate of political speech in liberal democracies. The work is done in a comparative framework keeping the Indian experience as its focus, bringing in inferences from England, USA, and Australia to intervene and contribute to the debates on the concept of sedition within liberal democracies at large. On the basis of an analytical enquiry into the judicial discourse around sedition, the text of the sedition laws, their political uses, their quotidian existence, and their entanglement with the counter-terror legislations, the book theorizes upon the life of the law within liberal democracies.

scholarly journals A Study on Supply–Demand Satisfaction of Community-Based Senior Care Combined with the Psychological Perception of the Elderly

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 643
Author(s):  
Jiangang Shi ◽  
Wenwen Hua ◽  
Daizhong Tang ◽  
Ke Xu ◽  
Quanwei Xu
Keyword(s):  
Latent Variables ◽  
Structural Equation ◽  
Care Service ◽  
Elderly Care ◽  
The Elderly ◽  
Living Environment ◽  
Equation Modeling ◽  
Strategic Decisions ◽  
Community Based ◽  
The Government

Based on Maslow’s hierarchy of needs theory and customer satisfaction theory, we constructed a satisfaction model for supply–demand satisfaction for community-based senior care (SSCSC) combined with the psychological perspective of the elderly, and four dimensions of basic living needs (BLNs), living environment (LE), personal traits (PTs), and livability for the aged (LA) were selected to construct the model. The data were obtained from 296 questionnaires from seniors over 50 years old (or completed by relatives on their behalf, according to their actual situation). Twenty-two observed variables were selected for the five latent variables, and their interactions were explored using structural equation modeling. The results showed that LA was the most significant factor influencing SSCSC, and it was followed by BLNs and LE. PTs did not show a direct effect on LA, but they could have an indirect effect on SSCSC through influencing BLNs and LE. Based on the current state of community aging satisfaction, we propose to establish a community elderly care service system based on the basic needs of the elderly population, providing differentiated and refined elderly care services and improving the level of aging-friendly communities. This study provides references for the government to formulate relevant policies and other supply entities to make strategic decisions and has important implications for further enhancing community elderly services to become an important part of the social security system for the elderly.

scholarly journals The failure of community-based health insurance schemes in Tanzania: opening the black box of the implementation process

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ramadhani Kigume ◽  
Stephen Maluka
Keyword(s):  
Health Insurance ◽  
Community Health ◽  
Rural Areas ◽  
Health Coverage ◽  
Access To Health Services ◽  
Community Based ◽  
Community Based Health Insurance ◽  
Urban Districts ◽  
Health Fund ◽  
The Government

Abstract Background Globally, there is increased advocacy for community-based health insurance (CBHI) schemes. Like other low and middle-income countries (LMICs), Tanzania officially established the Community Health Fund (CHF) in 2001 for rural areas; and Tiba Kwa Kadi (TIKA) for urban population since 2009. This study investigated the implementation of TIKA scheme in urban districts of Tanzania. Methods A descriptive qualitative case study was conducted in four urban districts in Tanzania in 2019. Data were collected using semi-structured interviews, focus group discussions and review of documents. A thematic approach was used to analyse the data. Results While TIKA scheme was important in increasing access to health services for the poor and other disadvantaged groups, it faced many challenges which hindered its performance. The challenges included frequent stock-out of drugs and medical supplies, which frustrated TIKA members and hence contributed to non-renewal of membership. In addition, the scheme was affected by poor collections and management of the revenue collected from TIKA members, limited benefit packages and low awareness of the community. Conclusions Similar to rural-based Community Health Fund, the TIKA scheme faced structural and operational challenges which subsequently resulted into low uptake of the schemes. In order to achieve universal health coverage, the government should consider integrating or merging Community-Based Health Insurance schemes into a single national pool with decentralised arms to win national support while also maintaining local accountability.

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