<div class="title-block"><h1><i class="fa fa-question-circle"></i> Helpdesk Reports</h1><div class="post-type-description">The HEART Helpdesk is a rapid response research service synthesising relevant evidence to address specific policy questions. Our reports provide a brief literature review, including summaries and comments from subject experts. We run a pre-paid service for DFID advisers through the K4D programme and feature all reports relevant to HEART thematic areas here. We can offer a tailored service to other organisations and institutes. Please email <a href="mailto:info@heart-resources.org">info@heart-resources.org</a> for more information.</div></div> – Health and Education Advice and Resource Team http://www.heart-resources.org Providing DFID staff and other development actors with health, education and nutrition knowledge and expertise from around the world Fri, 02 Mar 2018 13:10:49 +0000 en-US hourly 1 https://wordpress.org/?v=4.9.4 How does education affect migration from fragile and conflict-affected areas? http://www.heart-resources.org/2016/11/education-affect-migration-fragile-conflict-affected-areas/ http://www.heart-resources.org/2016/11/education-affect-migration-fragile-conflict-affected-areas/#respond Wed, 02 Nov 2016 13:11:48 +0000 http://www.heart-resources.org/?p=29679 Read more]]> This report found that almost all of the information on education and migration from fragile and conflict-affected states (FCAS) deals with integrating refugees into schools, providing schools in refugee camps, and/or using education to promote peace and tolerance. This body of literature often includes the educational level and status of migrants, but does not examine whether education is a reason for migration.

The large quantity of literature examined for this review (approximately 100 studies) on reasons for migrating away from conflict showed no evidence that education was a strong factor in decisions. Violence, security, economic factors and social networks are all given consistently in the literature as the primary drivers of migration from FCAS.

In general, across low-income contexts, more educated people are more likely to migrate, due to a combination of greater aspirations and lack of appropriate employment in their home environment.

The literature suggests that education plays very little role in the decision to leave a conflict-affected area, as this is primarily a security issue, followed by livelihoods issues. However, education may play a part once people are on the move, in deciding where to go.

There is little to no evidence to suggest that provision of education in FCAS would change migration flows; as education is not a key driver of migration such provision is not likely to overcome the stronger drivers of insecurity and livelihood opportunities.

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The teacher labour market in Pakistan http://www.heart-resources.org/2016/10/teacher-labour-market-pakistan/ http://www.heart-resources.org/2016/10/teacher-labour-market-pakistan/#comments Tue, 11 Oct 2016 20:17:58 +0000 http://www.heart-resources.org/?p=29401 Read more]]> This study questions the feasibility of imposing a broad-based minimum wage legislation for teachers. It focuses on those working in the low-fee sector within the Pakistani context. The scale of the private school sector is unknown. Low-fee schools are likely to be unregistered and unrecognised. They will not exist on government books. The plan for implementing legislation is unclear. Such legislation may have an impact on the operations of small-scale informal low-fee enterprises. They charge low fees and pay low salaries. The legislation may result in illegality and corruption. It may cause large scale closures.

The government must effectively regulate the functioning of these enterprises. The realities of  all kinds of providers must be considered. Elite urban private schools should not dominate regulation formation. Careful consideration of the implications of legislation and ordinances on the diverse range of providers is needed. This is usually partly due to a lack of understanding about the true nature of the private sector. Education legislation is often framed with the more ‘visible’ urban high-fee charging private schools. The diversity of private schools at varying fee levels is not always considered. A better and more comprehensive understanding of low-fee schools needs to be established through further research.

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Approaches to promoting educational inclusion, participation and learning achievement among Roma children http://www.heart-resources.org/2016/09/approaches-promoting-educational-inclusion-participation-learning-achievement-among-roma-children/ http://www.heart-resources.org/2016/09/approaches-promoting-educational-inclusion-participation-learning-achievement-among-roma-children/#respond Wed, 07 Sep 2016 13:35:06 +0000 http://www.heart-resources.org/?p=29374 Read more]]> This report summarises available evidence on approaches to promoting inclusion, participation and achievement in education for Roma children.

