Bridging the Gap Trainee – First month at LSHTM Archives

Hello! My name’s Manasseh and this is my first blog post as a Digital Archives Trainee for LSHTM Archives, since starting 6 weeks ago.

So, as part of The National Archives Bridging the Digital Gap programme I will be at LSHTM Archives for 15 months learning what it means to work in an archive. I will be helping the department initiate their digital preservation strategy and crucially really finding out what it means to be a Digital Archivist Assistant in this ever evolving world of Digital technologies.

I’ve come from a Arts and Heritage background with a degree in Humanities with History, only in the last year and a half I have been trained in software development with a placement at The National Archives. I am very excited to use my skills and experiences as a Digital archives trainee. So far it’s been a really interesting couple of weeks; I’ve attended a 3 day basecamp, meeting all the other 7 trainees as part of the Bridging the gap programme at The National Archives and had a tour of their amazing repositories. I’ve made a very dry Trench Cake for the Archives annual Great War Bake Off. This event was so much fun, (though I am currently working on perfecting a more edible cake) and I’ve also represented LSHTM Archives on History Day at Senate House, where I got to take in all the interesting Libraries, Archives and publishers in London and beyond.

Some of the topics I’ve covered so far in my modules have been Archive Management and Digital preservation, with an insight into how the Domesday book has been digitally preserved, considering it’s 900+ years lifespan. I’ve also been introduced to the LSHTM’s Archive service cataloguing system, Calm and the user’s gateway to the fascinating items in the catalogue through Calmview.

I’m really looking forward to what the next several months will bring as I’ll have the opportunity to visit my fellow trainees organisations at King’s College London, The Wellcome Collection and UCL Institute of Education as well as taking every opportunity to learn as much as I can at LSHTM’s Archives.

Posted in Archives | Comments Off on Bridging the Gap Trainee – First month at LSHTM Archives

Director of Program Evidence, Measurement & Evaluation at the END Fund: Claire Chaumont

MSc Health Policy Planning and Financing (2011) alumna, Claire Chaumont tells us about studying at LSHTM and how her training at the school has been useful at key points in her professional life, including in her new job as Director of Program Evidence, Measurement & Evaluation at the END Fund.

Claire started her career working as a management consultant for hospitals in France, after getting a first master’s in International Business from Science Po Paris. However, she soon realized that she lacked some foundational knowledge in health. “It was frustrating to implement policies without fully understanding their impact. Also, I had always wanted to work in global health, but didn’t quite know how to enter this field. I knew LSHTM was a respected institution in this field, so I looked into their programmes and applied.” Claire told us that she had initially planned to apply for the MSc in Public Health for Development, but changed her mind at the last minute and applied to the double degree in Health Policy Planning and Financing with LSHTM and LSE instead. “This turned out to be a great decision.”

“I wouldn’t be where I am today if it was not for this degree. During the summer of 2011, I moved to Mexico for my master’s dissertation. When I contacted the National Institute of Public Health of Mexico (INSP), I was put in touch with Dr. Gustavo Nigenda. He agreed to host me in part because he had himself studied in the same master’s programme some years ago. That was an amazing stroke of luck. I ended up working with the INSP for more than 4 years as a Research Director in their Centre for Health in Systems Research.” During that time, Claire coordinated a multi-million dollar research project on the costs of HIV interventions in Zambia, Nigeria, Kenya, South Africa and Rwanda. Over the course of the project, Claire and her team trained teams to visit over 500 health facilities to collect data. The subsequent results were shared with governments and published widely. “I am very proud of how we managed to develop strong academic relationships across all five countries, including with individuals who I still collaborate 7 years after this project began. Organizing such a large scale survey was also quite a logistic feat. I am glad to have been a part of it.”

Claire told us that while studying an MSc at LSHTM, the biggest challenge she faced was how to deal with her own FOMO (fear of missing out). “The class schedules at LSHTM and LSE don’t quite overlap, which made it particularly hard to select classes in the second part of the year. I had to make a lot of hard trade-offs. Also the programme only being a year, it all went really fast. Looking back, I regret not engaging more with faculty.”

Claire formed good relationships while studying at LSHTM. “First, I joined a community of friends, not just colleagues. I have kept in touch with several of my classmates in the last 7 years since the programme finished, and got a chance to meet with many of them in places as varied as Cambodia, Geneva, the UK, the USA, Burundi and Mexico. These are people I feel privileged to have in my life, they have also been an invaluable source of support.” Claire advises current students to be curious and try new things. “Engage with faculty. Learn from your fellow students, they have so much to offer.”

