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Recent Knowledge on Soul Beat

Subtitle: 
A Guide to Action for Religious Leaders and Communities
Publication Date
Publication Date: 
Wednesday, June 1, 2016

"Online sexual abuse and exploitation is a growing global problem for girls and boys, many of whom suffer in silence at the hands of people closest to them in their homes and communities. Through their values, moral authority and extensive networks, religious communities and faith-based organizations play a critical role in helping to break the silence around this crime, protecting children from this atrocity and linking children affected to support services, essential for their healing and protection." - UNICEF Director of Programmes Ted Chaiban

Languages: 

English; Spanish

Number of Pages: 

48 (English); 52 (Spanish)

Contacts (user reference): 
ECPAT International
Source: 

Canee.net, August 16 2017.

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"What was really eye-opening was that with the phone, the illiterate ASHA, who seemed overwhelmed and a bit lost, was transformed to someone with increased skills and confidence, who was effective in her work and respected in her community. - Satish Srivastava, Health and Nutrition Manager, CRS (Lucknow)

Reducing Maternal and Newborn Deaths (ReMiND) project is a counselling and interpersonal communication intervention that uses technology as a support. Considering the poor health indicators in Uttar Pradesh (UP), India, and seeing the unrealised potential of the Accredited Social Health Activist (ASHA) programme, in April 2011, Catholic Relief Services (CRS), Dimagi, and local partner Vatsalya formed the ReMiND project, which has the following objectives:

Communication Strategies: 

The integration of information and communication technology (ICT) into this initiative at the community level in select districts of the state of UP, India, is part of a strategy for improving interpersonal communication and supportive supervision in order to strengthen community health systems.

ASHAs use mobile phones operating open-source software that equips them with multimedia job aids to support client assessment, counseling, and early identification, treatment, and/or rapid referral of pregnancy, postpartum, and newborn complications. The main focus is on the ASHA's central task: visiting pregnant women in her coverage area and providing counseling for appropriate health behaviours and referral services. She registers each new mother, entering client data into the phone, and on each subsequent visit, the application walks ASHAs through checklists, questions, and educational prompts to identify current issues, determine if prior treatment was followed, and share new counseling points based on the woman's stage of pregnancy. Once a birth is reported, SMS reminders repeatedly prompt the ASHA to conduct scheduled postpartum visits until that visit is recorded in the system. The system also alerts ASHA supervisors via SMS if ASHAs miss postpartum home visits. The application also guides ASHAs in early identification of problems and supports rapid referral of women and newborns with complications to appropriate care. A range of educational modules present behaviour change messages through use of images and audio, which are fully aligned with government guidance for ASHA pregnancy home visits.

The Data Dashboard is a visualisation tool summarising data collected by the ASHA. The data are transmitted in real time to a CommCare cloud-based server. This allows project supervisors and government health professionals to monitor ASHAs' activities in even the most remote areas and provide timely, effective guidance. Date ranges for key indicators can be selected by quarter. (The goal is to build trust by creating very clear and achievable expectations; an ASHA knows her targets and the supervisor can clearly see if she has achieved them. "This trust and confidence built between the ASHA and the supervisor through the app is visible - and is at the heart of the project's success.")

Central steps have included (for further details, see the reports cited in the Source section, below):

