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Book
Media and Messages for Nutrition and Health : Assessing Media Appropriateness for Nutrition and Health-Related Social and Behavior Change Communication in Four High Stunting-Burden Provinces of Lao PDR
Authors: --- --- ---
Year: 2020 Publisher: Washington, D.C. : The World Bank,

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The Lao People's Democratic Republic (Lao PDR) has experienced rapid and significant economic growth over the past decade. However, poor nutritional outcomes remain a concern. Rates of childhood undernutrition are particularly high in remote, rural, and upland areas. Media have the potential to play an important role in shaping health and nutrition-related behaviors and practices as well as in promoting sociocultural and economic development that might contribute to improved nutritional outcomes. This report presents the results of a media audit (MA) that was conducted to inform the development and production of mass media advocacy and communication strategies and materials with a focus on maternal and child health and nutrition that would reach the most people from the poorest communities in northern Lao PDR. Making more people aware of useful information, essential services and products and influencing them to use these effectively is the ultimate goal of mass media campaigns, and the MA measures the potential effectiveness of media efforts to reach this goal. The effectiveness of communication channels to deliver health and nutrition messages to target beneficiaries to ensure maximum reach and uptake can be viewed in terms of preferences, satisfaction, and trust. Overall, the four most accessed media channels for receiving information among communities in the study areas were village announcements, mobile phones, television, and out-of-home (OOH) media. Of the accessed media channels, the top three most preferred channels were village announcements (40 percent), television (26 percent), and mobile phones (19 percent). In terms of trust, village announcements were the most trusted source of information (64 percent), followed by mobile phones (14 percent) and television (11 percent). Hence of all the media channels, village announcements are the most preferred, have the most satisfied users, and are the most trusted source of information in study communities from four provinces in Lao PDR with some of the highest burden of childhood undernutrition.


Book
Smart Linkage to Care : Evaluation Report
Authors: --- --- --- --- --- et al.
Year: 2018 Publisher: Washington, D.C. : The World Bank,

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Many new HIV cases are lost to follow-up before they can be enrolled in care and treatment programs. This report summarises a proof-of-concept evaluation of a mHealth intervention which aims to improve linkage of newly diagnosed HIV cases to care. The design was a randomised controlled multi-center trial enrolling consenting patients in clinics in Inner-city Johannesburg. The trial developed and tested the "SmartLink" app which is designed to make laboratory data directly available to patients via a secure account and send them appointment reminder and notifications on their smartphone. The primary endpoint was linkage to care in the first 8 months after diagnosis, as evidenced by a HIV-related laboratory test. The report provides the key findings on phone ownership of the target group, and which demographics can best be reached via apps and data-based communication (which is cheaper and offers more scope than text messaging). The app worked best in younger HIV patients under 30 years of age, who had their linkage to HIV care improved by 20 percent through the app. This younger age group is difficult to reach with traditional interventions, and reacted positively to a technology solution. The unique feature of this custom-made app (sending real-time CD4/VL test data from the laboratory database to HIV clients) is highly scalable among smartphone owners.


Book
Impact Evaluation on Improving Voluntary Medical Male Circumcision Demand in Malawi through the Use of Incentives
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Year: 2017 Publisher: Washington, D.C. : The World Bank,

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This report presents an impact evaluation assessing the effect of incentives on improving the uptake of Voluntary Medical Male Circumcision (VMMC) in two districts in Malawi. The cluster randomised control trial was led by the National AIDS Commission of Malawi and implemented from December 2015 to April 2016. The primary research question was whether incentives can increase VMMC uptake among in-school and out-of-school males aged 10-34. Collective incentives (e.g. whiteboards, football equipment) to schools and Mothers' Groups, as well as individual incentives in the form of vouchers for VMMC were tested. The evaluation found that incentives in the form of vouchers for VMMC work. The vouchers had a significant positive impact on VMMC demand by increasing the odds of getting circumcised by over seven times. Secondary distribution by voucher recipients showed potential to informally increase distribution networks without increasing costs. There was some evidence of spill-over to relatives: nearly a third of participants in both study districts who had been given vouchers reported that they gave vouchers to relatives. Using the participants' own social networks had the result of expanding the reach of the intervention without additional distribution costs. The evaluation also found that community-involvement, especially in the form of Mothers' Groups, was essential to motivate young men to seek VMMC. The report discusses the policy implications of this positive finding of incentives.


