Making the most of existing research: an evidence gap map of the effects of food systems interventions in low-income and middle-income countries.

OBJECTIVE: Identify and describe the available evidence on the effects food systems interventions on food security and nutrition outcomes in low-income and middle-income countries. METHODS: An adapted version of the high-level panel of experts food systems framework defined the interventions and outcomes included studies. Included study designs were experimental and quasi-experimental quantitative impact evaluations and systematic reviews. Following standards for evidence gap maps developed by 3ie, a systematic search of 17 academic databases and 31 sector-specific repositories in May 2020 identified articles for inclusion. Trained consultants screened titles/abstracts, then full texts of identified articles. Studies meeting eligibility criteria had meta-data systematically extracted and were descriptively analysed. Systematic reviews were critically appraised. RESULTS: The map includes 1838 impact evaluations and 178 systematic reviews. The most common interventions, with over 100 impact evaluations and 20 systematic reviews each, were: provision of supplements, fortification, nutrition classes, direct provision of foods and peer support/counselling. Few studies addressed national-level interventions or women's empowerment. The most common final outcomes were: anthropometry, micronutrient status, and diet quality and adequacy. Intermediate outcomes were less studied.Most evaluations were conducted in sub-Saharan Africa (33%) or South Asia (20%). Many studies occurred in lower-middle-income countries (43%); few (7%) were in fragile countries. Among studies in a specific age group, infants were most frequently included (19%); 14% of these also considered mothers.Few evaluations considered qualitative or cost analysis; 75% used randomisation as the main identification strategy. DISCUSSION: The uneven distribution of research means that some interventions have established impacts while other interventions, often affecting large populations, are underevaluated. Areas for future research include the evaluation of national level policies, evaluation of efforts to support women's empowerment within the food system, and the synthesis of dietary quality. Quasi-experimental approaches should be adopted to evaluate difficult to randomise interventions.

Strengthening women's empowerment and gender equality in fragile contexts towards peaceful and inclusive societies: A systematic review and meta-analysis.

Background: Across the globe, gender disparities still exist with regard to equitable access to resources, participation in decision-making processes, and gender and sexual-based violence. This is particularly true in fragile and conflict-affected settings, where women and girls are affected by both fragility and conflict in unique ways. While women have been acknowledged as key actors in peace processes and post-conflict reconstruction (e.g., through the United Nations Security Council Resolution 1325 and the Women, Peace and Security Agenda) evidence on the effectiveness of gender-specific and gender-transformative interventions to improve women's empowerment in fragile and conflict-affected states and situations (FCAS) remains understudied. Objectives: The purpose of this review was to synthesize the body of evidence around gender-specific and gender-transformative interventions aimed at improving women's empowerment in fragile and conflict-affected settings with high levels of gender inequality. We also aimed to identify barriers and facilitators that could affect the effectiveness of these interventions and to provide implications for policy, practice and research designs within the field of transitional aid. Methods: We searched for and screened over 100,000 experimental and quasi-experimental studies focused on FCAS at the individual and community levels. We used standard methodological procedures outlined by the Campbell Collaboration for the data collection and analysis, including quantitative and qualitative analyses, and completed the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) methodology to assess the certainty around each body of evidence. Results: We identified 104 impact evaluations (75% randomised controlled trials) assessing the effects of 14 different types of interventions in FCAS. About 28% of included studies were assessed as having a high risk of bias (45% among quasi-experimental designs). Interventions supporting women's empowerment and gender equality in FCAS produced positive effects on the outcomes related to the primary focus of the intervention. There are no significant negative effects of any included interventions. However, we observe smaller effects on behavioural outcomes further along the causal chain of empowerment. Qualitative syntheses indicated that gender norms and practices are potential barriers to intervention effectiveness, while working with local powers and institutions can facilitate the uptake and legitimacy of interventions. Conclusions: We observe gaps of rigorous evidence in certain regions (notably MENA and Latin America) and in interventions specifically targeting women as actors of peacebuilding. Gender norms and practices are important elements to consider in programme design and implementation to maximise potential benefits: focusing on empowerment only might not be enough in the absence of targeting the restrictive gender norms and practices that may undermine intervention effectiveness. Lastly, programme designers and implementation should consider explicitly targeting specific empowerment outcomes, promoting social capital and exchange, and tailoring the intervention components to the desired empowerment-related outcomes.

