As the world gathers at the 20th International AIDS Conference in Melbourne, Australia, July 20–25, 2014, we have an excellent opportunity to share how investing in evidence-based strategies can change the trajectory of the epidemic once and for all.
By Rose Wilcher, Director, Research Utilization, FHI 360
Earlier this month, the U.K. Department for International Development (DFID) released a report that seeks to answer a compelling question: Does research drive international development?
Through an extensive literature review, the authors examined the evidence supporting the commonly held assumption that investing in research leads to positive impacts on socioeconomic development. One of the specific pathways they explored is whether investment in research leads to development through more evidence-informed policy and practice. While the authors provide several examples of how research has led to policy and program improvements, they also conclude that “there are significant gaps in the capacity, incentives and systems necessary to ensure that research is systematically used in decision making.”
To put it more simply, research can be a powerful development tool if the results are used. Generating new evidence or finding a new solution is half the battle. Only when that solution is adopted in policy and practice can research lead to impact. But, the reality is that no matter how compelling a body of evidence or research finding may be, information does not put itself into practice. As a result, large gaps or long time lags too often exist between what we know and what we do.
Obstacles to putting research into practice
The barriers to getting research into practice are well documented. They include limited end-user involvement in research, weak attempts to communicate research findings and advocate for their use, and research designs that fail to consider the potential for scale-up. Other barriers noted by the DFID report include the inadequate capacity of decision makers to understand and use research evidence and the lack of incentives to drive research utilization. Short of a miracle occurring, overcoming these barriers requires deliberate, planned and sustained efforts over time. (more…)
The United Nations Development Programme (UNDP)’s 2014 Human Development Report, entitled Sustaining Human Progress: Reducing Vulnerabilities and Building Resilience, calls attention to the persistent vulnerability that threatens human development. According to the recently released report, 2.2 billion people are poor or near-poor, and unless policies and social norms systematically address their vulnerabilities, development will fail to be equitable or sustainable.
The report proposes multiple ways to strengthen resilience, such as the provision of basic social services and stronger policies for social protection and full employment.
“By addressing vulnerabilities, all people may share in development progress, and human development will become increasingly equitable and sustainable,” said UNDP Administrator Helen Clark. Read the report.
By Mike Merrigan, Regional Technical Advisor and Kerry Aradhya, Science Writer, FHI 360
At approximately 18 percent, the prevalence of HIV in Botswana’s general population is one of the highest in the world. As a result, national HIV prevention efforts have focused more intensively on the general population than on other populations. Little is known about key populations, such as female sex workers and men who have sex with men, whose behaviors are both stigmatized and illegal in Botswana.
In 2012, the Botswana Ministry of Health used an integrated behavioral and biological surveillance survey to estimate population sizes and prevalence of HIV and sexually transmitted infections (STIs) among female sex workers and men who have sex with men. The study was historic. For the first time, it showed the HIV and STI burden among these two key populations and raised awareness about how they might have contributed to the generalized HIV epidemic.
The survey, carried out with technical assistance from FHI 360 through the Preventive Technologies Agreement (funded by the U.S. Agency for International Development), uncovered a population of more than 4,000 female sex workers in the three districts where the survey was conducted. Among these female sex workers, HIV prevalence was 61.9 percent, and the prevalence of gonorrhea and chlamydia were both higher than 10 percent. The female sex workers had a mean of more than seven partners per week, and condom failure, which includes condom breakage and being paid or forced not to use condoms, was common. (more…)
By Bitra George, FHI 360 Country Director, India
At the 20th International AIDS Conference (AIDS 2014) in Melbourne, Australia, staff from FHI 360’s India office will present a poster on a study that shows improved HIV testing among clients of female sex workers. The study contributes to evidence about what works to strengthen HIV prevention.
Why focus research on the clients of female sex workers?
Recent studies from India suggest that the purchase of sex from female sex workers is most predominant in higher HIV-prevalence states, such as Andhra Pradesh, Maharashtra and Tamil Nadu. In India, there is a growing recognition of the importance of considering clients when looking to stop HIV transmission, and a number of prevention efforts under the national program have targeted these clients, most of whom are men.
Conducting surveys among clients of sex workers is challenging, because clients do not like to be identified. There is also little evidence that establishes clients’ risk of contracting HIV in India. To bridge this gap and to provide invaluable information on HIV trends and risk behavior, FHI 360 designed and managed the largest integrated biological and behavioral assessment (IBBA) for most-at-risk populations in India.
Collecting evidence to inform HIV programming
Conducted in 2006 and 2009, this cross-sectional survey interviewed approximately 10,000 clients of sex workers as part of Avahan (the India AIDS initiative). This program, funded by the Bill & Melinda Gates Foundation, gathered evidence to inform future HIV prevention programs in India. The IBBA survey was implemented by the institutes of the Indian Council of Medical Research, and technical support was provided by FHI 360. (more…)
By Ward Cates, FHI 360 Distinguished Scientist and President Emeritus and Kimberly Green, FHI 360 Chief of Party, Ghana
A version of this blog originally appeared on The Lancet Global Health blog. We are reprinting with permission. You can view the original post here.
In an era of limited resources, HIV prevention, care and treatment efforts need to focus on the smartest investments. This means investing in programs that can have the greatest impact in halting HIV transmission and turning back the epidemic. From a public health perspective, the effective use of resources requires focusing on key populations who have the highest level of HIV infection and tackling the barriers that discourage and prevent them from accessing health systems and services. These populations are broadly defined as sex workers, men who have sex with men, transgender persons and persons who inject drugs.