  1. Initiate - Successful ICT for development (ICT4D) interventions start with a common understanding among all stakeholders of the purpose and scope of the project, roles and responsibilities, and anticipated outcomes. The ReMiND project started out as a testing ground for Dimagi's beta version of their CommCare app. CRS and Vatsalya provided project structure. The partnership allowed Dimagi to build the ReMiND team's capacity in mHealth from the outset. CRS has worked in UP in the area of maternal and child health for many years, with strong networks across a number of districts. Prior to ReMiND, CRS had an SMS (text messaging) reporting system for the Sure Start project. CRS and Vatsalya were also partners in the United States Agency for International Development (USAID)'s Vistaar project (2006-2012), working in Kaushambi, which had a strong focus on strengthening community-level systems through improved supervision. These past projects helped refine the team's focus for the ReMiND project.
  2. Develop requirements and architect solutions - The ReMiND project worked with different stakeholders to understand system constraints and user needs - clearly defining the requirements for a phone-based solution. When the project started in 2011, the team reviewed a report from the National Health Systems Resource Centre/National Health Mission that identified some of the key reasons for the poor performance of the ASHA programme in UP. There was insufficient capacity, no support, and no management structure. CRS also conducted additional assessments, which backed up these findings. In addition, from 2006 to 2011 (when the Sangini cadre was introduced), no one was checking the ASHA records, and they were largely left to themselves in terms of problem solving. The CommCare ASHA counselling app provides a solution to these systems bottlenecks by supporting improved, structured interpersonal communication between ASHAs and beneficiaries, and consequently between ASHAs and Sanginis. Consulting with different stakeholders to assess needs and opportunities allowed the ReMiND team to get a thorough understanding of the requirements for an mHealth solution, and build broad commitment.
  3. Design - The ReMiND team created ongoing iterations based on user experience, feedback, and emerging needs. The ReMiND team designed the initial ASHA app collaboratively with Dimagi over a year, working with 10 ASHAs on a daily basis; this made it easy to understand their roles and needs. This close working with ASHAs at the outset was in itself a big step away from traditional programming, as they were usually at the receiving end of a programme - or may have been brought in for a token consultation at the end. All the content was taken straight from the government guidelines, and then converted into an app-based format by Dimagi. Despite working so closely with the ASHAs, after a year of continual iteration, the team found the app was still not suitable. At the first training, it was discovered that only about 35% of the ASHAs were not literate; so, the team had to include more voice components and additional visuals. Initially the voice of one of the Lucknow team members was used for the voice part. But it was quickly realized that it was more compelling to women if it was in a local person's voice, using local vernacular - so they recorded the voice of an ASHA. The women felt like it was their friend talking to them. One of the key ways ReMiND catalyses system transformation is through building capacity. At the project's outset, the Sector Facilitators were ReMiND project staff, providing the main link between the ASHAs and the ReMiND team at headquarters. These project team members accompanied the ASHAs on field visits, helped them with technical issues with the phone, and provided ongoing handholding support. They supported the ASHAs in building their confidence and overcoming caste and social barriers, so they were able to extend their coverage. To create the app that supports this supervisory job role, the ReMiND team approached the staff of the National Health Systems Resource Centre (NHSRC) in 2013 to ask them what they had in mind for the role of the ASHA Facilitator (or Sangini). The NHSRC had developed a list of 10 indicators to define whether an ASHA was functional or not. The ReMiND team took this checklist and put it in an app-based format. The Sector Facilitators were replaced by the Sanginis in 2014. ReMiND then created a new cadre of project staff called Block Mentors, who provide supervisory support to the Sanginis using another app: the Supervisory Monitoring app.
  4. Deploy - In the ReMiND project, training became a strong focus in building user capacity, and enabled feedback on the extent to which the solution met user needs. Alongside the sector-facilitators, ReMiND also built capacity through training, developing a rigorous training preparation process. Dimagi took the lead in developing the initial training materials, suggesting many components such as using local terms and metaphors for phone features. They had a training preparation checklist, which was combined with CRS' "seven steps" for planning a training, and tailored to the ReMiND project. These were captured in a facilitation guide developed collaboratively by all partners (this is included in the online ReMiND toolkit). The capacity building process started with helping ASHAs to simply feel comfortable with the phone and the new technology. There was a lot of initial discomfort with the phones, and the team had to thoroughly revise the training approach to accommodate the low literacy levels. For the non-literate ASHAs, family members were invited so they could also provide support. They also used a lot of visual material. the ASHAs were trained in small groups of about 15 so they could be given individual attention. Supervisors were also included in the training so they could learn and provide follow-up support where required.
  5. Operate, maintain, and improve the ICT solution over its life cycle - The ReMiND project made a constant and ongoing effort to understand the needs of ASHAs and Sanginis, and to revise the solution design accordingly. One example of how the app changed with feedback was a reduction in counselling topics. Initially, in the pilot, there was a checklist of health behaviours, and then the ASHAs were supposed to provide counselling on all the topics in the checklist. The shorter protocol is easier and more comfortable for both the ASHA and her client, and the ASHA does not wear out her welcome.
  6. Capture and share results - Capturing results and lessons learned from the implementation of ICT projects is critical in accelerating adoption and ensuring future success. ReMiND has a comprehensive monitoring and evaluation system that feeds into ongoing quality improvements. The project team compiles monthly and quarterly reports against indicators, for sharing with the team, health managers, government counterparts, and partners. This data is shared in monthly meetings and used for project refinements, performance management and resource allocation. Lessons learned have not just helped internal improvements, but have also made contributions to the mHealth knowledge base (see below).
Development Issues: 

Health, Women, Children

Key Points: 

Twenty-two percent of all children who die worldwide before reaching the age of five are born in India - more than 1.4 million boys and girls each year. With the goal of reducing preventable deaths, the Government of India in 2006 formed a network of 825,000 women who serve as ASHAs in rural communities. ASHAs are volunteer community health workers who act as the key links between rural households and the health system. While this new cadre has the potential to improve health outcomes, its impact is undermined by uneven performance, low levels of literacy, poor role clarity, and no management structure.

