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Social Determinants of Health for Men Who Have Sex with Men and Transgender Women in San Salvador

Analysis of health problems from a social determinants perspective is a useful approach to identify overlapping areas across development sectors and reach development goals in education, governance, economic prosperity, and health.

In this research brief we analyze social determinants of health for MSM and TW in San Salvador by focusing on sex work and homelessness as social conditions that may influence the health of this population. Previous analyses of data from this study identified psychological pathways through which sexual stigma affects access to healthcare, stress, and well-being. In the current analyses, we explore the structural pathway through which sexual stigma may influence health for this population by limiting social and economic opportunities, and the resultant consequences for their health.

Access the brief in English or Spanish.

Improving Resource Allocation for HIV Programs with Geospatial Analysis

Using Geospatial Analysis to Improve Resource Allocation for HIV Programs in Iringa Region, TanzaniaUsing Geospatial Analysis to Improve Resource Allocation for HIV Programs in Iringa Region, Tanzania

Over a two-year period, MEASURE Evaluation worked with local authorities in the Iringa and Njombe regions of Tanzania to illustrate the potential of maps and geographic information systems (GIS) for supporting effective programming of resources and to enhance demand for and use of data for decision making in the health sector. The work started with activities designed to gather data on HIV transmission dynamics and service coverage, and continued with activities aiming to increase the capacity of district council health management teams to use this and other data to improve resource allocation for HIV programs.

This case study describes the capacity building process, summarizing the data used and providing illustrative examples of what worked. We conclude with lessons learned for other organizations interested in using GIS and improving data demand and use in their local HIV response, or in other health interventions.

Priorities for Local AIDS Control Efforts: Uganda

Priorities for Local AIDS Control Efforts Uganda, 2013-2014Priorities for Local AIDS Control Efforts Uganda, 2013-2014

The Priorities for Local AIDS Control Efforts (PLACE) method is a monitoring tool to identify priority prevention areas in a country and the specific venues within these areas where AIDS prevention pro-grams should be focused. The method translates the scientific principles of HIV/STI transmission epidemiology and applies new technologies in spatial analysis and HIV rapid testing into a step-by-step rapid assessment and planning tool for use at the local level. Scientific principles, available data, and information from experts are used to identify districts likely to have high incidence of HIV infection. Within these dis-tricts, a rapid assessment identifies gaps in HIV prevention programs. PLACE maps specific risk sites and provides indicators of the characteristics and behaviors of key populations that are critical to designing effective prevention programs.

Thirty districts in Uganda participated in the PLACE activities, carried out from July 2013 through July 2014. Districts were selected based on criteria determined by national-level stakeholders.

Reading: Evaluating Environment in International Development

evaluating-environment-intl-devEvaluating Environment in International Development
Uitto, Juha, editor. New York: Routledge, 2014.

Detailing perspectives and experiences from international aid agencies and programs, this book explores how systematic evaluation is key to sustainable development. Contributors explore how environmental concerns can be incorporated into the development agenda, evaluating normative work on the environment and economic consequences of development efforts.

Participatory Mapping to Assess Service Catchment and Coverage in Tanzania

Using Participatory Mapping to Assess Service Catchment and Coverage. Guidance from the Iringa Participatory Mapping ExerciseUsing Participatory Mapping to Assess Service Catchment and Coverage: Guidance from the Iringa Participatory Mapping Exercise

Effective program planning requires matching services with service needs. Program efficiency is enhanced when resources are targeted to or focused on program priorities, including areas of greatest need, underserved locations, or vulnerable populations. Geographic information systems (GIS) can be an effective decision-support tool to provide policy makers, program planners, and other stakeholders with maps of the spatial distributions of needs and service coverage, showing where services are matched to needs and where there are coverage gaps.

While such maps are easy to interpret, they are only as good as the data on which they are based. Some data may be readily available—for example, the locations of fixed facilities such as hospitals or clinics. Other data may need to be collected—for example, the size and location of groups who need specific services and the effective catchment area of program sites.

In Iringa Region, Tanzania, MEASURE Evaluation piloted a novel, low-cost approach using easily replicable methods to identify catchment areas and estimate coverage patterns for facility-based and outreach HIV services. The approach used combination of key informant interviews, printed maps, and open source GIS software to produce computer-generated, district-level maps of catchment and coverage patterns. This working paper details that approach for those seeking evaluate the spatial distribution of their own health programs.

Know Human Trafficking, Know Your Response: M&E Indicators for Trafficking in Persons and Health

Wayne Hoover, MEASURE Evaluation

Wayne Hoover, MEASURE Evaluation

Although awareness of trafficking in persons has increased significantly as a global concern with criminal justice, immigration, human rights, and economic ramifications, the health aspects and consequences of trafficking receive less attention. Individuals who have been trafficked experience a wide range of nega­tive health effects, including increased risk of gender-based violence, mental health problems, and poor sexual and reproductive health outcomes, including HIV[1]. Gender norms make both women and girls and men and boys vulnerable to different types of trafficking.

The MEASURE Evaluation project at the University of North Carolina at Chapel Hill has published a new compendium, Trafficking in Persons and Health: A Compendium of Monitoring and Evaluation Indicators. The compendium provides guidance on measurement at the intersection of trafficking, gender, and health — connections that are crucial to understanding and addressing the health needs of trafficked persons. All stakeholders involved in counter-trafficking efforts, from emergency health personnel and program managers to national policymakers, must consider the nexus of gender, health, and trafficking to adequately address and com­bat this complex human rights issue.

The compendium is designed to assist health program managers and decision-makers to plan, monitor, and evaluate their response to trafficking and health. A menu of indicator options allows users to select indicators that are most applicable to their programs or facilities.

“Trafficking is a human rights issue as well as a health issue,” says Abby Cannon, lead author of Trafficking in Persons and Health at MEASURE Evaluation. “We developed the compendium as a tool for programs and countries to track the health dimensions of the problem, and use that information to prioritize and address the health of individuals that have been trafficked. Ultimately, human trafficking is harmful and exploitative. If we want to have a society that nurtures and empowers people, we must understand and address trafficking at all levels, including health.”

MEASURE Evaluation developed the compendium of indicators in consultation with technical experts in the field of trafficking, gender, and health. Experts from USAID, the U.S. Department of State, the National Institute of Drug Abuse at the National Institutes of Health, UNICEF, the International Organization of Migration, the International Labor Organization, research institutions, non-governmental organizations, and civil society provided input.

To access a copy of the new publication, visit:

[1] Zimmerman C, Hossain M, Yun K, et al. The health of trafficked women: a survey of women entering posttrafficking services in Europe. Am J Public Health. 2008;98(1):55-59.

MEASURE Evaluation Strategic Information for South Africa Commemorates 16 Days of Activism


MEval-SIFSA team

Members of the MEval-SIFSA team show their painted hands after making a banner for the 16 Days campaign.

The MEASURE Evaluation Strategic Information for South Africa (MEval-SIFSA) team, in collaboration with John Snow, Inc., commemorated the 16 Days of Activism Against Gender Violence campaign. The group supported the campaign by making a personal a pledge against violence. The MEval-SIFSA team took part in creating a banner and made a pledge by placing their painted hand prints and signing their names on the banner.

The 16 Days of Activism Against Gender Violence is a global awareness campaign. It takes place every year from November 25, International Day for the Elimination of Violence Against Women, to December 10, International Human Rights Day. The South African government and many organizations are participating to create more awareness about gender violence and its effects on society.


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