Sexuality, Poverty and the Law: A Case Study Approach for Exploring Avenues of Change (original) (raw)
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Health Research Policy and Systems, 2011
Background Research institutions and donor organizations are giving growing attention to how research evidence is communicated to influence policy. In the area of sexual and reproductive health (SRH) and HIV there is less weight given to understanding how evidence is successfully translated into practice. Policy issues in SRH can be controversial, influenced by political factors and shaped by context such as religion, ethnicity, gender and sexuality. Methods The case-studies presented in this paper analyse findings from SRH/HIV research programmes in sub-Saharan Africa: 1) Maternal syphilis screening in Ghana, 2) Legislative change for sexual violence survivors In Ghana, 3) Male circumcision policy in South Africa, and 4) Male circumcision policy in Tanzania. Our analysis draws on two frameworks, Sumner et al’s synthesis approach and Nutley’s research use continuum. Results The analysis emphasises the relationships and communications involved in using research to influence policy and practice and recognises a distinction whereby practice is not necessarily influenced as a result of policy change – especially in SRH – where there are complex interactions between policy actors. Conclusion Both frameworks demonstrate how policy networks, partnership and advocacy are critical in shaping the extent to which research is used and the importance of on-going and continuous links between a range of actors to maximize research impact on policy uptake and implementation. The case-studies illustrate the importance of long-term engagement between researchers and policy makers and how to use evidence to develop policies which are sensitive to context: political, cultural and practical.
Health research policy and systems / BioMed Central, 2011
Assessing the impact that research evidence has on policy is complex. It involves consideration of conceptual issues of what determines research impact and policy change. There are also a range of methodological issues relating to the question of attribution and the counter-factual. The dynamics of SRH, HIV and AIDS, like many policy arenas, are partly generic and partly issue- and context-specific. Against this background, this article reviews some of the main conceptualisations of research impact on policy, including generic determinants of research impact identified across a range of settings, as well as the specificities of SRH in particular. We find that there is scope for greater cross-fertilisation of concepts, models and experiences between public health researchers and political scientists working in international development and research impact evaluation. We identify aspects of the policy landscape and drivers of policy change commonly occurring across multiple sectors an...
Mechanisms of adopting and reformulating comprehensive sexuality education policy in Ethiopia
Journal of Education Policy
Over the past few years, international organisations have advanced Comprehensive Sexuality Education (CSE) as a global policy to promote sexual and reproductive health and rights (SRHR) and address gender-based violence in schools. This paper analyses policy adoption, transfer mechanisms, and reformulation of CSE in Ethiopia, a late adopter of the policy. To do this, we identify education policy transfer mechanisms and apply a gender analysis by focusing on conceptualisations of gender relations in the uptake and reformulation of CSE policies. Drawing on document analysis and stakeholder interviews, the paper reveals that CSE in Ethiopia is largely a donor-driven agenda, advanced through dissemination and networking strategies. CSE is particularly embraced by the Ministry of Health, international organisations and NGOs in Ethiopia, but at the same time, the Ministry of Education and other critics continue to resist adoption, emphasising cultural differences. As a result, CSE in Ethiopia is (re) formulated and reflects narrow conceptualisations of how CSE can address gender-based violence, restricting its focus to health and development outcomes.
Health Research Policy and Systems, 2011
This commentary introduces the HARPS supplement on getting research into policy and practice in sexual and reproductive health (SRH). The papers in this supplement have been produced by the Sexual Health and HIV Evidence into Practice (SHHEP) collaboration of international research, practitioner and advocacy organizations based in research programmes funded by the UK Department for International Development. The commentary describes the increasing interest from research and communication practitioners, policy makers and funders in expanding the impact of research on policy and practice. It notes the need for contextually embedded understanding of ways to engage multiple stakeholders in the politicized, sensitive and often contested arenas of sexual and reproductive health. The commentary then introduces the papers under their respective themes: (1) The theory and practice of research engagement (two global papers); (2) Applying policy analysis to explore the role of research evidence in SRH and HIV/AIDS policy (two papers with examples from Ghana, Malawi, Uganda and Zambia);
Sexuality and Poverty Synthesis Report
2014
IDS is a charitable company limited by guarantee and registered in England (No. 877338). The IDS programme on Strengthening Evidence-based Policy works across seven key themes. Each theme works with partner institutions to co-construct policy-relevant knowledge and engage in policy-influencing processes. This material has been developed under the Sexuality, Poverty and Law theme. The material has been funded by UK aid from the UK Government, however the views expressed do not necessarily reflect the UK Government's official policies. AG Level 2 Output ID: 226 Contents Acronyms Acknowledgements We owe a debt of gratitude to all those community members who took part in interviews and focus group discussions during the implementation of the policy audits. Their inputs and analysis were invaluable in shaping our work. Their insights and experiences brought the issues alive and grounded the rather lofty process of policy analysis in their lived reality. Thanks to akshay khanna, Sonia Correa and Andrea Cornwall for their support throughout the audit process. Along with the authors they helped to shape the cross-cutting themes that order this document. Elizabeth Mills also provided support in reviewing the drafts of this document.
Culture & Psychology, 2019
The dominance of high-income countries in ‘generalised’ evidence-making is increasingly recognised as a barrier to advancing understandings of social change processes in international development. Building more equitable and collaborative institutionalised relationships with localities is therefore emphasised. This paper details how a dialogical case study of evidence-making in international development was developed through the single-case ethnography of a youth sexual behaviour change and empowerment intervention in Tanzania. It illustrates how dialogical theorising was applied in both data collection and analyses towards advancing understandings of the ethical and dynamic Self–Other interdependencies through which evidence is made and communicated. The analyses highlight the performativity of monitoring and evaluation activities: how networks of relations perform the logic of rigid predictability that underpins the design and funding of international development interventions. Th...
