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1.
PLoS One ; 14(11): e0223044, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31725717

RESUMO

Multi-stakeholder platforms have become mainstream in projects, programmes and policy interventions aiming to improve innovation and livelihoods systems, i.e. research for development interventions in low- and middle-income contexts. However, the evidence for multi-stakeholder platforms' contribution to the performance of research for development interventions and their added value is not compelling. This paper focuses on stakeholder participation as one of the channels for multi-stakeholder platforms' contribution to the performance of research for development interventions, i.e. stakeholder participation. It uses a quantitative approach and utilizes descriptive statistics and ARIMA models. It shows that, in three Ugandan multi-stakeholder platform cases studied, participation increased both in nominal and in unique terms. Moreover, participation was rather cyclical and fluctuated during the implementation of the research for development interventions. The study also shows that, in addition to locational and intervention factors such as type of the area along a rural-urban gradient targeted by the intervention and human resources provided for multi-stakeholder platform implementation, temporal elements such as phases of research for development intervention objectives and the innovation development process play significant roles in influencing participation. The study concludes that contribution of multi-stakeholder platforms to the performance of research for development projects, programs, policies and other initiatives is constrained by locational and temporal context and conditional on the participation requirements of the objectives pursued by research for development intervention.

2.
Malar J ; 18(1): 270, 2019 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-31395048

RESUMO

BACKGROUND: Malaria preventive measures, including long-lasting insecticide-treated bet nets (LLINs), indoor residual spraying (IRS), and controlling mosquito breeding sites, are key measures to achieve malaria elimination. Still, compliance with these recommended measures remains a major challenge. By applying a novel and comprehensive model for determinants of malaria prevention behaviour, this study tests how individual perceptions influence the intentions to use malaria preventive measures and explores strategies that stimulate their consistent use. METHODS: The study was carried out in the sectors of Ruhuha and Busoro, Rwanda during October and November 2017, and these were conducted into two phases. Phase one involved a questionnaire survey (N = 742), whereas Phase two employed a qualitative approach that included nine focus group discussions, seven key informant interviews, and three in-depth interviews. RESULTS: The findings of the quantitative study showed that participants very often use LLINs (66.6%), accept IRS (73.9%), and drain stagnant water in case of presence (62%). The intentions to use malaria preventive measures were consistently driven by perceived severity, perceived self-efficacy, perceived response efficacy, and subjective norms, and hindered by perceived barriers. The intentions were also positively associated with the actual use of LLINs, acceptance of IRS, and drainage of stagnant water. There is no evidence that either not having enough LLINs (ownership of at least one bed net in the household, here referred to as availability) or having sufficient LLINs (having one LLIN per two people in the household, here referred to as accessibility) moderated the relationship between behavioural intentions and actual use of LLINs. The qualitative study indicated that participants believed malaria risk to be high and perceived a high mosquito density. They also believed that repetitive malaria episodes are caused by the perceived low effectiveness of anti-malaria medications. Lack of LLINs increased the perceived added value of LLINs, and together with the increased malaria burden increased the perceived response efficacy. Participants highlighted the need to continuously mobilize and engage community members especially those who do not use LLINs when having one, and those who do not accept the spraying activities. CONCLUSION: Malaria prevention interventions should target individual perceptions to enhance consistent use of malaria preventive measures. Three strategies to improve consistent use and acceptance of these measures are highlighted: (1) ensure access to LLINs and regular spraying activities, (2) community mobilization and (3) citizen engagement in malaria prevention activities.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Malária/prevenção & controle , Percepção , Prevenção Primária/métodos , Adulto , Feminino , Humanos , Malária/psicologia , Masculino , Pessoa de Meia-Idade , População Rural/estatística & dados numéricos , Ruanda
3.
PLoS One ; 13(6): e0197993, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29870559