Book
Targeting Health Programs to Reach the Poor
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Year: 2000 Publisher: Washington, D.C. : The World Bank,

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In principle, the efficiency of poverty-oriented social programs can be increased dramatically through "targeting" an infelicitous term applied to efforts to focus development programs more directly on the poor. By one widely-cited estimate, a set of "perfectly targeted" programs -- that is, programs whose benefits reach all the poor and only the poor -- could eliminate poverty at less than 10% the cost of development programs that do not discriminate between poor and rich. No knowledgeable advocate of targeting, no matter how enthusiastic, would claim that the maximum attainable gain from targeting comes anywhere close to the theoretical maximum referred to above. But a measure does not have to be ideal in order to be worthwhile, and this raises the possibility that targeting might still have much to offer. The purpose of what follows is to explore this possibility.


Book
Aiming High : Indonesia's Ambition to Reduce Stunting
Authors: --- ---
Year: 2018 Publisher: Washington, D.C. : The World Bank,

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In the 1980's Indonesia became an example for other countries concerned with reducing high levels of malnutrition. At the time, Indonesia had started nutrition programming and surveillance at the village level using the integrated weighing and child health posts, or Posyandu. In the ensuing decades there have been successes: small scale and bigger scale interventions that reduced malnutrition. At the same time, there have been set-backs, loss of attention, other priorities, decentralization, weak management and poor governance. In August 2017, the Indonesian government unveiled a new strategy to accelerate reductions in rates of stunting. This book looks at what will be required to turn that strategy - the National Strategy to Accelerate Stunting Prevention (StraNas Stunting) 2017-2021 - from vision into reality. It looks at the country's ambitious reforms and goals to reduce stunting. It examines the government's plans to boost awareness about the economic, social and personal cost of stunting, to ensure a truly national "multi-sectoral" effort to tackle the problem at scale in a coordinated and cohesive fashion in communities across Indonesia. It chronicles past successes and setbacks, drawing lessons from them about the future. We think Indonesia is on a path towards new success: this time at scale. It is a story worthtelling.


Book
Evaluation of the National Adherence Guidelines for Chronic Diseases in South Africa : Patient Perspectives on Differentiated Care Models, 2017.
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Year: 2017 Publisher: Washington, D.C. : The World Bank,

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This report presents the result of the qualitative evaluation to understand the implementation of five adherence interventions from the patient perspective in four South African provinces. The research is part of the evaluation of the new Adherence Guidelines for HIV, TB and other chronic diseases. The study sought to answer four key questions: questions: 1. How does patient satisfaction with care at the intervention sites compare to the control sites among HIV positive patients? 2. What are the barriers to and facilitators of ART initiation and adherence among HIV-positive patients eligible for each intervention? 3. What are the strengths and weaknesses of each intervention for HIV positive patients from the patient perspective? 4. What additional strategies do patients feel would be helpful in improving treatment adherence? The report presents the triangulated qualitative and quantitative data from patient surveys and focus group discussions under each of the four questions. The results show that from the patient perspective, each intervention has promise and supported either ART initiation or adherence, however each could be improved. Detailed illustrative quotes are provided for each intervention according to the main themes identified. Specifically, patients had very positive feelings about Adherence Clubs and Decentralized Medication Delivery in focus group discussions.


