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Using Theory of Change in the development, implementation and evaluation of complex health interventions. A practical guide
Mary De Silva, Lucy Lee& Grace Ryan
The Centre for Global Mental Health &the Mental Health Innovation Network
(2015)
C1
This guide provides a practical overview of the process of developing a Theory of Change, focusing on using a stakeholder-driven, workshop approach to achieve this.
Right now, we are facing an unpredictable and highly dynamic situation as a global community. However, as we have seen from the solidarity, support and power of communities in the HIV epidemic and already in communities responding to the COVID-19 pa
...
ndemic, the response must not be fear and stigma. We need to build a culture of solidarity, trust and kindness. Our response to COVID-19 must be grounded in the realities of people’s lives and focused on eliminating the barriers people face in being able to protect themselves and their communities. Empowerment and guidance, rather than restrictions, can ensure that people can act without fear of losing their livelihood, sufficient food being on the table and the respect of their community. Ultimately it will give us a more effective, humane and sustainable response to the epidemic.
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21 August 2020
This guidance provides specific considerations for the use of non-medical masks, also known as fabric masks, by children as a means for source control in the context of the current COVID-19 pandemic. It also advises on the use of medical masks for children under certain conditions.
In Paraguay, 1.8% of the population are indigenous people. The Maká community
29 mainly live in urbanized areas in the Central Region. This study focuses on the epidemiology
30 of tuberculosis (TB) among indigenous Maká and the non-indigenous pe
...
ople living in the
31 Central Region, the biggest metropolitan area of the Paraguay.
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Background
Noncommunicable diseases are major contributors to morbidity and mortality worldwide. Modifying the risk factors for these conditions, such as physical inactivity, is thus essential. Addressing the context or circumstances in which physical activity occurs may promote physical activity a
...
t a population level. We assessed the effects of infrastructure, policy or regulatory interventions for increasing physical activity.
Methods
We searched PubMed, Embase and clinicaltrials.gov to identify randomised controlled trials (RCTs), controlled before-after (CBAs) studies, and interrupted time series (ITS) studies assessing population-level infrastructure or policy and regulatory interventions to increase physical activity. We were interested in the effects of these interventions on physical activity, body weight and related measures, blood pressure, and CVD and type 2 diabetes morbidity and mortality, and on other secondary outcomes. Screening and data extraction was done in duplicate, with risk of bias was using an adapted Cochrane risk of bias tool. Due to high levels of heterogeneity, we synthesised the evidence based on effect direction.
Results
We included 33 studies, mostly conducted in high-income countries. Of these, 13 assessed infrastructure changes to green or other spaces to promote physical activity and 18 infrastructure changes to promote active transport. The effects of identified interventions on physical activity, body weight and blood pressure varied across studies (very low certainty evidence); thus, we remain very uncertain about the effects of these interventions. Two studies assessed the effects of policy and regulatory interventions; one provided free access to physical activity facilities and showed that it may have beneficial effects on physical activity (low certainty evidence). The other provided free bus travel for youth, with intervention effects varying across studies (very low certainty evidence).
Conclusions
Evidence from 33 studies assessing infrastructure, policy and regulatory interventions for increasing physical activity showed varying results. The certainty of the evidence was mostly very low, due to study designs included and inconsistent findings between studies. Despite this drawback, the evidence indicates that providing access to physical activity facilities may be beneficial; however this finding is based on only one study. Implementation of these interventions requires full consideration of contextual factors, especially in low resource settings.
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This document on logistics management information systems (LMIS) was developed to address the increasing need for harmonization and standardization of core indicators for managing medicines and health products for neglected tropical diseases (NTDs) at country level (i.e. for last-mile logistics). It
...
thereby responds to requests from Members States, pharmaceutical groups, financial donors and implementing partners for guidance from the World Health Organization (WHO) for a transparent, standardized reporting mechanism and key indicators for in-country logistics. More importantly, this document will also guide the last-mile logistics process and is relevant for the health workforce working at different levels of national health information systems. It can be adapted and used for any health products depending on the needs of the country or health programmes.
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Building on the WHO guidelines for disclosure to children up to age 12 in 2011, this implementation guidance provides evidence on existing interventions that support children and adolescents living with HIV in the process of disclosure. It includes
...
interventions that focuses on safe disclosure, as well as supporting children and adolescents with onwards disclosure. Specifically, this brief collates existing interventions via a scoping review; assesses key interventions through a realist evaluation lens, identifying what works, for whom, and in what contexts; and highlights emerging considerations, key gaps, and key actions.
