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Video: A Conversation with Leontine Gnassou

In a new short video, Leontine Gnassou discusses MEASURE Evaluation’s work in Côte d’Ivoire. Watch:

Validating Estimates of the Size of Key Populations: A Study in Region 4 of Guyana

Validating Estimates of the Size of Key Populations: A Study in Region 4 of GuyanaHIV is a major cause of death in Guyana. Cases are concentrated in the coastal regions, and certain subpopulations face much higher rates of HIV. Before effective interventions for these key populations can be designed, researchers must understand where they are and how to reach them. Previous partnerships between MEASURE Evaluation (funded by the U.S. Agency for International Development [USAID]) and Guyana’s National AIDS Programme Secretariat (NAPS), in 2014 and 2015, studied populations of special interest in the HIV epidemic using the Priorities for Local AIDS Control Efforts (PLACE) method. These earlier studies produced analyses of subgroup risk factors and locations that were used to set targets for outreach and testing among key populations.

Because the PLACE study was not designed to produce subnational size estimates, this report outlines a validation study conducted to update those earlier estimates. The study focus on Region 4 of Guyana, an area with a high density of key populations and need for outreach activities. The assessment, completed in the spring of 2017, was managed by the Society Against Sexual Orientation Discrimination (SASOD) with technical oversight from MEASURE Evaluation. Input was also received from national partners, such as the National AIDS Programme Secretariat.

The knowledge generated by this assessment will inform HIV outreach and prevention activities with key populations, primarily in Region 4. It will help outreach organizations better target their activities and determine whether they are reaching those who need services most.

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East Africa Cross-Border Integrated Health Report

East Africa Cross-Border Integrated Health ReportThis report presents the results of a cross-sectional study describing the health status and behaviors of mobile and vulnerable populations living in or traveling through 12 cross-border sites in the East African countries of Kenya, Rwanda, Tanzania, and Uganda. Findings will be used to better focus interventions to increase survival, improve quality of life, and reduce HIV transmission at cross-border sites.

The study employed a mixed-methods approach combining quantitative and qualitative research techniques. Health and service delivery outcomes were measured at 12 cross-border sites through two data collection components: the Priorities for Local AIDS Control Efforts (PLACE) method and a health facility survey consisting of a quantitative survey focused on services provided, a qualitative interview exploring experiences of healthcare workers based at facilities located in cross-border sites, and abstraction of clinical data to measure specific health indicators. Through qualitative interviews, the study team constructed a cohort of people first enrolled in HIV care and treatment at cross-border sites and interviewed a larger group of participants sampled from public places about their health behaviors and access to health services.

This study resulted in 12 key findings or recommendations concerning cross-border sites in East Africa, including lessons for future studies.

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Improving Health Networks: A Smart Idea

An organizational network analysis by MEASURE Evaluation showed that health providers can work together to improve HIV care without any need for new services. Watch a short video below and read more.

How Do Masters of Public Health Programs Teach Monitoring and Evaluation?

Hemali

Hemali Kulatilaka, MSc, MPA, is a senior technical specialist for capacity building with MEASURE Evaluation and a co-author of the journal article.

Introduction: The health systems in developing countries face challenges because of deficient monitoring and evaluation (M&E) capacity with respect to their knowledge, skills, and practices. Strengthening M&E training in public health education can help overcome the gaps in M&E capacity. There is a need to advance the teaching of M&E as a core element of public health education.

Objectives: To review M&E teaching across Masters of Public Health programs and to identify core competencies for M&E teaching in South Asian context.

Materials and methods: We undertook two activities to understand the M&E teaching across masters level programs: (1) desk review of M&E curriculum and teaching in masters programs globally and (2) review of M&E teaching across 10 institutions representing 4 South Asian countries. Subsequently, we used the findings of these two activities as inputs to identify core competencies for an M&E module through a consultative meeting with the 10 South Asian universities.

Results: Masters programs are being offered globally in 321 universities of which 88 offered a Masters in Public Health, and M&E was taught in 95 universities. M&E was taught as a part of another module in 49 institutions. The most common duration of M&E teaching was 4–5 weeks. From the 70 institutes where information on electives was available, M&E was a core module/part of a core module at 42 universities and an elective at 28 universities. The consultative meeting identified 10 core competencies and draft learning objectives for M&E teaching in masters programs in South Asia.

Conclusion: The desk review showed similarities in M&E course content but variations in course structure and delivery. The core competencies identified during the consultation included basic M&E concepts. The results of the review and the core competencies identified at the consultation are useful resources for institutions interested in refining/updating M&E curricula in their postgraduate degree programs. Our approach for curriculum development as well as the consensus building experience could also be adapted for use in other situations.

Access the journal article and read a related news story.

 

Video: A Coordinated Effort for Health

A short video shares parts of a ceremony co-organized by MEASURE Evaluation, with USAID support, to show broad coordination among multiple actors to roll out the DHIS 2 system — from the Ministry of Health, each region, district, and different departments of health programs using DHIS 2. Watch:

Availability of family planning services and quality of counseling by faith-based organizations: a three country comparative analysis

Availability of family planning services and quality of counseling by faith-based organizations: a three country comparative analysisBackground: Faith-based organizations (FBOs) have a long history of providing health services in developing countries and are important contributors to healthcare systems. Support for the wellbeing of women, children, and families is evidenced through active participation in the field of family planning (FP). However, there is little quantitative evidence on the availability or quality of FP services by FBOs.

Methods: The descriptive analysis uses facility-level data collected through recent Service Provision Assessments in Malawi (2013–14), Kenya (2010), and Haiti (2012) to examine 11 indicators of FP service and method availability and nine indicators of comprehensive and quality counseling. The indicators include measures of FP service provision, method mix, method stock, the provision of accurate information, and the discussion of reproductive intentions, client’s questions/concerns, prevention of sexually transmitted infections, and return visits, among others. Pearson’s Chi-square test is used to assess the selected indicators by managing authority (FBO, public, and other private sector) to determine statistical equivalence.

Results: Results show that FBOs are less likely to offer FP services than other managing authorities (p < 0.05). For example, 69% of FBOs in Kenya offer FP services compared to 97% of public facilities and 83% of other private facilities. Offering long-acting or permanent methods in faith-based facilities is especially low (43% in Malawi, 29% in Kenya and 39% in Haiti). There were few statistically significant differences between the managing authorities in comprehensive and quality counseling indicators. Interestingly, Haitian FBOs often perform as well or better than public sector health facilities on counseling indicators, such as discussion of a return visit (79% of FBO providers vs. 68% of public sector providers) and discussion of client concerns/questions (52% vs. 49%, respectively).

Conclusions: Results from this analysis indicate that there is room for improvement in the availability of FP services by FBOs in these countries. Quality of counseling should be improved by all managing authorities in the three countries, as indicated by low overall coverage for practices such as ensuring confidentiality (22% in Malawi, 47% in Kenya and 12% in Haiti), discussion of sexually transmitted infections (18%, 25%, 17%, respectively), and providing services to youth (53%, 27%, 32%, respectively).

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