The purpose of this report was to inform programme development for Roma education in Eastern Europe and the Middle East, and to support policy dialogue with governments, sub-national authorities and others. However, examples and evidence from the Middle East were not found to be available, and therefore the report draws primarily on evidence and examples from Eastern and South European countries. The review does not present findings or practices differentiated according to country or region, unless otherwise specified. However, the review draws on documentary evidence and case studies from the following countries: Albania; Bosnia & Herzegovina; Bulgaria; Croatia; Czech Republic; Greece; Hungary; Kosovo; Macedonia; Montenegro; Romania; Serbia; Slovakia.

In general terms, the range of interventions under each section can be categorised as either systemic inputs (e.g. educational resources, mechanisms, and infrastructure) or educational inputs (e.g. courses, content, teaching and learning approaches etc.). It is to be noted that the role of administration, infrastructure, and resources in countries may make up important differences in the effectiveness of types of education interventions for Roma children, particularly when focusing on school-level activities.

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Rights-based approaches to increasing access to Sexual and Reproductive Health and Rights http://www.heart-resources.org/2016/07/rights-based-approaches-increasing-access-sexual-reproductive-health-rights/ http://www.heart-resources.org/2016/07/rights-based-approaches-increasing-access-sexual-reproductive-health-rights/#respond Thu, 21 Jul 2016 20:28:49 +0000 http://www.heart-resources.org/?p=29314 Read more]]> This helpdesk report provides an overview of some of the most relevant evidence on rights-based approaches to increasing access to SRHR including how they have been measured and enhanced access where information is available. Section 2 of this report explores the impact of policy changes on accessing rights, and the impact that champions of SRHR within the government can have on the broader population’s access to information and services. Section 3 on improved services includes a programme in Guatemala which increased patients’ capacity to make informed contraceptive choices by reorganising and improving the content of consultations. Section 4 on female-focussed approaches includes a study which found that community-based interventions, particularly where village women provide basic health and family planning counselling to other women, had great success in overcoming barriers to access to contraception. In Section 5, two notable programmes were identified that discussed male-focussed approaches to improving access to SRHR. Section 6 focuses on broader approaches to increasing access to SRHR.

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Increasing access to sexual and reproductive health and rights via new innovations and technologies in Africa http://www.heart-resources.org/2016/07/increasing-access-sexual-reproductive-health-rights-via-new-innovations-technologies-africa/ http://www.heart-resources.org/2016/07/increasing-access-sexual-reproductive-health-rights-via-new-innovations-technologies-africa/#respond Thu, 21 Jul 2016 13:32:10 +0000 http://www.heart-resources.org/?p=29310 Read more]]> New innovations and technology, including mobiles and internet, have enormous potential for increasing access to sexual and reproductive health and rights (SRHR). They can be particularly helpful in reaching hard to access groups, including remote or stigmatised populations, due to the rapid spread of telecommunications infrastructure, mobile phones and broadband usage in low and middle income countries. This helpdesk report explores the evidence around innovations and technologies that increase access through broadening the availability and reach of information and services. Some of the papers on innovations and technologies identified in this helpdesk report do not quantify the increases in users but have been included regardless if they describe an interesting approach. This helpdesk report provides a snapshot of some of the most relevant evidence currently available.

The evidence suggests that mobile phones are extremely useful for increasing access to SRHR, both through educating the public directly or providing information to health professionals. Information can be provided directly or referrals made to clinics or other centres for accessing SRHR. Key challenges include a low proportion of the population owning mobile phones in some areas or lack of funds to charge them, and certain groups, including women, those over 45 and socio-economically disadvantaged groups being less likely to have access to a phone. Web-based approaches are also very useful in increasing access to SRHR. This includes online health education programmes, websites and social media platforms. These services are very popular for accessing information and are often described by users as non-judgmental and authoritative. Many clients are then referred on to other services. Challenges include lack of access to computers and embarrassment at visiting sites referring to SRHR in public. Mixed approaches were also common among programmes to increase access to SRHR and were found to be largely very successful in achieving their goals.