PROTOCOL: Aquaculture for improving productivity, income, nutrition and women's empowerment in low- and middle-income countries: A systematic review and meta-analysis.

The review aims to examine and synthesise the state of the evidence around what works to improve productivity, income, nutrition and women's empowerment outcomes of households involved in aquaculture in low- and middle-income countries. We are particularly interested in addressing the following research questions: (1) Do aquaculture interventions increase the productivity, income, nutrition and empowerment of individuals engaged in aquaculture and their households in low- and middle-income countries? (2) Do aquaculture interventions generate income and nutrition spillover effects beyond the farmers' households? (3) To what extent do the effects of aquaculture interventions vary by intervention type, population group, and location? In particular, to what extent do effects vary by gender? (4) What are the potential barriers and facilitating factors that impact the effectiveness of aquaculture interventions? (5) What is the cost-effectiveness of different aquaculture interventions focused on productivity, income, nutrition and empowerment outcomes?

Aquaculture for improving productivity, income, nutrition and women's empowerment in low- and middle-income countries: A systematic review and meta-analysis.

Background: A steady increase in the international production and consumption of fish has positioned aquaculture as a development option. Previous literature has highlighted the potential of aquaculture to improve economic, nutritional and gender equality outcomes, however, the evidence on the effectiveness of these programmes remains unclear. Objectives: The review assessed whether aquaculture interventions increase the productivity, income, nutrition, and women's empowerment of individuals. We additionally aimed to identify barriers and facilitators that could affect the effectiveness of these interventions, and the cost-effectiveness of such programmes. Methods: We searched for experimental and quasi-experimental studies focused on low- and middle-income countries. We used standard methodological procedures expected by The Campbell Collaboration for the data collection and analysis. Results: We identified 21 impact evaluations assessing the effect of 13 aquaculture interventions in low- and lower-middle income countries. Twelve of these studies have a high risk of bias. Aquaculture interventions lead to a small increase in the production value, income, total expenditures and food consumption of participants. The limited availability of evidence prevented us from assessing other nutritional and women's empowerment outcomes. We identified barriers and facilitators affecting the programmes' set up, the participation of beneficiaries, and the level of productive activities. Insufficient cost data hindered full comparisons across programmes. Conclusions: The review suggests a lack of rigorous evidence assessing the effectiveness of aquaculture programmes. Future research could focus on evaluating nutrition and women's empowerment impacts, promoting reporting standards, and the use of cost data to continue building quality evidence around aquaculture interventions.

Guidance for producing a Campbell evidence and gap map.

Evidence and Gap Maps (EGMs) are a systematic evidence synthesis product which display the available evidence relevant to a specific research question. EGMs are produced following the same principles as a systematic reviews, that is: specify a PICOS, a comprehensive search, screening against explicit inclusion and exclusion criteria, and systematic coding, analysis and reporting. This paper provides guidance on producing EGMs for publication in Campbell Systematic Reviews.

Evidence gap map of performance measurement and management in primary healthcare systems in low-income and middle-income countries.