Four years after graduating from LSHTM, Claire moved to Boston to do a Doctorate in Public Health at Harvard T. H. Chan School of Public Health. “Again, I know my LSHTM master’s was a big plus for my application. The solid foundation I had gained in health policy and health financing was also useful when navigating what classes to take and what topic to focus on for my final doctoral project.” “When I got accepted in the new Harvard Doctorate in Public Health, I turned to three of my friends from HPPF to ask for their advice – they advised I go. It’s precious to have this.”

Last year, Claire joined the END Fund to work as their new Director for Program Evidence, Measurement and Evaluation. The END Fund is a recently created organisation working in raising and investing funds to help end neglected tropical diseases, specifically onchocerciasis, trachoma, lymphatic filariasis, schistosomiasis and soil-transmitted helminths. “I’m there to help the organization grows its measurement and evaluation efforts, and further develop our capacity to measure the impact of our work and increase our reach. We’re still a young organization, so there are many ways in which we can better use our data for decision-making. I’m using some of my Master’s teaching on health policy and health financing on a regular basis. It’s not often that you can leverage analytical work towards such a concrete goal – ending preventable diseases in the next decade. It’s very exciting.”

In the long term, Claire hopes that her work can help developing strong health systems, which can really provide for everyone. But it’s not just about systems. “In the long run, I wish my work can play a small part in improving health governance and international relations at the global level, in a more respectful and inclusive way. I hope to be a small part of this.”

Feature image courtesy of Claire Chaumont. Image shows Claire (centre) with Karolina Tuomisto and Stephanie Kumpunen, two of her MSc friends

Would you like to share your experience of studying at the School on the Alumni Blog?

Whether you did a short course, studied distance learning, graduated last year or years ago, we would love to hear from you!

Get in touch with the Alumni Office at 

Violence against women and girls – a human rights and public health problem

The 25th of November marks the International Day for the Elimination of Violence against Women and the start of an annual campaign: The 16 Days of Activism against Gender-Based Violence. The international movement, which had its origins at the Women’s Global Leadership Institute in 1991, will see individuals and organisations calling for an end to violence against women and girls. This year’s theme is Orange the Word: #HearMeToo and the colour orange will decorate buildings and landmarks across the world, representing a brighter future free from gender-based violence.

Unfortunately that is far from today’s reality. For too long, violence against women and girls has been allowed by a patriarchal culture of stigma and silencing women. Despite recent campaigns such as #MeToo, #TimesUp and #Niunamenos, violence against women remains a global public health problem, requiring urgent and ongoing action. What these campaigns have achieved is drawing international attention to the problem so that gender-based violence is no longer invisible.

Globally over 1 in 3 women have experienced intimate partner violence or non-partner sexual violence; at least 38% of all murders of women are committed by intimate partners. This is not only a human rights issue, but a pandemic threat to the health of women, contributing to poorer physical, reproductive and mental health. Action is needed to protect the rights of women and girls to allow them to participate in society and maintain good health.

In order to understand and shed light on the magnitude of this problem, a landmark report was released by the World Health Organization (WHO), co-authored by the Gender Violence & Health and MARCH Centre researcher, Heidi Stöckl amongst other staff from the WHO, LSHTM and the South African Medical Research Council. The report was the first of its kind: a global systematic review of scientific data recording the prevalence of intimate partner and non-partner sexual violence against women.

The report shed an interesting light on how widespread violence against women and girls is, and like many public health problems, the biggest burden is on low- and middle-income countries. But not all regions are effected equally- prevalence estimates of physical and/or sexual intimate partner violence among women in relationships range from 24.6% (in the Western Pacific) to 37.7% (in South-East Asia). But no part of the world is exempt from this problem, with the prevalence in high-income countries estimated at 23.2%.

The framing of gender-based violence as a public health problem means we can delve into the far-ranging health impacts associated with it, which include

  • Sexual health (including the transmission of HIV and other STIs)
  • Reproductive health (including induced abortion, low birth weight and prematurity)
  • Mental health (including harmful alcohol use, depression and suicide)
  • Injuries (both non-fatal and homicides).

For example, women who have experienced physical or sexual abuse at the hands of their partners compared to those who have not are at least 16% more likely to have a low-birth-weight baby, almost twice as likely to experience depression, and, in some WHO regions, more than 1.5 times as likely to become infected with HIV.

As well as detailing these consequences, the report highlights the role of the health sector in primary, secondary and tertiary prevention. WHO has released clinical and policy guidelines on how individual health-care providers and the health sector at large can strengthen their response to this public health threat. For example, WHO doesn’t recommend laws requiring that cases of partner violence are reported without the woman’s consent, and instead suggest that providers inform women of their legal rights and offer to report if consent is given.