RESUMO

Multi-stakeholder platforms (MSPs) have been playing an increasing role in interventions aiming to generate and scale innovations in agricultural systems. However, the contribution of MSPs in achieving innovations and scaling has been varied, and many factors have been reported to be important for their performance. This paper aims to provide evidence on the contribution of MSPs to innovation and scaling by focusing on three developing country cases in Burundi, Democratic Republic of Congo, and Rwanda. Through social network analysis and logistic models, the paper studies the changes in the characteristics of multi-stakeholder innovation networks targeted by MSPs and identifies factors that play significant roles in triggering these changes. The results demonstrate that MSPs do not necessarily expand and decentralize innovation networks but can lead to contraction and centralization in the initial years of implementation. They show that some of the intended next users of interventions with MSPs-local-level actors-left the innovation networks, whereas the lead organization controlling resource allocation in the MSPs substantially increased its centrality. They also indicate that not all the factors of change in innovation networks are country specific. Initial conditions of innovation networks and funding provided by the MSPs are common factors explaining changes in innovation networks across countries and across different network functions. The study argues that investigating multi-stakeholder innovation network characteristics targeted by the MSP using a network approach in early implementation can contribute to better performance in generating and scaling innovations, and that funding can be an effective implementation tool in developing country contexts.


Assuntos
Difusão de Inovações , Participação dos Interessados , Humanos , Rede Social
4.
BMC Public Health ; 18(1): 329, 2018 03 06.
Artigo em Inglês | MEDLINE | ID: mdl-29510683

RESUMO

BACKGROUND: In 2012, a donor-supported proof of principle study was launched to eliminate malaria from Rusinga Island, western Kenya, using solar-powered mosquito trapping systems (SMoTS). SMoTS, which also provided power for room lighting and charging mobile telephones, were installed in houses. In view of the involvement of individual and collective benefits, as well as individual and collective maintenance solutions, this study qualitatively examined preferences of some project stakeholders towards SMoTS sustainability components to see if and how they related to social dilemma factors. METHODS: The data were collected through participant observation, semi-structured interviews and focus group discussions. RESULTS: The results show that respondents largely preferred individual solutions to various aspects of maintenance. Selective collective solutions such as table banking groups were considered positively for mobilising financial resources for maintenance, but respondents were hardly willing to contribute financially to a collective entity. Few people saw a meaningful role for a collective governing body; people preferred to rely on individual household responsibility and private service delivery for repairs and stocking spare parts. An overriding concern was that people lacked trust in other community members, leaders and/or technicians who would be employed by a governing body. Respondents also had little confidence that a governing body or saving group could effectively impose sanctions to misappropriation of funds, poor leadership, defecting group members or technicians that might abuse a salaried position. CONCLUSION: There seemed to be linkages between preferences towards organising various components of SMoTS sustainability and known hindrances to addressing social dilemmas. This posed considerable challenges to organising the sustainability of this innovative malaria control strategy. TRIAL REGISTRATION: NTR3496 .


Assuntos
Malária/prevenção & controle , Controle de Mosquitos/instrumentação , Controle de Mosquitos/métodos , Energia Solar , Difusão de Inovações , Feminino , Grupos Focais , Humanos , Quênia/epidemiologia , Malária/epidemiologia , Masculino , Observação , Pesquisa Qualitativa , Medição de Risco , Teoria Social
5.
Sci Total Environ ; 580: 1475-1482, 2017 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-28038875

RESUMO

The rubber boom across much of Southeast Asia has led to environmental destruction, and the resultant crash in the price of rubber has destabilised livelihoods. We investigated the necessary factors required to enable a transition towards a more sustainable model for rubber cultivation in Southwest China (i.e. the 'greening' of rubber cultivation), using a framework for the integrative study of multiple aspects in complex land use issues. We present findings from stakeholder interviews and a stakeholder workshop, and discuss their relevance within and beyond Southwest China. The current focus of researchers and development practitioners tends to be on finding technical solutions to address unsustainable rubber cultivation practices. However, stakeholder consultations revealed that the key barriers were more social: low levels of trust and knowledge exchange between stakeholder groups and fragmented visions about the future of the landscape. It is very important to continue the economic prosperity initially brought by rubber, but, without improved communication between government and researchers and smallholder farmers, this will be very difficult to achieve. A wider landscape perspective is needed to address issues in rubber cultivation to avoid repeating the same problems of cash crop boom and bust experienced with other crops, most notably bananas. We conclude that more effort should be put into developing mechanisms that integrate technical knowledge, enhance social relationships, and present a forum for reconciling - or at least acknowledging - the differing needs, knowledge, and objectives of different groups, and transcending the power dynamics between smallholder farmers and government and researchers.