INTRODUCTION: We mapped available evidence on performance measurement and management (PMM) strategies in primary healthcare (PHC) systems of low-income and middle-income countries (LMICs). Widely used, their effectiveness remains inconclusive. This evidence gap map characterises existing research and evidence gaps. METHODS: Systematic mapping of performance measurement and management research in LMICs from 2000 to mid-2018; literature searches of seven academic databases and institutional repositories of impact evaluations and systematic reviews. Using a combination of manual screening and machine learning, four reviewers appraised 38 088 titles and abstracts, and extracted metadata from 137 impact evaluations and 18 systematic reviews that met the inclusion criteria. The resulting visual representation of the evidence base was uploaded to a web-based platform. RESULTS: Since 2000, the number of studies has increased; the first systematic reviews were completed in 2010. Two-thirds of the studies were conducted in sub-Saharan Africa and South Asia. Randomised controlled trials were the most frequently used study design. The evidence is concentrated in two types of PMM strategies: implementation strategies (in-service training, continuing education, supervision) and performance-based financing. Major gaps exist in accountability arrangements particularly the use of audit and feedback. The least studied types of outcomes were unintended effects, harm and social equity. CONCLUSIONS: The evidence is clustered around interventions that are unlikely to achieve transformational change in health outcomes. The gaps identified suggest that routinely used PMM strategies are implemented without sufficient knowledge of their effects. Future efforts at redesigning PHC systems need to be informed by evidence on the most effective approaches for using PMM strategies.

Evidence gap map of performance measurement and management in primary care delivery systems in low- and middle-income countries - Study protocol.

Background . For the last two decades there has been growing interest in governmental and global health stakeholders about the role that performance measurement and management systems can play for the production of high-quality and safely delivered primary care services. Despite recognition and interest, the gaps in evidence in this field of research and practice in low- and middle-income countries remain poorly characterized. This study will develop an evidence gap map in the area of performance management in primary care delivery systems in low- and middle-income countries. Methods. The evidence gap map will follow the methodology developed by 3Ie, the International Initiative for Impact Evaluation, to systematically map evidence and research gaps. The process starts with the development of the scope by creating an evidence-informed framework that helps identify the interventions and outcomes of relevance as well as help define inclusion and exclusion criteria. A search strategy is then developed to guide the systematic search of the literature, covering the following databases: Medline (Ovid), Embase (Ovid), CAB Global Health (Ovid), CINAHL (Ebsco), Cochrane Library, Scopus (Elsevier), and Econlit (Ovid). Sources of grey literature are also searched. Studies that meet the inclusion criteria are systematically coded, extracting data on intervention, outcome, measures, context, geography, equity, and study design. Systematic reviews are also critically appraised using an existing standard checklist. Impact evaluations are not appraised but will be coded according to study design. The process of map-building ends with the creation of an evidence gap map graphic that displays the available evidence according to the intervention and outcome framework of interest. Discussion . Implications arising from the evidence map will be discussed in a separate paper that will summarize findings and make recommendations for the development of a prioritized research agenda.

Evidence & Gap Maps: A tool for promoting evidence informed policy and strategic research agendas.

A range of organizations are engaged in the production of evidence on the effects of health, social, and economic development programs on human welfare outcomes. However, evidence is often scattered around different databases, web sites, and the gray literature and is often presented in inaccessible formats. Lack of overview of the evidence in a specific field can be a barrier to the use of existing research and prevent efficient use of limited resources for new research. Evidence & Gap Maps (EGMs) aim to address these issues and complement existing synthesis and mapping approaches. EGMs are a new addition to the tools available to support evidence-informed policymaking. To provide an accessible resource for researchers, commissioners, and decision makers, EGMs provide thematic collections of evidence structured around a framework which schematically represents the types of interventions and outcomes of relevance to a particular sector. By mapping the existing evidence using this framework, EGMs provide a visual overview of what we know and do not know about the effects of different programs. They make existing evidence available, and by providing links to user-friendly summaries of relevant studies, EGMs can facilitate the use of existing evidence for decision making. They identify key "gaps" where little or no evidence from impact evaluations and systematic reviews is available and can be a valuable resource to inform a strategic approach to building the evidence base in a particular sector. The article will introduce readers to the concept and methods of EGMs and present a demonstration of the EGM tool using existing examples.

Climate change: effective ways of cutting greenhouse gas emissions

There are few rigorous impact evaluations of climate change interventions. But some examples in the field of conservation stand out. A number of recent studies evaluate the impact of protected areas, payment for environmental services and decentralized forest management. Climate change interventions have much to learn from experiences in such fields. Despite the limited experience so far in the area, there are many opportunities to conduct impact evaluation of climate change.