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Access to family planning and safe abortion http://www.heart-resources.org/2016/07/access-family-planning-safe-abortion/ http://www.heart-resources.org/2016/07/access-family-planning-safe-abortion/#respond Thu, 21 Jul 2016 11:03:09 +0000 http://www.heart-resources.org/?p=29304 Read more]]> A WHO systematic review looking at the evidence on sexual and reproductive health among adolescents in developing countries finds quality evidence to be lacking in many areas (WHO, 2012). The report includes the following:

  • No evidence was found on the efforts to influence laws and policies though this is recognised as important for increasing access.
  • Efforts at increasing access to contraceptives directed at community leaders is acknowledged as useful but no evidence was eligible. Attribution is particularly difficult in this area. Potential harms of community interventions are noted.
  • Some evidence was found to suggest that health service improvements can improve access. There are no harms in these areas and the panel recommends health service improvement for improving access.
  • Low quality evidence was found to suggest that over-the-counter hormonal contraception improves access. There can be problems with misinformation and lack of follow-up with this type of provision.

Evidence suggests that pills and injectable contraceptives can be safely provided at the community level by community health workers (CHWs) and through the retail sector. Provision of injectables by CHWs has been delivered to as high a standard as provision by nurses and midwives in Uganda according to one study. Technical experts have endorsed safety of the practice also. Research on the provision of injections in pharmacies suggests practices are often unsafe.

Evidence on increasing access to safe abortion includes:

  • A successful programme in Ethiopia has reduced unsafe abortion cases by deploying health extension workers to provide services. Health centres and hospitals also increased services also. The project ensured involvement of women and community leaders.
  • Efforts to increase availability of safe abortion at the University Teaching Hospital, Lusaka, Zambia was found to increase uptake.
  • A study was identified looking at the feasibility of introducing medication abortion in KwaZulu Natal, South Africa.
  • Provision of safe abortion services was successfully increased with the ‘Reducing Maternal Mortality and Morbidity’ (R3M) in Ghana.
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Independent curriculum and assessment bodies http://www.heart-resources.org/2016/07/produce-report-focused-pros-cons-independent-external-curriculum-assessment-body-efficient-effective-outside-ministry-education/ http://www.heart-resources.org/2016/07/produce-report-focused-pros-cons-independent-external-curriculum-assessment-body-efficient-effective-outside-ministry-education/#respond Thu, 21 Jul 2016 10:38:09 +0000 http://www.heart-resources.org/?p=29299 Read more]]> Limited evidence was identified which directly addresses the benefits and disadvantages of having an independent curriculum and assessment body at national level. Suggestive evidence from Latin America indicated that external assessment institutes have some advantages due to their higher level of autonomy including improved staff capacity; ability to sustain long-term plans and reduced impact of political pressures.

Other assessment bodies which are external to individual Ministries of Education, although often closely linked, are those which develop large-scale, system level assessments implemented across multiple countries. These include international student assessments, regional collaborations for assessment, donor-led and citizen-led assessments. These provide high quality data on system performance and contributing factors and can have a powerful impact on policy and practice.

Studies from Cyprus and South Africa highlight the potential for powerful political influence of governments on curriculum development. This could be an argument for the development of independent curriculum bodies.

Much of the debate around the structure and governance of curriculum development and assessment is focused, not on whether there should be an independent body at national level, but on the related question of the balance of decision-making power at national and local level. Evidence on decentralisation and school autonomy in curriculum development and assessment is therefore also included in this report.

