Monitoring equity and research policy

Community-based indicators for HIV Programmes
MEASURE Evaluation: Online, USA 2018

Community-based information systems (CBIS) are key to understanding how HIV programs are working to control the epidemic at the local level in countries with high burden. MEASURE Evaluation developed this collection of indicators to guide community-based HIV programs in monitoring their performance and thereby enhance informed decision making by governments, major donors, and implementing partners. The indicators cover the following themes: vulnerable children, prevention of mother-to-child transmission, key populations, HIV prevention, home-based care and data use cases. The site also provides useful resources and a summary list of indicators.

What is Zimbabwe’s real maternal mortality rate?
Mkudu M; van Wyk A: Africa Check, 2015

The authors report on conflicting figures for pregnancy and childbirth related deaths in Zimbabwe from 525 to 960 maternal deaths for every 100,000 live births. It would seem to be a relatively straightforward task to measure maternal mortality, but they note that in reality, that is not the case. Ideally, you would analyse death certificates, but even in countries with well-functioning birth and death registration systems, they report that the number of maternal deaths is routinely undercounted. This is because death certificates are not always complete and in some cases, the person signing a death certificate may not be aware that the woman was pregnant or that her pregnancy contributed in some way to her death. In some instances, health facilities have been known to try and conceal maternal mortalities because of political pressure to reduce the numbers. Zimbabwe is classified as a country with incomplete birth and death records by the UN. Researchers therefore rely on censuses and surveys to estimate maternal deaths. Household surveys reported 614 deaths / 100,000 live births for the period between 2007 and 2014, and 581 / 100 000 for 2009 to 2014, within the range of global organisations’ estimates.

Tracking SDG7: The Energy Progress Report
World Health Organisation: WHO, Geneva, 2018

Energy is crucial for achieving almost all of the sustainable development goals (SDGs), from eradication of poverty through advancements in health, education, water supply and industriali­zation to combating air pollution and climate change. This new report includes updated data from WHO on household air pollution showing that 3 billion people – or more than 40% of the world’s popula­tion – still do not have access to clean cooking fuels and technologies. Household air pollution from burning solid fuels and using kerosene for cooking alone are responsible for some 4 mil­lion deaths a year, with women and children being at greatest risk. The report provides a com­prehensive summary of the world’s progress towards the global energy targets on access to electricity, clean cooking fuels, renewable energy and energy efficiency. It was launched at the Sustainable Energy for All forum held on 2 May 2018 in Lisbon, Portugal.

Evaluating efforts that build social power and participation in health systems: Introduction to the briefs
Loewenson R; Mastoya M; Beznec P; Frenz P; Mbwili Mueya C; Obando F: TARSC Shaping health, 2018

These four briefs (separately shown on this site) provide information on evaluation of social participation and power in health to support capacity and practice. They are intended primarily for those working directly with social participation and power in health systems, but also for managers, funders and others who engage with them. They intend to inform thinking and approaches and provide links to deeper resources and do not intend to prescribe or be a ’how to’ toolkit. The four briefs address:
BRIEF 1: The concepts and approaches applied in ‘monitoring and evaluation processes at
BRIEF 2: Approaches to assessing change in social participation and power in health at
BRIEF 3: The methods used for participatory evaluation at
BRIEF 4: Engaging funders and formal systems on evaluations of social power in health at

Trials and tribulations: cross-learning from the practices of epidemiologists and economists in the evaluation of public health interventions
Powell-Jackson T; Davey C; Masset E; et al.: Health Policy and Planning 33(5) 702–706, 2018

The authors propose that there are some underlying differences between the disciplines of epidemiology and economics how trials are used and conducted and how their results are reported and disseminated. They hypothesize that evidence-based public health could be strengthened by understanding these differences, harvesting best-practice across the disciplines and breaking down communication barriers between economists and epidemiologists who conduct trials of public health interventions. Differences between disciplines suggests that more can be done to incorporate behavioural theory into trials and to improve the reporting of trial results and share data. The authors hypothesize that evidence-based public health can be strengthened by understanding differences in how economists and epidemiologists conduct trials of public health interventions and harvesting best-practice across the disciplines.

