Suchergebnisse

As social accountability (SA) initiatives in Indonesia continue to grow, evidence shows that mechanisms to engage citizens to monitor service provision and provide constructive feedback on large-scale programs in the public sector still need improvement. SA, or citizens' ability to hold governing actors and their partners accountable for their actions and commitments, is recognized as a fundamental right and an indispensable means of strengthening national health systems. The Government of Indonesia's commitment to improve basic service delivery to poor and vulnerable populations represents an opportunity to apply SA approaches to improve the access and quality of health services. This report aims to inform efforts to improve SA in Indonesia's health sector, particularly maternal and child health services. It gives an overview of common approaches to building social accountability, using examples from other comparable low- and middle-income countries, to extract lessons learned. It then analyses Indonesia's national regulatory and policy framework related to SA initiatives in the health sector. Next, it reviews Indonesian initiatives that have included SA components to identify programmatic opportunities, challenges, and remaining gaps for improving SA in Indonesia's health sector. Finally, it provides evidence-based recommendations for future SA policy and programming initiatives in Indonesia. Three common thematic SA approaches emerged from this review. These include: building awareness among communities, creating voice, and empowering action. This report finds that SA initiatives that include all three elements through multiple mechanisms are more likely to succeed. Programs need to develop comprehensive approaches that fit local contexts, accommodate multi-sector partnerships, and account for existing power dynamics and risks associated with increased decision-making authority. Efforts to prepare service providers and local officials to solicit routine citizen feedback on services, and to work with citizens to develop solutions that work for everyone, should be mainstreamed into all health system strengthening programs.

The humanitarian system is struggling to adapt to changes in the global political environment, trends in armed conflict and displacement, and advances in science and technology. In recent years, the international community has undertaken a number of efforts to overcome these challenges, such as the Agenda for Humanity, a plan that outlines the changes needed to alleviate suffering, reduce risk, and lessen vulnerability on a global scale. This article reviews recent evidence from a range of disciplines to inform these efforts, especially as they relate to the protection of children. Early childhood and adolescence constitute two critical periods of child development that lay the foundations for future health and wellbeing. Exposure to adversity in crisis contexts can compromise this development, with potentially life-long consequences. Evidence suggests that relationships with caregivers and peers play a central role in mediating childhood experiences of adversity. Unfortunately, interventions for children affected by crises are usually too fragmented to maximize the protective effects of healthy relationships. This article stresses the importance of developing multisectoral and relational interventions capable of promoting healthy development across the life course. Given the central role of caregivers, the household is an especially powerful level of intervention for combining approaches from different sectors. More concerted efforts are needed to develop household interventions that combine traditional sectoral approaches with innovative, cross-cutting measures, such as cash transfers and parental support. Household interventions should also be an integral part of broader community and society level actions, which together form more comprehensive systems of care.

The humanitarian system is struggling to adapt to changes in the global political environment, trends in armed conflict and displacement, and advances in science and technology. In recent years, the international community has undertaken a number of efforts to overcome these challenges, such as the Agenda for Humanity, a plan that outlines the changes needed to alleviate suffering, reduce risk, and lessen vulnerability on a global scale. This article reviews recent evidence from a range of disciplines to inform these efforts, especially as they relate to the protection of children. Early childhood and adolescence constitute two critical periods of child development that lay the foundations for future health and wellbeing. Exposure to adversity in crisis contexts can compromise this development, with potentially life-long consequences. Evidence suggests that relationships with caregivers and peers play a central role in mediating childhood experiences of adversity. Unfortunately, interventions for children affected by crises are usually too fragmented to maximize the protective effects of healthy relationships. This article stresses the importance of developing multisectoral and relational interventions capable of promoting healthy development across the life course. Given the central role of caregivers, the household is an especially powerful level of intervention for combining approaches from different sectors. More concerted efforts are needed to develop household interventions that combine traditional sectoral approaches with innovative, cross-cutting measures, such as cash transfers and parental support. Household interventions should also be an integral part of broader community and society level actions, which together form more comprehensive systems of care.

AbstractWhy do COVID-19 social distancing policies vary so widely across states in federal countries? This mixed-methods study of Brazil, Mexico, and the United States finds that state-level variation in the stringency of social distancing policies is driven not by the epidemiological, demographic, or socioeconomic factors commonly emphasized in previous research, but largely by political factors. Introducing a novel framework for explaining pandemic policymaking, the study shows the central importance of political parties, presidential power, and governors' coalitions in determining state-level policy stringency. In the United States and Mexico, statistical and qualitative evidence indicates that interstate collaboration among governors, combined with top-down pressures from national party elites and presidents, led to greater policy alignment among coordinated states. In Brazil, in contrast, where there is little evidence of either policy coordination or alignment, state-level policies resulted instead from intrastate factors and diffusion. Together, these findings highlight how a multilevel framework attuned to varied combinations of intra-unit, cross-unit, and cross-level causal factors strengthens our understanding of pandemic policymaking.

