Research

  • Does evidence tell us that integrated development approaches work? It depends!

    ID Summit logoWhen we tackle complex, global challenges and their many root causes, intuition tells us that development initiatives need to be more holistic — the approaches may need to be as interconnected as the problems. Even the Sustainable Development Goals (SDGs) agenda states its aims are integrated and indivisible. Yet, the critically important question, “What evidence supports integrated development in practice?” can best be answered through the saying “context is king.”

    Integration is an umbrella phrase that can describe thousands of different cross-sector approaches — from health and microfinance, to nutrition and education, to conservation and livelihoods. Consider how evidence showing huge impacts in the integration of savings groups with girls’ education would be relevant for people trying to decide whether to integrate agriculture and environmental conservation. Context matters. A lot. What is being integrated with what? How? For what purpose?

    Global development decisionmakers must resist the temptation for a simple, universal answer to whether integration works. The notion that any one gold-standard study on its own will answer the integrated development hypothesis is false. Evidence for cross-sector approaches will always depend on the specific sectors, geography and people in question.

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  • Creating healthier Nigerian communities through laboratory strengthening

    Laboratory strengthening is a component of Strengthening Integrated Delivery of HIV/AIDS Services (SIDHAS), a five-year project to build local capacity for the delivery of sustainable, high-quality and comprehensive HIV/AIDS prevention, treatment, care and support services. FHI 360 implements SIDHAS in 13 states in Nigeria.

    What is laboratory strengthening and how is SIDHAS meeting this need?

    Lab strengthening is a form of support to improve the capacity of a lab for quality service delivery, helping to achieve optimal performance, increase productivity and efficiency, deliver accurate and replicable diagnostics services, achieve customer satisfaction and promote safety. Lab strengthening also provides infrastructural development, equipment maintenance and quality control services to allow timely delivery and accurate results.

    FHI 360 has supported the improvement of labs through training and mentoring to facilitate good quality management systems and record keeping. This work in lab improvement aligns with the World Health Organization Africa Regional Office (WHO-AFRO) initiative known as Strengthening Laboratory Management Towards Accreditation (SLMTA). Working within SLMTA parameters with our Nigerian government counterparts provides regular collaboration and deepens the leadership, stewardship and sustainability of the country’s labs.

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  • A unique partnership develops emerging global health researchers

    WASH_ConferenceAd_10yrbadge_blueAt FHI 360, cultivating partnerships and building capacity are high priorities that lead to lasting impact globally. Capacity development in global health has many facets. In the more than 70 countries where we work, many of our global health, population and nutrition programs and research studies include the training of public health workers and scientists. We also value partnerships in the United States that foster the development of the next generation of public health leaders.

    This year marks the 10th anniversary of the FHI 360 and University of North Carolina (UNC) Gillings School of Global Public Health Research Fellowship Program. This relationship provides graduate students from the Gillings School with the opportunity to work side by side with leading global health researchers. For the last decade, FHI 360 and UNC have built and sustained a local partnership through which yearly at least two students from the Gillings School work at FHI 360 and are mentored by our global health research experts.

    Through this program, FHI 360 has had the privilege of working with some of the brightest young minds in the growing field of global health research. Over the years, 23 fellows have worked on a wide range of topics, generated research protocols, analyzed data, written manuscripts for scientific journals and developed technical skills that are essential to global health research.

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  • Perspectives on how implementation science can improve global health

    What is implementation science, and what can it do for the field of global health?

    Earlier this month, FHI 360 brought together over 150 public health specialists, researchers, scholars and donors in Washington, DC, for a day-long symposium to wrestle with these questions.

    One clear conclusion emerged: There is no single definition for implementation science. Symposium speakers used definitions including: the scientific study of methods to promote the integration of research findings and evidence-based interventions into health care practice and policy (U.S. National Institutes of Health); the application of systematic learning, research and evaluation to improve health practice, policy and programs (U.S. Agency for International Development); and the study of methods to improve the uptake, implementation and translation of research findings into routine practices (U.S. President’s Emergency Plan for AIDS Relief).

    Despite the lack of consensus on definitions, symposium participants agreed that implementation science can make essential contributions to global health. Setting implementation science apart from other research disciplines is its focus on how to implement proven interventions in real-world contexts, delivered at scale. Noting that implementation occurs within complex systems, Greg Aarons of the University of California, San Diego, introduced participants to frameworks that help us consider the interaction of factors that affect the success of the implementation process. (View the symposium’s presentations and webcast.)

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  • Maximizing the return on investment: Making research matter

    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.

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  • In the beautiful and remote Cambodian province of Pailin, FHI 360 is working with rural communities to reduce malaria transmission and save lives.