Assessing the influence of knowledge translation platforms on health system policy processes to achieve the health millennium development goals in Cameroon and Uganda: a comparative case study
Ongolo-Zogo P; Lavis J; Tomson G; et al: Health Policy and Planning 33(4), 539–554, 2018

This paper assessed, whether and how, two knowledge translation platforms housed in government-affiliated institutions in Cameroon and Uganda have influenced health system policy-making processes and decisions aiming at supporting achievement of the health millennium development goals and the general climate for evidence-informed health system policy-making. The authors conducted an embedded comparative case study of four policy processes in which Evidence Informed Policy Network Cameroon and Regional East African Community Health Policy Initiative Uganda were involved between 2009 and 2011. The authors combined a documentary review and semi structured interviews of 54 stakeholders. A framework-guided thematic analysis, inspired by scholarship in health policy analysis and knowledge utilization was used. The coproduction of evidence briefs combined with tacit knowledge gathered during inclusive evidence-informed stakeholder dialogues helped to reframe health system problems, unveil sources of conflicts, open grounds for consensus and align viable and affordable options for achieving the health millennium development goals thus leading to decisions. New policy issue networks have emerged. Knowledge translation platforms were perceived as change agents with positive impact on the understanding, acceptance and adoption of evidence-informed health system policy-making because of their complementary work in relation to capacity building, rapid evidence syntheses and clearinghouse of policy-relevant evidence. The authors indicate that this embedded case study illustrates how two knowledge translation platforms influenced policy decisions through pathways involving policy issue networks, interest groups interaction and evidence-supported ideas and how they influenced the general climate for evidence-informed health system policy.

Implementation of Urban Health Equity Assessment and Response Tool: a Case of Matsapha, Swaziland.
Makadzange K; Radebe Z; Maseko N; et al: Journal of Urban Health, doi: 10.1007/s11524-018-0241-y, 2018

This paper illustrates a case of applying the Urban Health Equity Assessment and Response Tool in Matsapha, Swaziland. A descriptive single-case study design using qualitative research methods was adopted to collect data from purposively selected respondents. The study revealed that residents of the Matsapha peri-urban informal settlements faced challenges with conditions of daily living which impacted negatively on their health. There were health equity gaps. The application of the tools was facilitated by the formation of an all-inclusive team, intersectoral collaboration and incorporating strategies for improving urban health equity into existing programmes and projects.

Mobilization initiative on gender equity in health research launched
TDR: World Health Organisation, Geneva, February 2018

TDR Global has launched a 3-month mobilization initiative on gender equity in health research. The aim is to enhance women’s position in health research and to address the impact of gender on infectious diseases of poverty through research. The initiative will share experience and thoughts on gender equity in health research. Challenge-solving workshops are being planned to identify local challenges, create local teams and offer training. TDR Global talks are opportunities to share best practices and experiences on enhancing gender equity in health research. Working groups on specific issues are options for organizing webinars, training and sharing ideas.

Research gaps and emerging priorities in sexual and reproductive health in Africa and the eastern Mediterranean regions
Ali M; Farron M; Ouedraogo L; et al: Reproductive Health 15(39) doi:, 2018

This paper presented the results of a priority setting exercise that brought together researchers and program managers from the World Health Organization Africa and Eastern Mediterranean regions to identify key sexual reproductive health issues. In June 2015, researchers and program managers from the World Health Organization Africa and Eastern Mediterranean regions met for a three-day meeting to discuss strategies to strengthen research capacity in the regions. A prioritization exercise was carried out to identify key priority areas for research in sexual reproductive health. The process included five criteria which are answerability, effectiveness, deliverability and acceptability, potential impact of the intervention/program to improve reproductive, maternal and newborn health substantially, and equity. The six main priorities were identified as creation and investment in multipurpose prevention technologies, addressing adolescent violence and early pregnancy, improved maternal and newborn emergency care, increased evaluation and improvement of adolescent health interventions including contraception, further focus on family planning uptake and barriers, and improving care for mothers and children during childbirth. They indicate that setting priorities is the first step in a dynamic process to identify where research funding should be focused to maximize health benefits. A focus on priority setting suggests a need to identify who is thus involved in this process.

Child Gauge 2017: Investing in children for sustainable development - Survive. Thrive. Transform
Jamieson L; Berry L; Lake L: The Children's Institute, South Africa, 2017

The South African Child Gauge® is published annually by the Children’s Institute, University of Cape Town, to monitor progress towards realising children’s rights. This issue focuses on children and the Sustainable Development Goals (SDGs). Part one summarises and comments on policy and legislative developments that affect children. These include developments in international and South African law. Part two motivates for greater investment to ensure South Africa’s children not only survive but thrive and reach their full potential, by focusing on the SDGs, ensuring that the 2030 Global Agenda promotes children’s survival and development, identifying local priorities, promoting nurturing care, creating safe environments, improving child nutrition, getting reading right, creating inclusive and enabling environments and reflecting on progress and calling for action. Part three presents child-centred data 2002-2015 to monitor progress and track the realisation of children’s socio-economic rights in South Africa. A set of key indicators tracks progress in demography, income poverty, unemployment and social grants, child health and access to education, housing and basic services.