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Mobile Technology for Monitoring and Evaluation and Health Information Systems in Low- to Middle-Income Countries

Mobile Technology for Monitoring and Evaluation and Health Information Systems in Low- to Middle-Income Countries In many developing country settings, limited resources constrain the development and expansion of certain technology infrastructures — such as high-speed Internet — that could facilitate more efficient data collection and reporting in the health sector. Mobile technologies may offer an affordable alternative to (or alongside) other electronic health applications in many low-resource settings. In this paper, current  uses of such mobile technologies in the developing world are discussed, and how these approaches can be applied to improve national monitoring and evaluation (M&E) systems. Suggested guidelines on the use of mobile technology for M&E purposes are provided.

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Seeing the World as a Network – Jessica Fehringer

FehringerJessica Fehringer is MEASURE Evaluation’s gender portfolio manager. She oversees and organizes the array of activities explicitly addressing gender (here is an example). Her team also helps us integrate gender perspectives throughout the project.

Jessica was a “Child Survival Officer” in Malawi with the Peace Corps (1999-2001). She returned to study public health at Johns Hopkins, where she got her PhD. In the process, she worked on M&E for a program addressing HIV and gender in Mozambique – sealing her commitment to gender in global health. She arrived at MEASURE in 2011.

You see Jessica here with her son, Dylan, a train set aficionado. Jessica’s husband is a health economist also here at UNC. Jessica loves many of the things I associate with joie de vivre: good music, dance, walking in the woods, and good food. She also builds community. Here in Chapel Hill, she occasionally organizes an “hour of happiness” at the neighboring restaurant. My Outlook calendar reads for the next one “Emerge from your winter cave to celebrate an hour of happiness.” How can anyone resist that?

Gender-Based Power and Couples’ HIV Risk in North India

Gender inequality is a long-recognized driver of the HIV epidemic. However, few studies have investigated the association between gender-based power and HIV risk in India, which has the world’s third largest HIV epidemic.

Population-based data collected in 2003 from 3,385 couples residing in Uttar Pradesh and Uttarakhand, North India, were used to examine associations between gender-based power (wife’s autonomy and husband’s inequitable gender attitudes) and indicators of couples’ HIV risk (whether the husband had had premarital sex with someone other than his eventual spouse, extramarital sex in the past year or STI symptoms in the past year). Structural equation modeling was used to create composite variables for the gender-based power measures and test their associations with HIV risk measures.

Twenty-four percent of husbands had had premarital sex, 7% had had extramarital sex in the past year and 6% had had STI symptoms in the past year. Structural equation models indicated that wives who reported higher levels of autonomy were less likely than other wives to have husbands who had had extramarital sex in the past year (direct association) or STI symptoms in the past year (indirect association). Moreover, husbands who endorsed more inequitable gender attitudes were more likely than others to report having had premarital sex with someone other than their spouse, which in turn was associated with having had extramarital sex and STI symptoms in the past year.

If the associations identified in this study reflect a causal relationship between gender-based power and HIV risk behavior, then HIV prevention programs that successfully address inequitable gender roles may reduce HIV risks in North India.

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Geospatial Analysis in Global Health Monitoring and Evaluation

Geospatial  Analysis in Global Health M&E: A Process Guide to Monitoring and Evaluation for Informed Decision MakingGeospatial Analysis in Global Health: A Monitoring and Evaluation Guide for Making Informed Decisions provides monitoring and evaluation (M&E) practitioners an overview of geospatial analysis techniques applicable to their work. This guide shows how geospatial analysis can be used to support public health program decision-making along with routine planning and M&E.

The use of geographic information systems (GIS) for M&E of health programs is expanding. As a result of this expansion, a growing number of users are seeking to move beyond basic GIS techniques (such as facility mapping), into more advanced GIS applications that combine various GIS techniques, outputs, and routine M&E datasets to conduct geospatial analysis. However, knowing which advanced analysis approaches are most relevant for M&E can be challenging for M&E professionals with limited formal GIS training.

