Health and Education Advice and Resource Team Providing DFID staff and other development actors with health, education and nutrition knowledge and expertise from around the world. Thu, 17 Sep 2015 14:32:21 +0000 en-US hourly 1 Rapid analysis of previous famines Tue, 08 Sep 2015 10:40:41 +0000 This helpdesk reports that defining famine has proved historically challenging. The Integrated Food Security Phase Classification (IPC) provides a common currency for classifying both the magnitude and severity of food insecurity through a set of standardised tools. Despite the standard definition that the IPC provides, there have been several incidents where mass nutrition related mortality have been recorded, that are not classified as famine. This helpdesk provides a synthesis of the evidence available on the major famines and similar crises since 1980. It provides data, where available, on Global Acute Malnutrition (GAM) and Severe Acute Malnutrition (SAM). It includes a discussion on why better data is needed to address famine and why evidence is needed to overcome food insecurity. The helpdesk identifies the main causes of mortality during famines as reported in the literature. To complement the synthesis of the evidence, an annotated bibliography is included. This provides an abstract and link for each resource used, making it easy for the reader to access the evidence directly.

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The Political Economy of NCDs in Low- and Middle-Income Countries Tue, 01 Sep 2015 17:03:28 +0000 There is a growing movement advocating for an increased focus on resourcing the control and treatment of non-communicable diseases (NCDs), ie The Lancet NCD Action Group and the NCD Alliance. The proponents of tackling NCDs often quote figures for NCD impact in LMICs without discussing disparities between socio-economic groups. The rapid search for this report identified some literature that questions the notion that NCD rates are more prevalent in wealthier socio-economic groups.

National NCD policies should be geared to addressing primary prevention and equity of health systems. Health systems need reconfiguration to ensure equitable access to essential NCD interventions. Context-specific research is identified as a requirement to address implementation gaps in NCD policy, as policy development and implementation are driven by political realities and cultural specificities.

Maher and Sridhar (2012) use a political policy priority framework to look at why funding for NCDs is inadequate and why plans to stop the spread of NCDs has been so difficult. They find that struggles for influence and determining which issues to champion is “informed by subjectively held notions of the right, the good, and the just”.

Negin and Robinson (2010) compare funding for HIV and NCDs to disease burdens in the Pacific Region. They find higher rates of mortality for NCDs but higher external funding for HIV. The authors do not investigate socio-economic groupings within this.

On a more practical level, Stenberg and Chisholm (2012) review various investment strategies related to prevention and control of NCDs. They suggest integrating NCDs into the process for national strategic health planning. Miranda et al (2008) propose reintegration of current vertical programmes (e.g. for malaria, polio, tuberculosis, HIV) into novel forms of family-orientated primary care to include NCDs. HIV advocates reject attempts to create divisions and competition between health agendas. They aim to communicate and reinforce coalitions with allied agendas, including coalitions focused on other diseases.

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Education in urban contexts Thu, 04 Jun 2015 10:56:57 +0000 Studies which find that enrolment rates are higher in urban areas than rural areas are likely to mask the high numbers of children who are out of school in urban areas. Slums often have dense populations where access to education is poor. Education is needed to break the poverty cycle in urban areas and increase employment opportunities. The importance of education for improved health in urban areas has been documented.

Cameron (2012) suggests some barriers to education that are particular to the urban rather than rural context. These include:

  • Greater inequality and powerlessness.
  • Street children, refugees and internally displaced people face high barriers to access due to legal status and lack of paperwork.
  • Busy roads and built up areas can make travelling even short distances to school difficult and time-consuming.
  • Slum evictions and high population mobility make it risky to invest in education projects: they risk losing all their students and having their buildings demolished.
  • The author suggests that the perceived ‘urban bias’ means that development policy for education in urban areas is neglected in favour of rural areas.

The 2015 Education for All (EFA) Global Monitoring Report (GMR) has done some work on disaggregating education data (UNESCO, 2015). Traditionally education statistics tend not to be disaggregated by urban/rural areas. UNESCO interviewed UN and NGO officials on the education situation in urban slums and found the most common response to be: ‘we don’t know. This is under researched.’(Kielland, 2015).

This helpdesk report also explores migration, governance and school type in the context of urban education.

The literature focused on urban areas is expanding to address issues of conflict/violence, migration/demography, climate, inequality, labour mobility and other areas. However, there seems to be little focus on implications for education.