Book
Verification in Results-Based Financing for Health : Summary of Findings and Recommendations from a Cross-Case Analysis.
Authors: --- --- ---
Year: 2016 Publisher: Washington, D.C. : The World Bank,

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Despite the increasing popularity of Results Based Financing, there is little evidence or documentation of different verification strategies and how strategies relate to the verification results. Documentation of implementation processes including those pertaining to verification of outputs/results is lacking in World Bank-financed RBF projects in the health sector. The overall objective of this cross-case analysis is to expand knowledge about verification processes andpractices to address the design and implementation needs of RBF projects. This study adds toavailable knowledge by comparing the characteristics of verification strategies as well as available data on costs (using level of effort as a proxy), savings, and verification results to date in six countries: Afghanistan, Argentina, Burundi, Panama, Rwanda, and the UK. These case studies were purposively selected to explore a number of factors, including: how a variety of results are verified; how the verification strategy is being implemented at different levels in the health system; and the implications of having different types of actors (that is, third-party versus internal verifiers) involved in the verification process. In this cross-case analysis, the discussion of similarities and differences in verification methods across the six cases as well as the analysis of findings is guided by a conceptual framework developed for this study. This study presents seventeen key findings, and nine recommendations.


Book
Evaluation of the National Adherence Guidelines for Chronic Diseases in South Africa : Healthcare Provider Perspectives on Different Care Models, 2017.
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Year: 2017 Publisher: Washington, D.C. : The World Bank,

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This report presents the result of the qualitative evaluation to understand the implementation of five adherence interventions from the provider perspective in four South African provinces. The research is part of the evaluation of the new Adherence Guidelines for HIV, TB and other chronic diseases. The study sought to answer four key questions: 1. What are the barriers to and facilitators of implementing the minimum package interventions from the perspective of the providers? 2. What are the strengths and weaknesses of each intervention for HIV positive patients from the perspective of providers? 3. How could implementation of adherence interventions and the minimum package of interventions be improved? 4. What additional strategies do providers feel would be helpful in improving treatment adherence? The report presents the thematic analysis of the qualitative interview transcripts under each of the four questions. Emerging themes are illustrated with quotes from respondents at intervention and control clinics. The results show that providers were generally positive about all the interventions, though they had mixed comments about the Direct Medicine Delivery and Tracing and Retention-in-Care models, largely because they were not always well implemented or providers felt they did not have the resources to implement them at scale. Additionally, providers' views were mixed on their perceived effectiveness of Adherence Clubs.


Book
Integrating Nutrition Promotion and Rural Development in Sri Lanka
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Year: 2018 Publisher: Washington, D.C. : The World Bank,

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'Integrating Nutrition Promotion and Rural Development' (INPARD) is a multisectoral approach to delivering nutrition-related interventions in rural development programmes in Sri Lanka. Although multisectoral approaches to health promotion are widely recommended, barriers to collaboration across sectors were identified in the INPARD study described in this document. These include a lack of clarity among stakeholders regarding their respective roles, communication gaps between those working in different sectors, and resistance by some who consider health outside the purview of the sector they work inches Improved collaboration will also require training for all concerned. The INPARD study was undertaken to investigate how effectively a rural development programme could be employed to deliver improved human nutrition outcomes - an objective not typically included in traditional rural development interventions in the past. The intervention considered was a large rural development project known as the Re-awakening Project (RaP), which carried out operations in 112 villages in the districts of Ampara and Moneragala. The villages were selected in part on prevailing poverty levels, and 20 of them were randomly selected for evaluation by the INPARD study as it was carried out alongside the larger RaP. 20 other villages in Ampara and Monergala were selected as the control group representing non-RaP villages. Finally, ten villages were selected from outside the RaP area altogether, in Kurungala district.


Book
Texting Parents about Early Child Development : Behavioral Changes and Unintended Social Effects
Authors: --- --- ---
Year: 2020 Publisher: Washington, D.C. : The World Bank,

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Parenting interventions have the potential to improve early childhood development. Text messages are considered a promising channel to deliver parenting information at large scale. This paper tests whether sending text messages about parenting practices impacts early childhood development. Households in rural Nicaragua were randomly assigned to receive messages about nutrition, health, stimulation, or the home environment. The intervention led to significant changes in self-reported parenting practices. However, it did not translate into improvements in children's cognitive development. When local opinion leaders were randomly exposed to the same text message intervention, parental investments declined and children's outcomes deteriorated. Since interactions between parents and leaders about child development also decreased, the negative effects may have resulted from a crowding-out of some local leaders.

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