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Antiretroviral treatment outcomes from a nurse-driven, community-supported HIV/AIDS treatment programme in rural Lesotho: observational cohort assessment at two years
Cohen, R., Sharonann, L., Bygrave, H., et al
Journal of the International AIDS Society (JIAS)
(2009)
CC
This paper aimed to demonstrate how participatory action research (PAR) within a Community-based Rehabilitation (CBR) project facilitated community participation to advocate for the rights of people
...
with visual impairment. An advocacy campaign, led by the local people with and without disabilities, was launched for the construction of an accessible foot over- bridge (FOB) at Vangani railway station in Maharashtra, India.
more
Depuis plus de trois décennies, le Bénin a souscrit à l’approche des soins de santé primaires
telle que définie à la conférence d’Alma-Ata (1978) et renforcée par l’Initiative de Bamako
(1987). Le pays a mis en oeuvre diverses expériences de soins de santé au niveau
communautaire
...
avec l’appui des Partenaires Techniques et Financiers (PTF) et la
participation des Organisations Non Gouvernementales (ONG) et les Organisations
Communautaires de Base (OCB). Celles-ci ont contribué à l’amélioration de l’offre des
services de santé, malgré l’absence d’une politique coordonnée devant servir de cadre
institutionnel à la santé communautaire.
A l’étape actuelle du processus de mise en oeuvre de diverses expériences pilotes d’actions
communautaires, le Ministère de la Santé s’est engagé dans une réflexion visant l’élaboration
d’une politique nationale de santé communautaire. Celle-ci devra servir à encadrer la mise à
l’échelle des interventions communautaires qui ont démontré leur efficacité et leur impact
sur les populations cibles. Cette réflexion a entraîné la tenue du forum national sur la santé
communautaire en Novembre 2013 à Cotonou.
Le document de Politique de Santé Communautaire s’arrime au Plan National de
Développement Sanitaire à travers lequel le Bénin ambitionne de « disposer en 2025 d’un
système de santé performant basé sur des initiatives publiques et privées, individuelles et
collectives, pour l’offre et la disponibilité permanente de soins de qualité, équitable et
accessible aux populations de toutes catégories, fondées sur les valeurs de solidarité et de
partage du risque pour répondre à l’ensemble des besoins de santé du peuple béninois » Dans
le présent document, il est défini une vision, des priorités et des stratégies pour les dix
prochaines années en santé communautaire. La principale innovation réside dans la
conception et la mise en place au niveau de chaque village et quartier de ville de la
composante locale du système national de santé (CoLoSS) en partenariat avec toutes les
parties prenantes. Le document précise les conditions requises et les mesures
d’accompagnement pour la réussite de la nouvelle politique dans le sens de l’autonomisation
(empowerment) progressive des populations.
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Pregnancy often results in exclusion from clinical trials of antiretroviral (ARV) drugs, resulting in limited data on pharmacokinetics (PK), drug safety, and the efficacy of new ARV drugs in pregnancy and lactation. However, pregnancy, lactation, or the potential for pregnancy should not preclude th
...
e use of drug regimens that would be chosen for people who are not pregnant, unless adequate drug levels are not likely to be attained in pregnancy or known adverse effects outweigh potential benefits
more
International Health and Human Rights (2018) 18:18
Disability awareness, Community, Attitudes, Experts-by-experience
The Onchocerciasis Control Programme in West Africa (OCP) undertook regional and large scale frght against onchocerciasis in West Africa in 1974 using a vector control strategy. By 2002 OCP had succeeded in eliminating the disease as a public health, socio-economic and development problem in 10 out
...
of I I countries. This campaign was highly technical and expensive. ln 1987, Merck & Co.,lnc. committed themselves to provide ivermectin free of charge for as long as needed to onchocerciasis endemic countries. This made it possible to envrsage the extension of onchocerciasis control activities to the remaining endemic countries in Africa.
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Climate change is one of the biggest crises of our time. Climate threats range from higher temperatures, heavy rainfalls and floods, erratic precipitation, droughts, desertification, and land degradation. This has negative implications on the quality and quantity of natural resources, such as land a
...
nd water, agricultural productivity, rural livelihood options, food prices, and nutrition security, particularly when there is a lack of adaptation capacities and preparedness measures (Pacillo, 2024). Farmers are at the forefront of the climate crisis where their livelihoods are being jeopardized, and they are faced with many challenges to secure water, energy, and agriculture inputs, and maintain agriculture productivity. This heightens the risk of competition over natural resources and aggravates grievances and structural inequalities related to land rights and ownership as well as land access, management, and governance. In Africa, land-related issues are among the triggers of many violent disputes (Medina et al, 2024). For instance, communal violence in Nigeria and Sudan is tied to competition over scarce fertile land and poor resource governance (Bruce and Bourdeaux, 2013).
more