    With support from the Global Fund through the Village Malaria Workers program, FHI 360 has trained people in 28 villages across this region to provide malaria education, diagnosis and treatment. Village workers have provided malaria testing to more than 15,000 fever patients in these remote areas and have treated over 3,600 patients for malaria.

    This World Malaria Day, visit Pailin by video. Your guide is an FHI 360 malaria program coordinator who shares how the program works.

    Village workers fight malaria in Pailin, Cambodia, from FHI 360 on Vimeo.

    This post also appeared on GBCHealth’s website as part of their World Malaria Day coverage here.

  • Vote for FHI 360 for Katerva’s People’s Choice Award

    We are very excited that two projects we love, Sino-implant (II) and C-Change are finalists for the 2012 Katerva Awards. This year Katerva has added a People’s Choice Award, where you can help decide the winner!

    Help us support these programs by voting for Sino-implant (II) or C-Change for Katerva’s People’s Choice Award. Voting is taking place through January 29th at www.katerva.org/vote.

    Please take a few minutes to learn more about these projects by watching the videos below. Keep an eye out for the winners to be announced on January 30th!

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  • Preventing mother-to-child transmission of HIV in Zambia: Replicating success

    In 2010, around 390,000 children under age 15 became infected with HIV, mainly through mother-to-child transmission. However, with effective interventions, mother-to-child transmission can be virtually eliminated to save the lives of thousands of children every year. One effective, evidence-based intervention is the preventing mother-to-child transmission of HIV (PMTCT) component of FHI 360’s Zambia Prevention, Care and Treatment Partnership (ZPCT). This USAID-funded program, which ran from 2004–2009 —and was renewed through 2014 as ZPCT II— serves as a model for other countries.

    The ZPCT I program increased the percentage of pregnant women in antenatal clinics who accepted HIV tests and received test results from 45 to 99 percent. Among women who tested positive for HIV, the program increased the percentage of women who received a full course of antiretroviral prophylaxis from 29 to 100 percent. Most importantly, observational data from ZPCT sites showed an HIV acquisition rate of 6.5 percent among children ages 0 to 6 weeks where the mother and infant received interventions, compared with 20 percent where no intervention was given to either mother or baby. The fact that this highly effective intervention costs merely US$113–126 per mother makes a compelling case for replicating it in other contexts.

    To support program designers who wish to replicate this program, FHI 360 produced Preventing Mother-to-Child Transmission of HIV: Implementation Starter Kit. This starter kit describes and provides access to all programmatic materials and tools (such as training materials and job aids) used by ZPCT and provides basic guidance on replicating effective programs. We hope that such an effective and low-cost intervention will be reproduced in other country contexts and that it will generate the same life-saving results.

  • World AIDS Day 2012: A Shared Vision of Getting to Zero

    FHI 360 has been partnering toward an AIDS-free generation since the beginning of the epidemic. As we approach World AIDS Day 2012, FHI 360 experts examine next steps needed to tackle HIV/AIDS for good. We’ll discuss new enhancements in the testing and treatment of women during pregnancy and in the prevention of mother-to-child transmission of HIV. We’ll also take a look at the HIV treatment cascade and how it can help people to take the initiative to learn their HIV status and close some of the gaps in treatment and service. Finally, we will share perspectives from the field with a program profile and success story.

    As we look to the future, from our work in Cambodia to Kenya to the U.S., FHI 360 will continue to partner toward a shared vision of “getting to zero.”


  • New Contraceptive Approaches Needed Now More Than Ever

    World Contraception Day 2012 (September 26) has come and gone, and 2012 marked the first International Day of the Girl Child. Together with the excitement from the London Summit on Family Planning this summer and the recent announcement of a major price drop for the contraceptive implant, Jadelle, it has been a banner year for media attention, political will and global resources on family planning and women’s and girls’ rights and empowerment. As part of these efforts, increasing access to safe, effective and affordable contraceptives will have a profound impact on the lives and health of women and their families throughout the world. To achieve the ambitious goals set forth by these international initiatives, however, the global health and development community must act on the current political momentum and not lose sight of the challenges that remain.

    The task ahead is large. Over 220 million women living in low-resource countries do not want to become pregnant and yet are not using an effective contraceptive method. This may seem strange when we have so many contraceptive choices available to prevent unintended pregnancy. However, not only is access to contraception limited for many of these women, but also the currently available methods do not always meet their needs, preferences or budgets. Approximately two-thirds of all women with an unmet need do not use modern contraception for reasons including side effects, perceived harm to health and desire to preserve future fertility. Along with our current method mix, we need to consider new contraceptive approaches that address these concerns.

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