The success of antiretroviral therapy (ART) to treat HIV and reduce transmission rates is critically dependent on lifelong adherence. Studies have found low retention and adherence in ART care among patients, which can lead to treatment failure and resultant morbidity and mortality. These factors can also increase the risk of HIV transmission and the development of drug-resistant HIV strains.
The number of rigorous studies on WASH promotion in households, schools and communities has increased substantially.
Very few rigorous studies exist on WASH promotion in medical facilities.
Many new studies evaluate previously under-researched approaches, such as community-led total sanitation, and measure important sector outcomes, including school attendance and reducing open defecation.
Tara Kaul and Samidha Malhotra
World Humanitarian Day 2018
Over 200 million people are in urgent need of humanitarian assistance across the world today. In 2017, the UN-coordinated appeals reported a shortfall of 41 per cent, despite receiving a record amount of funding. As the demands on these limited funds increase, there is a concurrent increase in the need for high-quality evidence on the most effective ways to improve humanitarian programming.
The International Initiative for Impact Evaluation (3ie) promotes evidence-informed equitable, inclusive and sustainable development. We support the generation and effective use of high-quality evidence to inform decision-making and improve the lives of people living in poverty in low- and middle-income countries. We provide guidance and support to produce, synthesise and quality assure evidence of what works, for whom, how, why and at what cost.
3ie impact evaluations
This study focuses on the interrelation between prevention and treatment of moderate acute malnutrition (MAM) on children aged 6–23 months. Although MAM affects an estimated 33 million children worldwide and is associated with more nutrition-related deaths than severe acute malnutrition (SAM) (IAEA 2014), the most effective way of addressing MAM is still not understood (Wegner et al. 2015).
Decades of research shows that risks in agricultural production trap farmers in a vicious cycle of low investment, low productivity and poverty. Agricultural risk mitigation programmes can play an important role in breaking this poverty trap. Many governments, multilateral development organisations and private agencies are proposing, piloting and implementing at scale programmes that use tools for financial agricultural risk mitigation (FARM). The potential of FARM instruments (e.g.
The improvement of agricultural innovations and technologies in low- and middle-income countries is paramount to increasing agricultural production and income sustainability. Although many agricultural technologies are available, adoption remains low among smallholder farmers. In order to identify existing evidence about the effectiveness of agricultural innovation programmes, 3ie produced an evidence gap map (EGM) of relevant completed and ongoing impact evaluations and systematic reviews.
The brief summarises the findings of a systematic review of the effectiveness oftwo main approaches to targetting populations in programmes and policies to reduce barriers to accessing WASH services and strategies during the MDGs.The review includes evidence from 11 Sub-Saharan African and South Asian countries.
3ie Impact evaluation report 67, 2017
This impact evaluation by Fabregas and colleagues examines the role of information in addressing the constraints smallholder farmers in Kenya face in adopting agricultural inputs. The study provides evidence on the effectiveness of two types of information-delivery methods in influencing farmers’ knowledge and choice of agricultural inputs.
3ie Impact evaluation report 68, 2018
This impact evaluation examines the impact of an empowerment training programme and a financial incentive programme to reduce child marriage and increase girls’ education in rural Bangladesh. The findings show that a relatively inexpensive conditional stipend programme targeted to the families of adolescent girls with a high rate of adolescent marriage is effective in delaying the marriage of those girls and improving rates of school enrolment.
HIV testing of exposed infants by 6–8 weeks of age is critical for preventing early morbidity and mortality among those who are HIV positive. When HIV-positive infants remain undiagnosed, they lose the opportunity to access antiretroviral therapy (ART) immediately. Zimbabwe’s paediatric HIV treatment guidelines recommend testing HIV-exposed infants at or before 6 weeks of age, yet practical implementation of these guidelines varies.
For close to three decades, Ethiopia has been plagued by severe food shortages. Until the early 2000s, Ethiopia’s response to food insecurity primarily involved providing emergency food aid. While the emergency aid helped save lives, it did not increase people’s resilience or help avert food shortages. In 2005, the government launched the Productive Safety Net Programme (PSNP) to help chronically poor rural populations create assets and become food self-sufficient.
According to the World Health Organization (WHO), 45,000 women died from preventable pregnancy-related complications in India in 2015. Rural women and adolescent girls are the most at risk. Severe shortages of qualified and trained midwives in rural areas is one of the primary reasons behind these deaths. In response, state governments are implementing programmes to encourage women to deliver at medical centres.
Over the last few decades, there have been significant improvements in the health and well-being of women, adolescents and children, however, gains have been uneven and inequalities persist.
Open defecation represents a major social and health burden for individuals, families and societies. India alone accounts for approximately 60 per cent of the global population defecating in the open, with the majority residing in rural India. Open defecation spreads diseases such as diarrhoea, schistosomiasis and trachoma and results in stunting and malnutrition of children. It can be dangerous and represent an affront to the dignity of vulnerable groups such as women, adolescent girls, the elderly and individuals with disabilities.