Suchergebnisse

IntroductionWhile biomedical innovations have made it possible to prevent the vertical transmission of HIV from mother to child, poor retention along the prevention of mother‐to‐child transmission (PMTCT) cascade continues to limit the impact of programmes, especially in low‐resourced settings. In many of the regions with the highest burden of HIV and the greatest number of new paediatric cases, the uptake of facility‐based care by pregnant women remains low. In such settings, the continuum of care for pregnant women and other women of reproductive age necessarily relies on the community. There is no recent review capturing effective, promising practices that are community‐based and/or employ community‐oriented groups to improve outcomes for the prevention of vertical transmission. This review summarizes those studies demonstrating that community‐based and community‐oriented interventions significantly influence retention and related outcomes along the PMTCT cascade.MethodsLiterature on retention within prevention of vertical transmission programmes available on PubMed, Psych Info and MEDLINE was searched and manuscripts reporting on key prevention of vertical transmission outcomes were identified. Short‐listed studies that captured significant PMTCT outcome improvements resulting from community‐based interventions or facility‐based employment of community cohorts (e.g. lay counsellors, community volunteers, etc.) were selected for review.ResultsThe initial search (using terms "HIV" and "PMTCT") yielded 430 articles. These results were further narrowed using terminology relevant to community prevention of vertical transmission strategies addressing retention: "community," "PMTCT cascade," "retention," "loss to follow up" and "early infant diagnosis." Nine of these reported statistically significant improvements in key prevention of vertical transmission outcomes while meeting other review criteria. Short‐listed articles reflect diverse study designs and a variety of effective interventions. Two interventions occurred exclusively in the community and four effectively employed community groups within facilities. The remaining three integrated community‐ and facility‐based components. The outcomes of the included studies focus on knowledge (n=3) and retention along the PMTCT cascade (n=6).ConclusionsThis review captures an array of promising community‐based and community‐oriented interventions that demonstratively improve key prevention of vertical transmission outcomes. Though the strategies captured here show that such interventions work, the limited number of rigorous studies identified make it clear that expansion of community approaches and complementary reporting and related research are sorely needed.

This research highlights the outcomes of the environmental diplomacy workshop held between members of civil society from Afghanistan and Pakistan on water cooperation in the Kabul River Basin, one of the most heavily conflicted transboundary river basins in the world. Lack of trust among these upstream and downstream riparian partners and persistent failures of Track 1 diplomacy initiatives has led to an absence of governance mechanisms for mitigating the water security concerns in the region. This research shows that science and public diplomacy, democratic participation, and social learning may pave a way to clear local misconceptions, improve transboundary water cooperation, and increase ecological stewardship in the Kabul River Basin.

This research highlights the outcomes of the environmental diplomacy workshop held between members of civil society from Afghanistan and Pakistan on water cooperation in the Kabul River Basin, one of the most heavily conflicted transboundary river basins in the world. Lack of trust among these upstream and downstream riparian partners and persistent failures of Track 1 diplomacy initiatives has led to an absence of governance mechanisms for mitigating the water security concerns in the region. This research shows that science and public diplomacy, democratic participation, and social learning may pave a way to clear local misconceptions, improve transboundary water cooperation, and increase ecological stewardship in the Kabul River Basin.

While there is growing interest in participatory research to address issues around environmental sustainability, the focus of analysis tends to be on the results or products of the research rather than the processes involved. Addressing this gap, the authors draw on their experience of specific mapping techniques, based on different systemic concepts and theories, that have helped facilitate, explore and capture different understandings of the relationships, perspectives and boundaries within situations involving environmental sustainability. The development of visual mapping techniques is explained and practical case studies describe their application in environmental sustainability projects, from working with farmers and their networks to using visual mapping with indigenous communities and managing coastal environments. Each case study provides a 'real world' project example from researchers with extensive experience of using these techniques to research different aspects of environmental sustainability over several decades