To identify the most appropriate spatial analysis techniques and help M&E professionals understand how to incorporate them into M&E, MEASURE Evaluation convened an experts meeting on Spatial Analytical Methods for M&E in December 2013 in Rosslyn, Virginia. Participating in the meeting were 18 GIS and global health experts with experience in either spatial analysis or M&E. The meeting’s objective was to identify key decision points where M&E practitioners might include spatial analysis techniques in their work.

Meeting participants recommended the development of a guide to give M&E and GIS practitioners an overview of how to select appropriate geospatial analysis techniques to help overcome the drawbacks of commonly used M&E data. This guide provides examples of ways to apply geospatial analysis within the context of M&E, along with resources for additional information if needed.

Prioridades para los esfuerzos locales de control de VIH (PLACE) en la República Dominicana

Prioridades para los esfuerzos locales de control de VIH (PLACE) en la República DominicanaEl objetivo principal del estudio PLACE (prioridades para los esfuerzos locales de control de VIH) en la República Dominicana es proporcionar información útil para la prevención estratégica del VIH y aumentar la capacidad de las organizaciones locales para recolectar tal información. PLACE se llevó acabo en seis regiones durante enero a julio del 2014. Para cada región, los objetivos fueron los siguientes:

  • Identificar las áreas de prevención prioritarias (APPs), también conocidas como zonas de alta transmisión o de alto riesgo (áreas que carecen de actividades de prevención)
  • Caracterizar y mapear los lugares y eventos de alto riesgo en cada APP donde se encuentren nuevas parejas sexuales o los usuarios de drogas socialicen, y donde se podrían implementar actividades de alcance comunitario (“outreach”) para personas en riesgo de adquirir y transmitir la infección
  • Caracterizar a los hombres y las mujeres que frecuentan lugares y eventos de alto riesgo y a personas que trabajan en estos lugares (incluyendo la prevalencia de sífilis y VIH), e identificar las brechas en la oferta de servicios de prevención del VIH (ej., pruebas de VIH y consejería, condones y programas para poblaciones clave)
  • Estimar el tamaño de las poblaciones clave en sitios, incluyendo las trabajadoras sexuales, hombres que tienen sexo con hombres, y personas transgéneros.

Otros objetivos al nivel nacional:

  • Describir las características de las poblaciones clave a nivel nacional, incluyendo una estimación de la prevalencia de sífilis y de VIH.
  • Aumentar la capacidad de las organizaciones locales y los proveedores de servicios para recolectar, analizar e interpretar los datos, y usar la información en el desarrollo de planes de acción regionales.

Prioridades para los esfuerzos locales de control de VIH (PLACE) en la República Dominicana

Reading: Economic Impact of HIV/AIDS on Households

Economic Impact of HIV/AIDS on Households
Falleiro, Savio P. New Delhi: Sage Publications, 2014.

Based on field-based studies in Goa, India, this book examines the economic impact of HIV/AIDS on HIV-infected individuals and HIV-affected households through comparative analyses with matched no-HIV/AIDS households. Through these findings, Falleiro seeks to influence policy-makers and improve existing initiatives to enhance the daily living of HIV-affected individuals and households.

Findings from a Multi-Country Assessment of Integrated Health Programs

Integration of health interventions is promoted to make better use of resources, meet health needs, and achieve sustained improvements in health.

The United States government (USG) contributes to a worldwide effort to communicate, learn about, and promote integration by funding projects, issuing guidance, developing indicators, convening meetings and working groups, sponsoring literature reviews and publishing. Specifically, a USG inter-agency group on integration published the GHI Principle Paper on Integration in the Health Sector in May 2012, developed a related results framework for integration, defined a list of indicators to measure the outputs and outcomes of integration (document forthcoming), and articulated a learning agenda. This report presents the results of a multi-country assessment of integrated health programs in 10 countries conducted by MEASURE Evaluation to inform this broader learning agenda on integration of health services.

This multi-country assessment was intended to be a first step in gathering information to understand the types of services that are being integrated; rationale for the choice of integration model and interventions; perceived strengths, weaknesses, and gaps of M&E systems; and environment, policies and systems that facilitate service integration.

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