Suchergebnisse

PROBLEM: The use of evidence-based policy is gaining attention in developing countries. Frameworks to analyse the process of developing policy and to assess whether evidence is likely to influence policy-makers are now available. However, the use of evidence in policies on caring for people with mental illness in developing countries has rarely been analysed. APPROACH: This case study from Viet Nam illustrates how evidence can be used to influence policy. We summarize evidence on the burden of mental illness in Viet Nam and describe attempts to influence policy-makers. We also interviewed key stakeholders to ascertain their views on how policy could be affected. We then applied an analytical framework to the case study; this framework included an assessment of the political context in which the policy was developed, the links between organizations needed to influence policy, external influences on policy-makers and the nature of evidence required to influence policy-makers. LOCAL SETTING: The burden of mental illness among various population groups was large but there were few policies aimed at providing care for people with mental illness, apart from policies for providing hospital-based care for people with severe mental illness. RELEVANT CHANGES: The national plan proposes to incorporate screening for mental illness among women and children in order to implement early detection and treatment. LESSONS LEARNED: Evidence on the burden of mental ill-health in Viet Nam is patchy and research in this area is still relatively undeveloped. Nonetheless the policy process was influenced by the evidence from research because key links between organizations and policy-makers were established at an early stage, the evidence was regarded as rigorous and the timing was opportune.

The last major review of urban health in developing countries was published in 1992. At that time, knowledge was largely limited to crude rural-urban comparisons and some ad hoc studies of low-income urban communities. Most research was done on communicable (infectious) diseases and little was known about the relationship between urban life in developing countries and chronic illness such as mental ill-health, heart disease and cancer. This paper updates knowledge by reviewing recent research on intra-urban health inequalities, urban health-seeking behaviour and the importance of urban-rural links for health. It also presents a new model of urban health that incorporates changes in urban health research and practice.

This article addresses the relationship between a Ministry of Health and a City Council, and identifies key issues to consider in the decentralisation of urban health activities: roles and responsibilities; legislation; co-ordination and communication; and resource constraints. The case-study highlights aspects of planning which need to be considered by national and local governments. (DSE)

Diffusion studies in sub-Saharan Africa have typically focused on the impact of traditional adoption factors on uptake of technological innovations. This study draws on semi-structured interviews of rural farmers and in-depth interviews of stakeholders in southwest Nigeria to examine the impact of institutional factors on the success of technological innovations. The findings indicate that government policies, markets, financial institutions, infrastructure and other institutional conditions play significant role on the success of technological innovations. A successful innovation package should integrate institutional reforms with promotion of innovative inputs, and vibrant farmers' cooperatives can be at the heart of such agrarian reform. This is the accepted manuscript of an article whose final and definitive form has been published in African Journal of Science, Technology, Innovation and Development 2014, 6(4) © 2014. Institutional barriers to successful innovations: Perceptions of rural farmers and key stakeholders in southwest Nigeria is available online at: http://www.tandfonline.com/10.1080/20421338.2014.966039

SummaryEffective community based malaria control programmes require an understanding of current perceptions of malaria as a disease and its severe manifestations. Quantitative and qualitative surveys of mothers on the Kenyan Coast suggest that fever is conceptualised in biomedical terms whereas the aetiology of severe malaria is perceived to be of more complex cultural origin. This is reflected in the treatments sought for convulsions. The results are discussed in the context of ethnographic factors. To be effective, future health information programmes must take cultural beliefs into account.

Although primary school enrolment in Vietnam is high (91 per cent), most primary school students receive little more than half the annual teaching time defined by international norms. The Vietnamese school year is very short by international standards, covering only 33 weeks. In addition, only around 20 per cent of children in Vietnam receive a full-day of schooling, 5 or 6 hours according to international standards. Extra classes, outside of the normal school system, have proliferated in all regions of Vietnam. These classes fall into two categories. Legal classes, organised by schools themselves, include those provided for low-score performers or for outstandingly talented children. Illegal classes are taught by teachers who deliberately reduce the duration and content of their school-based classes to encourage students to take private tuition. The Vietnamese government is committed to providing full shifts of primary education by 2015 and has banned extra classes provided outside the normal school system. Nonetheless, the availability of and enrolment in illegal extra classes continue to increase. Young Lives research examined the extent and effects of extra classes for eight-year-old children in Vietnam. It tested for association between extra classes and numeracy, reading and writing skills. The paper presents statistical data on the amount of time and money spent on extra classes. The authors argue that such classes should be restricted because of the financial pressure that they place on poor households –without improving the attainment of children who take them.