6.
Lancet ; 388(10050): 1193-201, 2016 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-27520594

RESUMO

BACKGROUND: Odour baits can attract host-seeking Anopheles mosquitoes indoors and outdoors. We assessed the effects of mass deployment of odour-baited traps on malaria transmission and disease burden. METHODS: We installed solar-powered odour-baited mosquito trapping systems (SMoTS) to households on Rusinga Island, Lake Victoria, western Kenya (mean population 24 879), in a stepped-wedge cluster-randomised trial. All residents in the completed health and demographic surveillance system were eligible to participate. We used the travelling salesman algorithm to assign all households to a cluster (50 or 51 geographically contiguous households); nine contiguous clusters formed a metacluster. Initially, no cluster had SMoTS (non-intervened). During the course of the intervention roll-out SMoTS were gradually installed cluster by cluster until all clusters had SMoTS installed (intervened). We generated 27 cluster randomisations, with the cluster as unit of randomisation, to establish the order to install the traps in the clusters until all had a SMoTS installed. Field workers and participants were not masked to group allocation. The primary outcome of clinical malaria was monitored through repeated household visits covering the entire population, once before roll-out (baseline) and five times throughout the 2-year roll-out. We measured clinical malaria as fever plus a positive result with a rapid diagnostic test. The SolarMal project was registered on the Dutch Trial Register (NTR 3496). FINDINGS: We enrolled 34 041 participants between April 25, 2012, and March 23, 2015, to 81 clusters and nine metaclusters. 4358 households were provided with SMoTS during roll-out between June 3, 2013, and May 16, 2015. 23 clinical malaria episodes were recorded in intervened clusters and 33 episodes in non-intervened clusters (adjusted effectiveness 40·8% [95% CI -172·8 to 87·1], p=0·5) during the roll-out. Malaria prevalence measured by rapid diagnostic test was 29·8% (95% CI 20·9-38·0) lower in SMoTS clusters (prevalence 23·7%; 1552 of 6550 people) than in non-intervened clusters (prevalence 34·5%; 2002 of 5795 people). INTERPRETATION: The unexpectedly low clinical incidence of malaria during roll-out led to an imprecise estimate of effectiveness from the clinical incidence data. The substantial effect on malaria prevalence is explained by reduction in densities of Anopheles funestus. Odour-baited traps might be an effective malaria intervention. FUNDING: COmON Foundation.


Assuntos
Anopheles , Efeitos Psicossociais da Doença , Mosquiteiros Tratados com Inseticida , Malária/epidemiologia , Malária/prevenção & controle , Controle de Mosquitos/métodos , Odorantes , Animais , Medicina Baseada em Evidências , Feminino , Humanos , Incidência , Insetos Vetores , Mosquiteiros Tratados com Inseticida/estatística & dados numéricos , Quênia , Malária/diagnóstico , Malária/transmissão , Masculino , Prevalência , Projetos de Pesquisa , Resultado do Tratamento
7.
Trials ; 17: 356, 2016 07 26.
Artigo em Inglês | MEDLINE | ID: mdl-27460054

RESUMO

BACKGROUND: Increasing levels of insecticide resistance as well as outdoor, residual transmission of malaria threaten the efficacy of existing vector control tools used against malaria mosquitoes. The development of odour-baited mosquito traps has led to the possibility of controlling malaria through mass trapping of malaria vectors. Through daily removal trapping against a background of continued bed net use it is anticipated that vector populations could be suppressed to a level where continued transmission of malaria will no longer be possible. METHODS/DESIGN: A stepped wedge cluster-randomised trial design was used for the implementation of mass mosquito trapping on Rusinga Island, western Kenya (the SolarMal project). Over the course of 2 years (2013-2015) all households on the island were provided with a solar-powered mosquito trapping system. A continuous health and demographic surveillance system combined with parasitological surveys three times a year, successive rounds of mosquito monitoring and regular sociological studies allowed measurement of intervention outcomes before, during and at completion of the rollout of traps. Data collection continued after achieving mass coverage with traps in order to estimate the longer term effectiveness of this novel intervention. Solar energy was exploited to provide electric light and mobile phone charging for each household, and the impacts of these immediate tangible benefits upon acceptability of and adherence to the use of the intervention are being measured. DISCUSSION: This study will be the first to evaluate whether the principle of solar-powered mass mosquito trapping could be an effective tool for elimination of malaria. If proven to be effective, this novel approach to malaria control would be a valuable addition to the existing strategies of long-lasting insecticide-treated nets and case management. Sociological studies provide a knowledge base for understanding the usage of this novel tool. TRIAL REGISTRATION: Trialregister.nl: NTR3496 - SolarMal. Registered on 20 June 2012.


