Suchergebnisse

This article is a response to Ray Pawson's critique of critical realism, the philosophy of science elaborated by Roy Bhaskar. I argue with Pawson's interpretation of critical realism's positions on both natural and social science and his charges concerning its totalizing ontology, its arrogant epistemology and its naive methodology. The differences between critical realism and realist evaluation are not as significant as Pawson contends. The main differences between the two realisms lie in their approaches to the relationship between social structures and human agency, and between facts and values. I argue that evaluation scientists need to clearly distinguish structure and agency. They should also make their values explicit. The uncritical approach of realist evaluation, combined with its underplaying of the importance of agency, leaves it open to implication in the abuses of bureaucratic instrumentalism.

' e-government for You' ( EGOV4U) was a European Commission (EC) funded project developed to pilot models of multi-channel, public and community e-services designed to tackle social exclusion and disadvantage through a range of initiatives delivered by five project partners from a variety of European countries. The project evaluation employed a theory-driven approach and the use of mixed methods for data capture and analysis. In this article we combine this with a form of mechanistic explanation that has been specifically developed for realist evaluation: namely the context + mechanism = outcome (CMO) approach. Our contention is that by so doing we further enhance the analytical focus and granularity of the evaluation process and thus the material we present here. This article aims to make use of previously unused material from the EGOV4U evaluation, and provide a realist insight into what works, for whom, in what circumstances and why.

While there are well-tested methods for evaluating projects, it is much more difficult to evaluate budget support with the same rigour. This article outlines the challenges of evaluating budget support. In addition to applying a rigorous counterfactual for assessing impact, we argue that there are three other challenges, mainly caused by the ambiguities in the theory and practice of budget support. We then present a typology of different approaches for evaluating budget support based on two dichotomies: 'qualitative versus quantitative' and 'country case study versus cross-country research'. Discussing the strengths and weaknesses of each, we show that an eclectic combination of the different methods can successfully solve the challenges.

Within development cooperation, development issues are increasingly recognized as complex problems requiring new paths towards solving them. In addition to the commonly used two dimensions of complex problems (uncertainty and disagreement), we introduce a third dimension: systemic stability; that is, stability provided by rules, relations and complementary technology. This article reflects on how development evaluation methodologies and especially those introducing a complexity perspective address these three dimensions. Inferring that this third dimension deserves more attention, we explore the characteristics of reflexive evaluation approaches that challenge systemic stability and support processes of learning and institutional change. We conclude that reflexive evaluation approaches may well complement current system approaches in development evaluation practice.

Evaluating gender equity involves the assessment of the equality of opportunities and the equality of outcomes that public policies seek to attain for women and men. It focuses on how and to what extent both genders cooperate to expand access to paid work and control over material resources while sharing care and reproductive responsibilities. Drawing on complexity theory, this article puts forward a theoretical framework to identify cooperative behaviors within the household and the workplace as well as within broader socioeconomic, political and institutional domains.

IntroductionIncreased life expectancy of HIV‐positive individuals during recent years has drawn attention to their quality of life, which includes fulfilment of fertility desires. In particular, heterosexual HIV serodiscordant couples constitute a special group for whom the balance between desired pregnancy and the risk of viral transmission should be carefully considered and optimized. Although advanced assisted reproductive technologies are available, such treatments are expensive and are often unavailable. Moreover, standard viral load testing and antiretroviral therapy may not be accessible due to structural or individual barriers. To reduce the risk of HIV transmission, a lower cost alternative is timed condomless sex combined with other risk‐reduction strategies. However, timed condomless sex requires specific knowledge of how to accurately predict the fertile window in a menstrual cycle. The aim of this study was to summarize inexpensive fertility awareness methods (FAMs) that predict the fertile window and may be useful for counselling HIV‐positive couples on lower cost options to conceive.MethodsOriginal English‐language research articles were identified by a detailed Medline and Embase search in July 2014. Relevant citations in the included articles were also retrieved.Results and discussionCalendar method, basal body temperature and cervicovaginal mucus secretions are the most accessible and sensitive FAMs, although poor specificity precludes their independent use in ovulation detection. In contrast, urinary luteinizing hormone testing is highly specific but less sensitive, and more expensive. To maximize the chance of conception per cycle, the likelihood of natural conception needs to be assessed with a basic fertility evaluation of both partners and a combination of FAMs should be offered. Adherence to other risk‐reduction strategies should also be advised, and timely referral to reproductive medicine specialists is necessary when sub/infertility is suspected.ConclusionsFAMs provide effective, economical and accessible options for HIV serodiscordant couples to conceive while minimizing unnecessary viral exposure. It is important for health care providers to initiate conversations about fertility desires in HIV‐positive couples and to educate identified couples on safer conception strategies.