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The role of education in contributing to safety and well-being in conflict settings http://www.heart-resources.org/2016/07/role-education-contributing-safety-well-conflict-settings/ http://www.heart-resources.org/2016/07/role-education-contributing-safety-well-conflict-settings/#respond Mon, 18 Jul 2016 13:22:16 +0000 http://www.heart-resources.org/?p=29285 Read more]]> The purpose of this report was to provide a summary of existing research on the non-academic benefits of education in a conflict setting. The review seeks to identify particular educational interventions and contextual factors that may influence outcomes in the associated area.

In general terms, the range of interventions under each section are categorised as either systemic inputs (e.g. educational resources, mechanisms, and infrastructure) or educational inputs (e.g. courses, content, teaching and learning approaches etc.). It is to be noted that the role of administration, infrastructure, and resources in countries affected by conflict may make important differences in the effectiveness of types of education interventions, particularly when focussing on school-level activities.

Evidence from a broad variety of sources and settings indicate that the following interventions are seen to contribute to the role of education and schooling as a provider of safety and well-being in conflict-affected settings:

  • Evidence shows that communities play a key role in supporting the contributions that education in conflict-affected settings can make to the safety and well-being of both children and the community at large.
  • Evidence shows that the teaching workforce have a key role to play in establishing education and the school environment as a safe, protective and fear-free setting for children affected by conflict.
  • Some anecdotal and observational evidence suggests that the school environment itself has a central role to play in fostering the safety and well-being of children in conflict-affected settings.
  • Inclusive and equitable access to schooling is regarded by some as a key factor in supporting social stability at both community and national levels.
  • In largely practical terms, the school setting is regarded in conflict-affected contexts as a key point of access to the community, and as such can support community-level safety and well-being through numerous ‘non-academic’ interventions.
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Health budgets for primary health facilities http://www.heart-resources.org/2016/07/health-budgets-primary-health-facilities/ http://www.heart-resources.org/2016/07/health-budgets-primary-health-facilities/#respond Sat, 16 Jul 2016 16:54:16 +0000 http://www.heart-resources.org/?p=29274 Read more]]> This helpdesk response aimed to discover what the recommended proportion of an annual national health budget in sub-Saharan Africa is for the maintenance of primary health facilities. From both a rapid review of the evidence available and from correspondence with experts in public health financing, it is clear that no such recommendation exists.

In light of the lack of a specific recommendation, this report presents some background information on health budgeting. It provides a brief history of health system strengthening, including the 1978 Alma Ata Declaration that called for primary health care to be included as part of a comprehensive national health system, and the 2001 Abuja Declaration, which pledged to set a target of allocating at least 15% of each national budget to improve the health sector annually. Some budgeting options are discussed and cases studies on health financing are highlighted.

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Measuring the quality and performance of healthcare providers in conflict settings http://www.heart-resources.org/2016/07/measuring-quality-performance-healthcare-providers-conflict-settings/ http://www.heart-resources.org/2016/07/measuring-quality-performance-healthcare-providers-conflict-settings/#respond Sat, 16 Jul 2016 16:05:19 +0000 http://www.heart-resources.org/?p=29268 Read more]]> The purpose of the review was to provide a summary of possible indicators which might be used to measure the performance and quality of healthcare in conflict-affected settings. There is considerable guidance on measuring access, availability and quantity of health provision in these settings, but much less on whether this care is sufficient or effective. This review identifies and summarises some indicators which have been used or are suggested as appropriate.

Quality of care in humanitarian contexts is under-studied. It is both difficult to define and difficult to measure. In general, all indicators used should be SMART: Specific (what and who); Measurable; Appropriate; Realistic (achievable); Time bound. And should be grouped under structural, process and outcome domains.

The most agreed-on predictors of quality of care are:

  • Number of outpatient consultations per person per year
  • Number of consultations per clinician per day
  • Time spent on patient consultation and counselling
  • Case Fatality Ratio for the most common diseases (a direct measurement of the efficacy of treatment)
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