There was limited discussion of employability and labour market issues in relation to education in the urban context. More research is also needed on the range of providers and how each may contribute to improving education in urban areas.

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Effective professional development and training Sat, 02 May 2015 20:06:37 +0000 This helpdesk provides an overview of the literature that focuses on professional development and capacity building. It specifically seeks to explore the evidence on how best to deliver effective professional development and training for technical experts, and how the impact of conferences, seminars, short courses and e-learning can be maximized.

There is a range of literature focusing on particular aspects of professional development. The existing literature suggests that building capacity through training is critical. There is no consensus on the most effective way to achieve the desired results or how to maximize the impact of professional development. There is a paucity of literature available to compare the spectrum of models available.

A literature review based on four problem-based approaches to professional development was identified. It found that case problems are ill structured in action learning and problem-based learning, are moderately structured in a goal-based scenario, and are fairly well structured in the case study approach. The design differences suggest that the case study and goal-based scenario approaches are more likely to result in single-loop learning and to foster the ability to solve well-structured problems, whereas the problem-based learning and action learning approaches are more likely to lead to double-loop learning and to promote the ability to solve ill-structured problems.

Capacity is a complex concept, comprising of a blend of motivation, skill, positive learning, organisational conditions and culture, and infrastructure of support. If capacity development is successful, it can benefit individuals, groups, whole institutions, organisations, communities and systems. (Stoll et al 2006) One approach to achieving improved sustainable capacity is to developing professional learning communities.

This helpdesk report provides information on:

  • andragogy
  • types of training
  • and, examples of approaches to professional development from other organisations, institutes and donors
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Health and nutrition drivers in urban areas Wed, 15 Apr 2015 15:40:47 +0000 On average, urban health levels are better than those in rural areas. However, averages can be misleading: once the data are disaggregated, it is clear that the urban poor face health risks often as high as and sometimes worse than those of rural residents, despite the proximity of modern health services (UNFPA, 2012).

This report investigates the role of working conditions, diet and lifestyle, living conditions, access to WaSH, access to and quality of health services and other factors on the health status of the urban poor. Some interventions were also identified. However, there was not scope within this report to fully investigate evidence on interventions.

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Ebola – Traditional healers, witch doctors, burial attendants Tue, 17 Mar 2015 10:34:24 +0000 This helpdesk focuses on the impact of traditional healers, witch doctors and burial attendants on ebola in West Africa. It seeks to establish if there is a difference between witch doctors, herbalists and traditional healers in terms of when people see them and the kind of treatment they provide. It goes on to explore the roles of these actors in preparing bodies for burial and at funerals. It provides information on secret societies. The report goes on to explore behaviour change. It provides information on payment of traditional healers as a leverage point.

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The education system in Lebanon Fri, 06 Mar 2015 11:28:11 +0000 Since the civil war in 1975, the quality of the Lebanese education system has suffered. Two in every three students now attend private schools, where the quality of education is higher than that offered by the public schools. Education was recognised in the peace treaty as a means of moving towards reconciliation, prompting large scale education reform. However, gaps have developed between advantaged and disadvantaged youths. The majority of school-aged Lebanese children are educated in private schools, with only 27 percent or 300,000 Lebanese children enrolled in public education, mostly because they are unable to afford private school. Public schools suffer teacher shortages and often have infrastructure problems. Most secondary schools are segregated by religion with communities controlling what is taught in classrooms.


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Pre-service teacher training Mon, 02 Mar 2015 10:57:09 +0000 This helpdesk report is a synthesise of relevant evidence that is focused on the circumstances under which pre-service teacher education can be deemed effective. The evidence included is primarily focused on Ghana and West Africa. Some of the evidence from further afield, which was deemed to be directly relevant, was also included. This report includes this summary overview and a brief literature review.

Education policies, however well-intentioned, and official curricula, however well crafted, cannot succeed without the teacher, whose professional management of the teaching- learning process ensures that education really takes place. It is not just any teacher that can make education happen. It has to be an effective teacher. An effective teacher is not just born; they are made over time through training and experience. Teacher education is crucial in this process. Teacher education refers to the policies and procedures designed to equip prospective teachers with the knowledge, attitudes, behaviours and skills they require to perform their tasks effectively in the classroom, school and wider community.  Although ideally it should be conceived of, and organised as a seamless continuum, teacher education is often divided into three stages:

  • Initial teacher training / education: a pre-service course taken before entering the classroom as a fully responsible teacher.
  • Induction: a process of providing training and support during the first few years of teaching or the first year in a particular school.
  • Teacher development or continuing professional development (CPD): an in-service process for practicing teachers.