Assuntos
Culicidae/parasitologia , Vetores de Doenças , Malária/prevenção & controle , Controle de Mosquitos/métodos , Odorantes , Energia Solar , Animais , Humanos , Incidência , Quênia/epidemiologia , Malária/epidemiologia , Malária/parasitologia , Malária/transmissão , Prevalência , Projetos de Pesquisa , Fatores de Tempo
8.
Trop Med Int Health ; 20(8): 1048-56, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25851562

RESUMO

OBJECTIVE: To investigate community adherence to recommended behaviours for proper deployment of solar-powered mosquito trapping systems (SMoTS) after 3- to 10-week use. METHODS: Solar-powered mosquito trapping system, which also provided power for room lighting and charging mobile phones, were installed in houses in Rusinga Island, western Kenya. We used a structured checklist for observations and a semi-structured questionnaire for interviews in 24 homesteads. We also analysed the subject of 224 community calls to the project team for technical maintenance of SMoTS. RESULTS: Most respondents cared for SMoTS by fencing, emptying and cleaning the trap. Our observations revealed that most traps were fenced, clean and in good working condition. A significantly higher proportion of community calls was lighting-related. Lighting was the main reason respondents liked SMoTS because it reduced or eliminated expenditure on kerosene. However, some respondents observed they no longer heard sounds of mosquitoes inside their houses. All respondents reportedly slept under insecticide-treated nets (ITNs) before receiving SMoTS. After receiving SMoTS, most respondents reportedly continued to use ITNs citing that the project advised them to do so. Some beach residents stopped using ITNs because they no longer heard mosquitoes or due to heat discomfort caused by lights. CONCLUSION: Electricity-related incentives played a greater role in encouraging adherence to recommended behaviours for proper deployment of SMoTS than the potential health benefits in the early stages of the intervention. Although energy-related financial incentives may play a role, they are insufficient to ensure adherence to health advice, even in the short term. Ongoing community engagement and research monitors and addresses adherence to recommended behaviours including continuation of current malaria control strategies.


Assuntos
Eletricidade , Conhecimentos, Atitudes e Prática em Saúde , Iluminação , Malária/prevenção & controle , Controle de Mosquitos/métodos , Aceitação pelo Paciente de Cuidados de Saúde , Energia Solar , Adolescente , Adulto , Animais , Telefone Celular , Culicidae , Desenho de Equipamento , Feminino , Humanos , Mosquiteiros Tratados com Inseticida , Quênia , Luz , Masculino , Controle de Mosquitos/instrumentação , Fatores Socioeconômicos , Inquéritos e Questionários
9.
Parasit Vectors ; 7: 523, 2014 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-25404420

RESUMO

BACKGROUND: There has been increasing effort in recent years to incorporate user needs in technology design and re-design. This project employed a bottom-up approach that engaged end users from the outset. Bottom-up approaches have the potential to bolster novel interventions and move them towards adaptive and evidence-based strategies. The present study concerns an innovative use of solar-powered mosquito trapping systems (SMoTS) to control malaria in western Kenya. Our paper highlights the co-dependence of research associated with the development of the SMoTS technology on one hand and research for enhancing the sustainable uptake of that very same intervention within the community on the other. METHODS: During the pre-intervention year, we examined the design, re-design and piloting of a novel technology to generate lessons for malaria elimination on Rusinga Island. Initial ideas about many technological necessities were evaluated and re-designed following feedback from various sources, including technical and social research as well as broader interactions with the social environment. We documented the interlocking of the multiple processes and activities that took place through process observation and document reviews. We analysed the data within the conceptual framework of system innovation by identifying mutual shaping between technical and social factors. RESULTS: Our findings illustrate how various project stakeholders including project staff, collaborators, donor, and community members simultaneously pursued interdependent technological transformations and social interests. In the ongoing process, we observed how partial outcomes in the technological domain influenced social events at a later phase and vice versa. CONCLUSIONS: Looking at malaria intervention projects employing novel technologies as niches that may evolve towards system innovation, helps to reveal interrelations between the various technical and social aspects. Revealing these interrelations requires a different role for research and different perspective on innovation where innovation is more than the technical aspects. This approach therefore requires that research is designed in a way that enables obtaining feedback from both aspects.