This article considers how mattering and meaning are mutually constituted in the production of knowledge (Barad, 2007). Drawing on a research project with first year early childhood education (ECE) students in a university setting, I argue that material-feminism, as understood through the work of Barad (2007, 2008), offers a lens through which pedagogical practices can be re-conceptualized as more than anthropocentric endeavours. The research project explores the processes that occurred when a group of ECE students and I engaged with and in pedagogical narrations over one academic term as we attempted to make visible and disrupt the hegemonic images we held of both children and childhood. In the doing of pedagogical narrations, artefacts were produced that were not merely representations of our collaborative thinking. Rather, the artefacts that emerged-in between the material, the discursive and the participants, were themselves agentic; they invited us to shift our gaze and our conversation, and thereby new meanings and realities were produced. I provide one example that discusses how the presence of the artefacts invited "race" into a conversation of childhood in a way that reverberated in our thinking, feeling, and being. The article concludes by considering the pedagogical implications for learning, for both children and those learning to work with children, when matter comes to matter in the classroom.

BackgroundEarly identification and entry into care is critical to reducing morbidity and mortality in children with HIV. The objective of this report is to describe the impact of the Tingathe programme, which utilizes community health workers (CHWs) to improve identification and enrolment into care of HIV‐exposed and ‐infected infants and children.MethodsThree programme phases are described. During the first phase, Mentorship Only (MO) (March 2007–February 2008) on‐site clinical mentorship on paediatric HIV care was provided. In the second phase, Tingathe‐Basic (March 2008–February 2009), CHWs provided HIV testing and counselling to improve case finding of HIV‐exposed and ‐infected children. In the final phase, Tingathe‐PMTCT (prevention of mother‐to‐child transmission) (March 2009–February 2011), CHWs were also assigned to HIV‐positive pregnant women to improve mother‐infant retention in care. We reviewed routinely collected programme data from HIV testing registers, patient mastercards and clinic attendance registers from March 2005 to March 2011.ResultsDuring MO, 42 children (38 HIV‐infected and 4 HIV‐exposed) were active in care. During Tingathe‐Basic, 238 HIV‐infected children (HIC) were newly enrolled, a six‐fold increase in rate of enrolment from 3.2 to 19.8 per month. The number of HIV‐exposed infants (HEI) increased from 4 to 118. During Tingathe‐PMTCT, 526 HIC were newly enrolled over 24 months, at a rate of 21.9 patients per month. There was also a seven‐fold increase in the average number of exposed infants enrolled per month (9.5–70 patients per month), resulting in 1667 enrolled with a younger median age at enrolment (5.2 vs. 2.5 months; p<0.001).During the Tingathe‐Basic and Tingathe‐PMTCT periods, CHWs conducted 44,388 rapid HIV tests, 7658 (17.3%) in children aged 18 months to 15 years; 351 (4.6%) tested HIV‐positive. Over this time, 1781 HEI were enrolled, with 102 (5.7%) found HIV‐infected by positive PCR. Additional HIC entered care through various mechanisms (including positive linkage by CHWs and transfer‐ins) such that by February 2011, a total of 866 HIC were receiving care, a 23‐fold increase from 2008.ConclusionsA multipronged approach utilizing CHWs to conduct HIV testing, link HIC into care and provide support to PMTCT mothers can dramatically improve the identification and enrolment into care of HIV‐exposed and ‐infected children.