Interventions to improve refugee children's access to education and quality learning: A scoping review of existing impact evaluations.

Refugee children face numerous challenges in accessing quality education. In the past years, the number of interventions aiming to address these challenges has grown substantially. What is still scarce, however, is systematic evidence on what works to improve refugee children's enrolment and learning. The authors of this article set out to find what robust quantitative evidence exists regarding interventions that seek to improve access to education and quality learning for refugee children. They conducted a first scoping review of quantitative peer-reviewed articles which evaluate the effect of specific interventions which aimed to improve access to education and/or quality learning for refugee children. While their literature search for the time-period 1990-2021 resulted in 1,873 articles, only eight of these fit the authors' selection criteria. This low number indicates that there is a general lack of robust evidence as to what works to improve quality learning for refugee children. What the authors' mapping of the research evidence does suggest is that cash transfer programmes can increase school attendance and that learning outcomes, such as second-language acquisition, can be improved through physical education, early childhood development programmes, or online game-based solutions. Other interventions, such as drama workshops, appear to have had zero effect on second-language acquisition. The authors conclude their article by addressing the limitations and implications of this body of interventions for future research.

Interventions visant à améliorer l'accès des enfants réfugiés à l'éducation et la qualité de l'apprentissage : un examen approfondi des évaluations d'impact existantes ­ Les enfants réfugiés sont confrontés à de nombreuses difficultés pour accéder à une éducation de qualité. Ces dernières années, le nombre d'interventions visant à relever ces défis a considérablement augmenté. Cependant, les preuves systématiques de ce qui fonctionne pour améliorer la scolarisation et l'apprentissage des enfants réfugiés sont encore rares. Les auteures de cet article se sont mises en quête de preuves quantitatives solides concernant les interventions qui cherchent à améliorer l'accès à l'éducation et la qualité de l'apprentissage pour les enfants réfugiés. Elles ont procédé à une première analyse des articles quantitatifs examinés par des pairs qui évaluent l'effet d'interventions spécifiques visant à améliorer l'accès à l'éducation et/ou la qualité de l'apprentissage pour les enfants réfugiés. Bien que leur recherche documentaire pour la période 1990­2021 ait donné lieu à 1 873 articles, seuls huit d'entre eux correspondaient aux critères de sélection des auteures. Ce faible nombre témoigne d'une insuffisance généralisée de preuves solides sur ce qui fonctionne pour améliorer la qualité de l'apprentissage pour les enfants réfugiés. Ce que la cartographie des résultats de recherche des auteures suggère, c'est que les programmes de transferts monétaires peuvent augmenter la fréquentation scolaire et que les résultats d'apprentissage, tels que l'acquisition d'une seconde langue, peuvent être améliorés grâce à l'éducation physique, aux programmes de développement de la petite enfance ou aux solutions axées sur les jeux en ligne. D'autres interventions, telles que les ateliers de théâtre, semblent n'avoir eu aucun effet sur l'acquisition d'une seconde langue. Les auteures concluent leur article en abordant les limites et les implications de cet ensemble d'interventions pour la recherche future.

Maternal Health Care Among Refugees and Host Communities in Northern Uganda: Access, Quality, and Discrimination.

Introduction: Uganda is one of the largest refugee-hosting nations in the world, with the majority of the refugees having fled South Sudan. In the early 2000's the local government and refugee health systems were merged to create a more equal and integrated system for refugees and the host population. Our aim is to investigate whether mothers from the two groups experience the same access to and quality of maternal health services, and whether refugee- and host-community mothers perceive the maternal health services differently. Methods: In November-December 2019, we conducted a household survey of 1,004 Ugandan nationals and South Sudanese refugee mothers aged 15-49 in the West Nile region covering the districts of Arua, Yumbe, and Adjumani, and elicited information on access to maternal health care services, perceptions of the quality of services, and feelings of discrimination. The data was then analyzed using Ordinary Least Squares and logistic regression. Results: Our analyses do not reveal large differences between refugees and the host community in terms of access to and the quality of maternal health services. Results from bivariate models indicate that refugee mothers are 6% points less likely to receive antenatal care (p-value < 0.05) but are 8% points more likely to give birth at a health facility (p-value < 0.05). Refugee mothers are generally less satisfied with how they were treated during antenatal care (0.132 lower average value on a Likert scale, p-value < 0.01). Refugee mothers are also 4% points more likely to feel discriminated against during ANC compared to their counterparts in the host community (p-value < 0.05). Discussion: The way women feel treated at the health facility during maternal health care is an important aspect of quality care. While there seems to be equal access to resources between refugees and host community mothers in Northern Uganda in terms of access to and quality of care, there is still a discrepancy between the two groups in terms of how the women feel treated. Policymakers and practitioners in the health sector should pay attention to these perceived inequalities between refugees and women from the host communities to ensure equally inclusive treatment across groups.

Equity in aid allocation and distribution: A qualitative study of key stakeholders in Northern Uganda.