Assuntos
Malária/prevenção & controle , Controle de Mosquitos/instrumentação , Energia Solar , Animais , Participação da Comunidade , Conservação dos Recursos Naturais , Desenho de Equipamento , Habitação , Humanos , Ilhas , Quênia/epidemiologia , Malária/epidemiologia , Malária/transmissão , Controle de Mosquitos/métodos
10.
Health Educ Behav ; 40(2): 193-205, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22773596

RESUMO

Alcohol use among adolescents is a concern in the Netherlands because of its high prevalence and risks. To discourage adolescents from drinking alcohol, a televised entertainment-education (E-E) intervention was developed. This study investigated responses of adolescents on perceived realism and enjoyment of the E-E intervention, as well as its impact on alcohol drinking behavior. Viewers perceived the E-E narratives to be credible and enjoyable but did not relate to the characters in the narratives. However, exposure to the E-E intervention predicted desired changes in alcohol drinking behavior, intentions to decrease alcohol use, and perceived normative pressure, especially in less educated viewers. These findings demonstrate that E-E is a promising strategy to target adolescent alcohol use. Future research will focus on the individual processes and story elements that account for the positive results.


Assuntos
Consumo de Bebidas Alcoólicas/prevenção & controle , Educação em Saúde/métodos , Televisão , Adolescente , Feminino , Humanos , Masculino , Países Baixos , Comunicação Persuasiva
11.
Eval Program Plann ; 33(4): 428-35, 2010 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-20106527

RESUMO

The evaluation of community health promotion designed to create supportive social environments for health is still in its infancy. There is a lack of consensus on concepts, a lack of information on interventions that bring about social change, and a lack of feasible methods and tools. Consequently, the effectiveness of community health promotion may not be evaluated under all relevant headings. Therefore, this study aims to contribute to the evaluation of change in the social environment by presenting a framework. On the basis of the relevant literature we describe the relation between social environment and health predicting mediators. We selected participation and collaboration as core concepts in moderating the social environment of health because these terms give insight into the actual dynamics of health promotion practice. We synthesize the results into a framework with operational variables and offer four guidelines on how to apply the framework: use the variables as a menu, set specific aims for social change processes, use an action research approach, and triangulate data. The framework and guidelines enable the start-up, facilitation and evaluation of social change and learning processes and provide common ground for researchers and practitioners to improve the practice of their professions.


Assuntos
Redes Comunitárias , Promoção da Saúde/organização & administração , Avaliação de Programas e Projetos de Saúde , Meio Social , Pesquisa sobre Serviços de Saúde , Humanos , Países Baixos , Literatura de Revisão como Assunto
12.
Afr J AIDS Res ; 8(3): 261-74, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25864542

RESUMO

This paper characterises children orphaned by AIDS in the Couffo region of Benin. A 2006 census conducted for the research revealed a total of 315 such orphans, aged 0 to 14 years, within 88 households. Seventy-one percent of these children were under the care of their mothers or grandmothers, 68% were fatherless, 58% were between the ages of 7 and 12, and 68% were in primary school. An in-depth study of the orphans' lives, undertaken to complement the census, revealed that these orphans were highly mobile between households, with almost 50% of them moving homes within a six-month period. An analysis of this phenomenon found that orphan mobility was a deliberate household strategy to manage orphanhood. Tensions arising out of care arrangements and resource allocation were among the main reasons for the high degree of orphan mobility. The context of orphan mobility also highlighted the practical role the orphans were able to fulfil within the affected households. The findings show that orphan mobility is a social phenomenon with two functions: on one hand, it may help HIV/AIDS-affected households to manage the increase in the number of orphans; on the other, it can provide an opportunity for orphans to move to a 'safer' environment anytime they do not feel secure. The implications for institutions providing care to orphans were also identified. Among other things, we recommend that a distinction be made between the main caregiver and the 'endorser' of an orphan as this was found to be an important difference. We also recommended that a distinction be made between orphans under and over the age of 10. For instance, children in the age group 10-14 years should be defined as 'pre-adults,' as their position within the household and their needs for services are different from those of orphans under age 10.

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