As the world gathers at the 20th International AIDS Conference (AIDS 2014) in Melbourne, Australia, July 20–25, 2014, we have an excellent opportunity to share how investing in evidence-based strategies can change the trajectory of the epidemic once and for all. (more…)
By Carina Omoeva and Rachel Hatch, FHI 360 Education Policy and Data Center
Today, we celebrate Malala Day, a commemoration of girls’ empowerment and gender equality across all areas of human development. Like Malala Yousafzai, thousands of girls around the globe are dedicated to pursuing their education and choosing their life path yet are prevented from realizing their full potential. For the vast majority of these girls, the greatest barrier to schooling is not the bullets of terrorists — it is the day-to-day economic pressures and the unequal social expectations they face as they enter adolescence and young adulthood. It is a sad reality that in the 21st century, many girls are forced into marriage and starting a family as early as age 14, which brings their educational aspirations to a halt.
Teenage, Married, and Out of School, a new study by the FHI 360 Education Policy and Data Center, highlights the heavy toll early marriage inflicts on school participation among adolescent girls in nine countries of east and southern Africa. While the universally ratified 1990 African Charter on the Rights and Welfare of the Child (ACRWC), as well as national legislation in all nine countries, protect children against marriage before age 18, early marriage is still visibly present across the region. Some countries, such as Rwanda, have managed to bring this disturbing phenomenon down to a minimum, while marriage at age 14 through age 17 appears to be fairly commonplace in others (Figure 1). (more…)
By Kate Plourde, Technical Officer and Robyn Dayton, Senior Technical Officer, FHI 360
A version of this blog originally appeared on the Interagency Youth Working Group’s Half the World blog. We are reprinting with permission. You can view the original post here.
In honor of this year’s World Population Day, the theme of which is youth engagement and the sustainable development agenda, we are reflecting on youth — our future leaders, parents, entrepreneurs and citizens. Today’s generation of young people is the largest in history: there are 1.8 billion people between the ages of 10 and 24 on the planet. In many countries, more than half of the population is under age 25, creating opportunities for national economic growth but also underscoring the need for greater investment in their health — with consequences that will affect the world’s social, environmental and economic well-being for generations.
Investment in young people’s sexual and reproductive health in particular ensures that young people are not only protected from HIV and other STIs, but also that they have the number of children they desire, when and if they wish to have them. The ability to control one’s fertility increases individuals’ productive capacity and can lead to a decline in a country’s dependency ratio (number of working citizens compared to nonworking citizens). When the dependency ratio declines in conjunction with adequate investments in youth education and economic opportunity, per capita income can increase — a phenomenon known as the demographic dividend.
Unfortunately, many young people do not have access to the critical sexual and reproductive health information and services required to stay healthy and avoid unintended pregnancy. Many young women report not wanting to become pregnant, but the level of unmet need for contraception among adolescents is more than twice that of adults. In some regions of the world, the unmet need for contraception among adolescents is as high as 68 percent. Fulfilling the unmet need for contraceptives among adolescents alone could prevent an estimated 7.4 million unintended pregnancies annually. (more…)
By Dr. Timothy Mastro, FHI 360 Director, Global Health, Population and Nutrition
The fourth decade has brought hope, based on extraordinary progress in learning how to combine HIV treatment and prevention. However, much work remains to be done, including in the United States where, according to the U.S. Centers for Disease Control and Prevention, the groups most seriously affected are gay, bisexual and other men who have sex with men, and, in particular, young African-American men who have sex with men.
On June 29, 2014, Governor Andrew Cuomo of New York announced an initiative designed to achieve an AIDS-free generation in his state by 2020. Governor Cuomo’s three-pronged plan focuses on improved testing, preventing the spread of the virus and providing better treatment for those living with HIV.
At FHI 360, we applaud Governor Cuomo’s bold plan to end the HIV epidemic in New York State. We currently have the scientifically proven prevention and treatment tools to stop HIV transmission. Now, we need to commit to using these tools for all populations in order to end the epidemic in New York, the United States and globally.
We are encouraged to see Governor Cuomo take a brave stand against HIV and hope that others will join him. Together, we believe we can make a world without AIDS a reality.
By Ann Jimerson, Senior Specialist in Behavior Change, Alive & Thrive, FHI 360
Organizations around the world have committed to Every Woman Every Child, a multi-stakeholder movement to inspire action toward the United Nations’ Global Strategy for Women’s and Children’s Health. FHI 360, through the Alive & Thrive project funded by the Bill & Melinda Gates Foundation, commits to improving infant and young child feeding and maternal nutrition in several countries in Asia and Africa. This commitment is one way that FHI 360 is helping to meet the aim of Every Women Every Child — to save the lives of 16 million women and children by 2015.
Whether he’s aware of his influence or not, almost every father in every culture influences his family’s choices about how to feed the children. His everyday decisions about how many of the eggs the family’s chickens lay will be sold at market and how many will be kept at home for the family to eat can make the difference between a stunted child and one who reaches his or her full growth potential.
The Alive & Thrive project reviewed programs from around the world that were designed to engage fathers in child feeding, identifying the strategies that seem to make these programs work. Not surprisingly, the six strategies we identified in the most innovative “dads” programs echo sound principles from behavior change and social marketing. Our review indicated that, especially when program planners apply these six strategies, fathers’ actions can lead to real improvements in nutrition. (more…)