Despite government interest in promoting birth registration, more than a third of Indonesian children do not have a birth certificate, affecting the realisation of both their human and citizen rights. While barriers to registering children's births in Indonesia have been assessed, there is limited research on how communities perceive the importance of having a birth certificate. This study used focus group discussions to explore parental motivations around birth registration. The results of a thematic analysis found that perceived use of birth certificates, perceived control over the application process and social norms related to certificate ownership affect the intention to apply.

The Three Delays Model has proven a useful framework for examining barriers to seeking obstetric care and preventing maternal and child mortality. This article demonstrates the applicability of the Three Delays Model to the case of civil registration in rural Indonesia and examines ways that efforts to strengthen civil registration services can draw on lessons from maternal and child health programming. Twenty focus group discussions were conducted using a participatory ranking exercise in four Indonesian districts. Focus groups were stratified into four groups: (1) government officials involved in civil registration, (2) civil society organization members that assist communities in civil registration, and (3) female and (4) male community members. Transcripts were analyzed using constant comparative method and thematic analysis, revealing barriers that communities commonly faced in accessing civil registration services. In examining the categories and themes related to these barriers, the research team found a significant overlap with the factors and phases of the Three Delays Model. Participants were delayed from seeking registration services by a range of sociocultural factors and by the perceived inaccessibility and poor quality of services. Once they decided to seek care, long distances to services and poor transportation options delayed their access to registration offices. Finally, a series of bottlenecks in service provision created extended delays once applicants reached registration offices. Ownership of civil registration documents in Indonesia remains exceptionally low, with just over half of children and youth possessing a birth certificate. To strengthen civil registration and health systems more generally, it is important to understand the factors that enable and constrain civil registration, how these factors relate to one another, and how they change over a child's life.

Abstract

Background
Youth resettling to the U.S. from conflict-affected countries in the Middle East and North Africa (MENA) face countless challenges. As they cope with their experiences of armed conflict and forced migration, these girls and boys must also adjust to the language and social norms of their new society, often encountering prejudice and discrimination along the way. Previous studies indicate that schools can play a central role in facilitating this adjustment while also promoting mental health and psychosocial wellbeing. This qualitative study aims to understand the lived experiences of MENA newcomers resettled in Austin, Texas and Harrisonburg, Virginia and to assess how schools, families, and communities support their mental and psychosocial wellbeing.


Methods
We held six focus group discussions across the two cities with a total of 30 youths (13–23 years) from Iraq, Syria, and Sudan. We also conducted semi-structured interviews with 30 caregivers and 27 key informants, including teachers, administrators, service providers, and personnel from community-based organizations.


Results
Guided by Bioecological Theory, our thematic analysis identifies several means by which various actors work together to support resettled adolescents. We highlight promising efforts that seek to enhance these supports, including sheltered instruction, school-parent collaboration, peer support programming, social and emotional learning initiatives, and integrated mental health centers.


Conclusion
While this study underscores the resilience of newcomers and the value of local support systems, it also reflects the importance of investment in schools, mental health systems, and resettlement programs that can enable newcomers to achieve their full potential.

Abstract
Every year, thousands of young refugees and their families face challenges as they adjust to schools in the US. This article explores how families resettled to the US from conflict-affected, Arab-majority countries in the Middle East and North Africa region, such as Iraq and Syria, view education, and how parents support their children's education following the experiences of resettlement. To centre the voices and lived experiences of these families, we analysed focus group discussions with 30 adolescents and in-depth interviews with 30 parents and 27 key informants. Analysis using constant comparative method and thematic analysis showed that, upon resettlement, education remained highly valued by families. Our study finds that, despite the challenges associated with families' newcomer status, parents in this study provided educational support to their children by engaging with the school and with their children's learning at home. We offer suggestions on how schools and organizations can bolster parents' ability to support their children's education.

Abstract
Adolescents resettled to the US from conflict-affected countries in the Middle East and North Africa region face a range of acculturative challenges, including language barriers, that may affect their wellbeing. This qualitative study aims to understand the variety of approaches US schools use to support the education of Arabic-speaking students. Utilizing Ruíz's influential typology of language orientations, our analysis reveals a range of school approaches aligning most closely with the 'language-as-problem' and 'language-as-resource' orientations. Participants identified several perceived effects of these orientations on academic achievement and acculturation, and providers highlighted promising directions and potential barriers for bolstered language supports. Findings indicate that Arabic-speaking newcomer students experience persistent language inequity but also locate promising pathways towards reducing these inequities. We discuss structural shifts schools can implement to bolster language as a resource and move towards larger systems change in which heritage language is a right.