Quality teacher education starts with the initial teacher training course (pre-service training).  This stage is vitally important as it lays the foundations for motivation and ensures that new teachers are competent before entering the classroom. However, many countries face ongoing challenges of delivering good quality pre-service teacher training to respond effectively to the constantly changing needs of the curriculum, learners and school communities. This challenge persists whether the issue is improved learning outcomes in literacy, mathematics, languages or HIV prevention and sexuality education. Nevertheless, strengthening pre-service teacher training is necessary as research shows that it is the most effective way to raise educational quality as it will have overall benefits across the whole education system.

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Education Expenditure Reviews Fri, 06 Feb 2015 12:20:17 +0000 Expenditure reviews appear to be useful for identifying the flow of public funds and their use. A key finding of most surveys is public resource leakage. They also highlight the problem of delays and bottlenecks, payroll ghosts, equity in resource allocation, information asymmetry and poor record keeping.

Challenges highlighted in the literature include:

  • Surveys can be expensive and difficult to conduct.
  • Resource flows are often complex and data may be unreliable or unavailable making leakage difficult to measure.
  • In some cases an absence of strict allocation rules make it difficult to design effective techniques to determine the amounts of money allocated to a particular region or facility.
  • Translating the findings into policy reforms and institutional changes is seen as a major challenge.

Few countries are found to effectively follow-up on reform suggestions that are identified by tracking surveys. Lack of political will is often a factor behind weak institutional change. There is often lack of policy dialogue, insufficient dissemination of results and discussions to ensure the transfer of information about problems identified in the service delivery system. Surveys should be assessed on their capacity to induce policy reforms to correct the various governance problems identified.

Suggestions for dissemination and follow-up include:

  • Strike a practical balance for making findings from a survey actionable. Help define key priorities and tractable options for addressing weaknesses in prevailing systems.
  • Carefully align the timing and dissemination of the survey results with the event schedules of both government counterparts and the wider public.
  • Partnerships between the government and civil society or user groups can significantly enhance the capacity of the government and perform an oversight function in ensuring the delivery of services.
  • Approach a survey as a routine part of the ongoing monitoring and analysis process.
  • Establish a survey monitoring and follow-up mechanism.
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Complementary Basic Education Thu, 15 Jan 2015 12:01:34 +0000 The evidence reviewed for this paper suggests that:

  • Many countries implement CBE programmes and they are very diverse; some have been initiated by the state and others by non state actors such as non government organisations. Some CBE programmes are time bound and some are on-going.  A number of countries have more than one CBE programme targeting different sub populations.
  • There is substantial robust evidence suggesting that CBE’s have achieved considerable success in meeting the needs of underserved populations, not only in terms of access and equity but also in completion, learning outcomes and a return to formal schooling.
  • Not all CBE programmes have Government sponsorship and support. Where they do, it is usually, but not always, the Ministry of Education (MoE) where overall responsibility for coordination lies.  However, it can be different sections within the MoE which take the lead.
  • As CBE systems offer an alternative means to access the same basic education as children in regular Government Schools, rather than an alternative education, they seem to be more often managed and co-ordinated by the Basic Education Division rather than the Non Formal. Nevertheless, there is little to no concrete evidence available that this approach is what works best rather that this is what makes sense in light of the nature and aims of CBE. Moreover, evaluations of some CBE programmes indicate that strong connections to the formal basic education is one of the major success factors as it accords some parity of esteem with public formal education, which generates public confidence.
  • There is some emerging evidence of what works to ensure CBE programmes are successful and therefore, more likely to become part of national education plans and regular MOE business. One factor that is consistently present across the evidence is the policy space accorded by the national government and their willingness to engage in innovative partnerships with other state and non state actors.
  • Although there is substantial evidence about why it is important to establish innovative partnerships and cooperation between state and non state actors, there is currently little evidence on how this can be established and maintained.  The little evidence there is to hand indicates that the most effective ways to ensure cooperation between the Government and other actors is to define clear roles and responsibilities, which are centred on what each partner does best.
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