The Sustainable Development Goals have spurred a growing interest in and focus on equitable development. In theory, donors can play an important role in promoting equity within a country by providing services, influencing government policies and incorporating equity into decision-making. However, we know little about whether this actually happens on the ground. We conduct what we believe is the first study to explore the extent to which equity is prioritised in the allocation and distribution of aid, based on in-depth interviews with government officials, bilateral and international donors, and implementing partners operating in Northern Uganda. We find that a broad category of people are perceived to be marginalised/vulnerable, with a substantial segment largely untargeted by major donor programmes. Various stakeholders employ a wide range of strategies to identify the most vulnerable individuals and groups, including the use of available data and statistics, consultation and engagement with relevant stakeholders, and undertaking primary data collection. The strategies used to incorporate equity in aid allocation and distribution include: targeting the regions of Northern Uganda and Karamoja in particular, targeting both refugees and host populations in refugee-hosting districts, prioritising the critically vulnerable in any aid distribution process, and using specific tools and consultants to ensure that major equity issues are addressed in proposals. Challenges undermining the process include poor understanding of the concept of equity among some implementing partners, lack of comprehensively disaggregated data, corruption, and political interference in choice of aid location from government officials and donors.

Effects of an empowerment program for survivors of sexual violence on attitudes and beliefs: evidence from the Democratic Republic of Congo.

BACKGROUND: Women's empowerment may require women to change their beliefs and views about their rights and capabilities. Empowerment programs often target women who have survived sexual and gender-based violence (SGBV), with the justification that these women may develop disempowered beliefs as a coping mechanism, or face greater barriers to, or derive greater benefits from, the adoption of empowered beliefs and preferences. We investigated an intensive, six-month residential empowerment program ("City of Joy") for SGBV survivors in eastern Democratic Republic of the Congo (DRC), where more than one in five women have experienced SGBV. METHODS: We asked 175 participants about their beliefs and preferences pertaining to political, financial, and domestic empowerment. Interviews took place immediately before and after participation in the program, and we tested for differences in views of empowerment between entry and exit using paired t-tests and McNemar's test. We also conducted 50 semi-structured interviews about empowerment with an additional 30 women who had completed the program up to 5 years earlier and then returned to their home community. RESULTS: Prior to enrolling in the program, participants had fairly empowered views regarding politics, less empowered views regarding finances, and still less empowered views regarding the domestic sphere. After completing the program, participants had significantly more empowered views in all three domains, particularly regarding domestic violence, how families should treat men and women, and women's economic rights. Participants in their home communities reported taking a more active role in community affairs and speaking out against the mistreatment of women. CONCLUSION: This study adds to the evidence that women's empowerment programs can change participants' beliefs and thus increase the confidence with which they participate in their communities and support one another.

Armed conflict and maternal mortality: A micro-level analysis of sub-Saharan Africa, 1989-2013.

There is existing country-level evidence that countries with more severe armed conflict tend to have higher Maternal Mortality Rates (MMR). However, during armed conflict, the actual fighting is usually confined to a limited area within a country, affecting a subset of the population. Hence, studying the link between country-level armed conflict and MMR may involve ecological fallacies. We provide a more direct, nuanced test of whether local exposure to armed conflict impacts maternal mortality, building on the so-called "sisterhood method". We combine geo-coded data on different types of violent events from the Uppsala Conflict Data Program with geo-referenced survey data from the Demographic and Health Surveys (DHS) on respondents' reports on sisters dying during pregnancy, childbirth, or the puerperium. Our sample covers 1,335,161 adult sisters aged 12-45 by 539,764 female respondents in 30 countries in sub-Saharan Africa. Rather than aggregating the deaths of sisters to generate a maternal mortality ratio, we analyze the sisters' deaths at the individual level. We use a sister fixed-effects analysis to estimate the impact of recent organized violence events within a radius of 50 km of the home of each respondent on the likelihood that her sister dies during pregnancy, childbirth, or the puerperium. Our results show that local exposure to armed conflict events indeed increases the risk of maternal deaths. Exploring potential moderators, we find larger differences in rural areas but also in richer and more educated areas.

The impact of support programmes for survivors of sexual violence: micro-level evidence from eastern Democratic Republic of the Congo.

In the eastern Democratic Republic of the Congo there are several support programmes for sexual violence survivors, but their impacts are rarely systematically assessed. We investigated the effects for women from two support programmes that include both survivors of sexual and gender-based violence (SGBV) and others. Specifically, we estimated (1) the effect of SGBV on social exclusion and economic well-being, and (2) the effects of support programmes on social exclusion and economic well-being, as well as differential effects for SGBV survivors and others. Based on an original survey of 1,203 women, we found that survivors felt less included across various social settings, but their economic well-being was no different than that of other women. We also found that support programmes significantly improve both perceived social inclusion and economic well-being for survivors and non-survivors. The effects on economic well-being were larger for survivors. In conclusion, these support programmes brought important benefits to survivors and non-survivors alike, although there is potential for improvement, particularly on social inclusion for SGBV survivors.

Organized Violence and Institutional Child Delivery: Micro-Level Evidence From Sub-Saharan Africa, 1989-2014.

The conditions under which a mother gives birth greatly affect the health risk of both the mother and the child. This article addresses how local exposure to organized violence affects whether women give birth in a health facility. We combine geocoded data on violent events from the Uppsala Conflict Data Program with georeferenced survey data on the use of maternal health care services from the Demographic and Health Surveys. Our sample covers 569,201 births by 390,574 mothers in 31 countries in sub-Saharan Africa. We use a mother fixed-effects analysis to estimate the effect of recent organized violence events within a radius of 50 km of the home of each mother on the likelihood that her child is born in a health facility. The results indicate that geographical and temporal proximity to organized violence significantly reduces the likelihood of institutional births. Although the level of maternal health care overall is lower in rural areas, the negative effect of violence appears to be stronger in urban areas. The study further underscores the importance of household and individual resilience, indicating that the effect of organized violence on institutional child delivery is greater among poor and less-educated mothers.