Experience from this project has helped CRS, Dimagi, the Ministry of Health in UP, and other partners understand how to implement mHealth projects in different contexts, both within UP and globally. All along, ReMiND mobilised resources and built relationships with research partners to support additional studies and assessments to understand what worked in terms of ICTs and community health workers. Case studies of ReMIND have been included in a number of toolkits and frameworks, such as the World Health Organization (WHO)'s The MAPS Toolkit: mHealth assessment and planning for scale.

Partner Text: 

CRS, National Health Mission, Dimagi, and Vatsalya. The CommCare Exchange was built with funding from United States Agency for International Development (USAID) Development Innovation Ventures fund (DIV) programme.

Contacts (user reference): 
Catholic Relief...

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Subtitle: 
A Three-Day Course for Kyrgyz Mentor-Supervisors - Facilitator's Guide
Publication Date
Publication Date: 
Wednesday, March 1, 2017

"Strengthening the ability of mentor-supervisors to provide ongoing mentoring can help health workers improve their counseling performance with patients and clients."

Languages: 

English, Russian

Number of Pages: 

96 (English); 115 (Russian)

Contacts (user reference): 
jnicholson77
Source: 

SecureNutrition and SPRING website, both accessed on August 3 2017. Image credit: SPRING/Kyrgyz Republic

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Subtitle: 
Briefing Series
Publication Date
Publication Date: 
Tuesday, March 1, 2016

Developed by the International Center for Research on Women (ICRW) in collaboration with Girls Not Brides, this series of 10 briefs provides a short, accessible introduction to incorporating and measuring child marriage prevention and response throughout the programme lifecycle within a variety of sectoral and cross-sectoral programming. The overview brief and accompanying sector briefs are intended to serve as quick, go-to resources for a broad audience and may be of particular use during the needs assessment and programme design stages.

  <div class="field button"><a href="http://www.girlsnotbrides.org/resource-centre/child-marriage-brief-role-of-sectors/" target="_blank">Click here to access the 10 briefs.</a></div>
Number of Pages: 

4 pages each (sector briefs), with a 12-page overview brief

Contacts (user reference): 
Girls Not Brides
Source: 

Girls Not Brides website, August 16 2017.

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Publication Date
Publication Date: 
Tuesday, August 1, 2017

“Recent years have witnessed a shift from development programs that focus on a single health or development topic, to initiatives that encompass multiple topics within a single program.”

This resource brings together current best practices to guide programme planners and/or implementers in the design and implementation of an integrated social and behaviour change (SBCC) programme. “Integrated SBCC refers to SBCC programming designed to cohesively address more than one health or development issue within the same program. Typically, this involves developing a logical and unified SBCC strategy that addresses multiple topics and/or behaviors and considers how they relate or interact with one another.” Examples of integrated programmes include:

  <div class="field button"><a href="https://sbccimplementationkits.org/integrated-sbcc-programs/" target="_blank">Click here to access this I-Kit online. </a></div>
Cost: 
Free to download
Languages: 

English

Contacts (user reference): 
Health Communic...
kbose
Source: 

HC3 website on August 8 2017.

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  <h4>Lessons from the Field</h4>
Publication Date
Saturday, July 1, 2017

The 2016 Annual Report for the UNFPA-UNICEF Joint Programme on Female Genital Mutilation/Cutting provides two perspectives: The main document analyses progress in quantitative terms, offering profiles of each of the 17 programme countries. A partnership between the United Nations Population Fund (UNFPA) and the United Nations Children's Fund (UNICEF), the Joint Programme works to apply a culturally sensitive, human-rights-based approach that strategically leverages social dynamics to promote abandonment of female genital mutilation/cutting (FGM/C). This companion booklet uses a qualitative and narrative approach to examine more specifically the challenges, complexities, and achievements on the ground. It explores the approaches the Joint Programme teams, partners, and activists employ to deconstruct the social norms that allow FGM/C to continue in many communities.