Global Public Health, 2021
Background: Sub-Saharan Africa (SSA) has the highest number of people living with HIV/AIDS, with Nigeria, South Africa, and Uganda accounting for 48% of new infections. A systematic review of the HIV burden among women engaged in sex work (WESW) in 50 low-and middle-income countries found that they had increased odds of HIV infection relative to the general female population. Social structural factors, such as the sex work environment, violence, stigma, cultural issues, and criminalization of sex work are critical in shaping sexually transmitted infection (STI)/HIV risks among WESW and their clients in Uganda. Poverty is the most commonly cited reason for involvement in sex work in SSA. Against this backdrop, this study protocol describes a randomized controlled trial (RCT) that tests the impact of adding economic empowerment to traditional HIV risk reduction (HIVRR) to reduce new incidence of STIs and HIV among WESW in Rakai and the greater Masaka regions in Uganda. Methods: This three-arm RCT will evaluate the efficacy of adding savings, financial literacy and vocational training/ mentorship to traditional HIVRR on reducing new incidence of STI infections among 990 WESW across 33 hotspots. The three arms (n = 330 each) are: 1) Control group: only HIVRR versus 2) Treatment group 1: HIVRR plus Savings plus Financial Literacy (HIVRR + S + FL); and 3) Treatment group 2: HIVRR plus S plus FL plus Vocational Skills Training and Mentorship (V) (HIVRR + S + FL + V). Data will be collected at baseline (pre-test), 6, 12, 18 and 24months post-intervention initiation. This study will use an embedded experimental mixed methods design where qualitative data will be collected post-intervention across all conditions to explore participant experiences. Discussion: When WESW have access to more capital and/or alternative forms of employment and start earning formal income outside of sex work, they may be better able to improve their skills and employability for professional advancement, thereby reducing their STI/HIV risk. The study findings may advance our understanding of how best to implement gender-specific HIV prevention globally, engaging women across the HIV treatment cascade. Further, results will provide evidence for the intervention's efficacy to reduce STIs and inform implementation sustainability, including costs and cost-effectiveness.
Health and Human Rights, 2008
The Global Fund to Fight AIDS, Tuberculosis and Malaria has allowed countries to bring their response to HIV/AIDS to an unprecedented scale, resulting in innovative projects that reach otherwise underserved communities with HIV prevention, treatment, and care. But in regions and countries where sex workers, men who have sex with men, or lesbian, gay, bisexual, and transgender persons are criminalized or stigmatized, organizations that are led by or work with these groups face challenges participating in Global Fund processes and accessing funding. This article explores the potential of the Global Fund to create space for the participation of these groups in decision-making and to increase their access to resources; examines barriers that hinder their participation; and proposes measures to overcome them. introduction During a trip to Botswana in July 2006, we asked a group of representatives of community-based non-governmental organizations (NGOs) that were receiving, or hoped to receive, funding from the Global Fund to Fight AIDS, Tuberculosis and Malaria if any of them worked with sex workers or men who have sex with men (MSM). "Sex work is illegal, so it's difficult to work with these groups," one replied. Others said that they would not submit projects targeting sex workers or MSM for fear that conservative government officials would reject their proposals, or even worse, that the stigma attached to sex workers and MSM would become attached to these NGOs. Like many countries, Botswana does not collect data about HIV prevalence rates among sex workers, MSM, or people who identify as lesbian, gay, bisexual, or transgender (LGBT), so it is difficult to know with certainty whether HIV prevalence is higher in these communities than it is in the general population. But if Botswana is similar to the few African countries where data are available, it is safe to assume that specific HIV prevention and treatment services for these groups are lacking or nonexistent. Sex workers, LGBT individuals, and MSM are criminalized and highly stigmatized in Botswana. Lesbians, Gays and Bisexuals of Botswana (LeGaBiBo), the only organization in the country that works to promote the rights of the LGBT community, has been barred by the government from registering as a legal entity, which also prevents it from receiving donor funding. In this cultural and political context, accessing Global Fund resources or participating in country-level decision-making processes that set priorities for proposals and oversee Global Fund grants is near impossible. Unfortunately, the situation in Botswana is not unique.
From Research to Policy: Using Evidence from Impact Evaluations to Inform Development Policy
Recent years have seen a tremendous growth in impact evaluations of development policies, and an increasing trend towards considering rigorous evidence while making policy decisions. But there is much greater scope for incorporating results from impact evaluations into policy decisions, even in the presence of political and administrative constraints. We discuss how evidence is currently incorporated into policymaking, the constraints on greater adoption of evidence-based policy, and suggest specific ways that stronger policy-research partnerships can help overcome these constraints. Recognizing that there are many different channels to influence policy, we provide examples from the Abdul Latif Jameel Poverty Action Lab's (J-PAL's) policy outreach work in the hope that this paper can help in greater sharing of best practices from the impact evaluation field on how best to use evidence to inform policy.
Practical lessons for bringing policy-makers on board in sexual and reproductive health research
BMC health services research, 2016
The need to translate research into policy, i.e. making research findings a driving force in agenda-setting and policy change, is increasingly acknowledged. However, little is known about translation mechanisms in the field of sexual and reproductive health (SRH) outside North American or European contexts. This paper seeks to give an overview of the existing knowledge on this topic as well as to document practical challenges and remedies from the perspectives of researchers involved in four SRH research consortium projects in Latin America, sub-Saharan Africa, China and India. A literature review and relevant project documents were used to develop an interview guide through which researchers could reflect on their experiences in engaging with policy-makers, and particularly on the obstacles met and the strategies deployed by the four project consortia to circumvent them. Our findings confirm current recommendations on an early and steady involvement of policy-makers, however they a...