  <div class="field button"><a href="http://www.unfpa.org/sites/default/files/pub-pdf/17ways-web.pdf" target="_blank">Click here for the 80-page document in PDF format.</a></div>
Contacts (user reference): 
United Nations ...
Source: 

UNFPA website, August 21 2017. Image credit: © UNFPA /Omar Gharzeddine

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  <h4>Synthesis Report</h4>
Publication Date
Tuesday, August 1, 2017

"These findings are of concern because they suggest that in the communities studied, the existing gender discrimination, the low social position of women and the gendered distribution of labour are being taught from the earliest age, instilled in young children before they even reach primary school and in this way are being transmitted from one generation to the next."

  <div class="field button"><a href="https://plan-international.org/research-gender-equality-and-ecd-initiatives#download-options" target="_blank">Click here in order to download the 15-page report in PDF format.</a></div>
Contacts (user reference): 
melanie.swan
Source: 

Plan website, August 3 2017.

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Author: 
Jenny Parkes
Jo Heslop
Freya Johnson Ross
Rosie Westerveld
Elaine Unterhalter
Publication Date
2016
Affiliation: 

University College London, Institute of Education

As reports have proliferated on widespread violence experienced by girls and boys in and around schools across the globe, school-related gender-based violence (SRGBV) has become a major concern for policymakers, education practitioners, and researchers. To that end, the Global Partnership for Education (GPE), the United Nations Children's Fund (UNICEF), the University College London Institute of Education, and the United Nations Girls' Education Initiative joined forces to launch the End Gender Violence in Schools Initiative, combining research, capacity building, and knowledge exchange in an effort to contribute to the objectives of: increased equity, gender equality, and inclusion for all in a full cycle of quality education, reaching the economically poorest and most marginalised, as reflected in the GPE Strategic Plan and the Incheon Declaration. This report presents the findings of a review of research evidence on approaches to addressing SRGBV.

  <div class="field button"><a href="https://www.unicef.org/education/files/SRGBV_review_FINAL_V1_web_version.pdf" target="_blank">Click here for the 80-page report in PDF format.</a></div>
Contacts (user reference): 
UNICEF - Public...
Source: 

UNICEF Education website and Global Partnership for Education website, both accessed on August 14 2017. Image credit: © UNICEF/UNI177576/Richter

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Publication Date
2016

Using mobile phone-based health technology (mHealth) in Uttar Pradesh (UP), India, the Reducing Maternal and Newborn Deaths Project (ReMiND) aims to increase the adoption of key maternal newborn and child health practices by improving the presentation and content of health information provided by Accredited Social Health Activists (ASHAs), as well as strengthening support and supervision structures for the ASHAs through the ASHA supervisor called the ASHA Sangini. (For more information about this project, which is a collaboration between Catholic Relief Services (CRS), Dimagi, and local partner Vatsalya, see Related Summaries, below.) This report summarises ReMIND's midterm evaluation.

  <div class="field button"><a href="https://www.crs.org/sites/default/files/tools-research/remind-midterm-evaluation-summary.pdf" target="_blank">Click here for the 18-page report in PDF format.</a></div>
Contacts (user reference): 
Catholic Relief...
Source: 

New CRS publications - August 2017; and The ReMiND Project: Reducing Maternal and Newborn Deaths [Case Study - PDF], accessed on August 22 2017. Image credit: Elin Murless/CRS

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Author: 
Alison M. Glinski
Magnolia Sexton
Lis Meyers
Publication Date
Publication Date: 
Tuesday, September 1, 2015

This resource guide provides information on how the United States Agency for International Development (USAID) sectors, missions, and staff can integrate child, early, and forced marriage (CEFM) prevention and response into their programming. It provides both the rationale of why and approaches to how USAID's efforts can address CEFM. Prepared by Banyan Global and the International Center for Research on Women (ICRW), it reflects an effort to document how the global health, gender-based violence (GBV), youth, education, economic growth and workforce development, agriculture and food security, and legal reform sectors approach child marriage, including entry points, approaches, interventions, and monitoring and evaluation, and provides concrete recommendations on how to improve these approaches in the future.

Number of Pages: 

185

Contacts (user reference): 
USAID
Source: 

USAID website, August 14 2017. Image credit: David Snyder/ICRW

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