Women are no longer prepared to be silenced on this issue. We have worked hard to bring gender-based violence out of the darkness and it’s now getting the attention it deserves. But simply talking about violence against women is not enough – it is time to take action. Prevention and management programs need to be tested and scaled up. Through health-care and other sectors, we can all act to ensure women and girls aren’t denied a life free of violence- a basic human right.

Jenny Renju’s rise to the top …..

Made it to the top of Mount Kilimanjaro!

 

 

Brain tumours have become a tragic and real part of my adult life. My Aunty Angela, my Dad, and my mentor and friend, Basia all take too early.  As a researcher the not knowing how and what can really be done is frustrating, as someone who has lost loved ones it is excruciating.  In 2018 I turned 40, reached my 10 year anniversary to Joe and became a mother of 4.  This year would also have been my Dad’s 70th year and it was time to push some boundaries. In memory of my wonderful dad and my amazing Aunty I decided to take on Kilimanjaro by running the half marathon (when I set the goal I couldn’t run 2kms) and then by striving to reach the rooftop of Africa.

At the time I didn’t actually like running and I really didn’t like climbing mountains, but I wanted more than a physical challenge, I wanted to push myself mentally, I wanted to find strength to conquer things, perhaps to help me cope and focus my grief. The half marathon (which quite literally went up up up for 8kms and then round and down) and the majestic mountain climb, did just that.  With every gruelling step for both I found head space and peace.

I highly recommend both. The spirit of the half marathon is incredible, the route is stunning, through coffee fields, villages, banana trees, with runners from all around the world, and completing surrounded by friends and family was magical.  And then Kilimanjaro, all I can say is DO IT!  It is just sensational.  It is not a technical climb.  My husband arranged the climb through his company (www.milestonesafaris.com) , and whilst I am biased I can honestly say this was the best experience ever, his team, the route (Rongai) the conditions, my climbing buddy (of course given I climbed with my husband) made the 6 days we climbed some of the best days of my life.  Being outside, above the clouds, looking down over Kenya first and then Moshi, walking (very very slowly) in fresh mountain air allowed me the time and headspace to remember my loved ones, to think about and curse brain cancer but more importantly to think about life.  I am so grateful to so many people for enabling me to aspire to and complete this challenge and to raise this significant amount of money to fund the fight!

Brain tumours kill more children and adults under the age of 40 than any other cancer. Just 1% of the national spend on cancer research has been allocated to this disease. Brain Tumour Research is leading voice calling for support and action for research into what is called the last battleground against cancer.  I hope my efforts can somehow help.  Please see my justigivng page for more on my journey and consider supporting this worthwhile need.

And if you ever want to climb Kilimanjaro please do get in touch!

 

 

 

  1. Completing my first Ever half marathon with my family (which in July 2018 became 6!)
  2. Jenny, Joe and the climbing team at Mawezni tarn camp (with Mawenzi behind them, 4315m above sea level)
  3. Day 4: Jenny and Joey moving closer to the summit
  4. Reaching Gilmans point together, 5685m above sea level, sadly Joe was suffering from Acute mountain sickness and had to      descend
  5. On the way to the rooftop of Africa (alone – well with two guides) but WOW!
Posted in News | Comments Off on Jenny Renju’s rise to the top …..

Future WHO Regional Director for the Western Pacific: Dr Takeshi Kasai

Public Health in Developing Countries (1999), Diploma in Tropical Medicine & Hygiene (DTMH) (1997) alumnus, Takeshi Kasai told us about being nominated to be the next Regional Director for the Western Pacific, based in Manila, Philippines. WHO’s Western Pacific Region includes 37 countries and areas, stretching from Mongolia and China in the north, all the way to French Polynesia in the east, and Australia and New Zealand in the south. WHO works to support all 37 countries and areas to promote health, keen the Region safe, and serve the vulnerable.

 

Before he worked for WHO, Dr Kasai decided to study at LSHTM because the School allowed students to take units in very different disciplines, such as epidemiology, health economics, health policy and anthropology, which stimulated his curiosity. “The School also offered the renowned DTMH course, and I took that after my master’s course.” Dr Kasai also chose to study at LSHTM because he wanted to do something different to his colleagues. At the time, most of his friends went to the US to study, but very rarely the UK.

 

Dr Kasai told us that he gained valuable knowledge and skills from studying at LSHTM, but his time at the School was not without its challenges. “The volume of English reading overwhelmed me at first. The only way to overcome the challenge was to just continue to read and read, day and night, except on Friday nights!”

Following his time at LSHTM, Dr Kasai worked on infectious disease control in his native Japan, before joining WHO in 2000.

Dr Kasai says that the greatest relief in his career to date was when the SARS crisis was over in 2004. “Our region was the epicenter of the crisis, and we lost a colleague during the response. It was one of the most intense periods in my career. After SARS, we organised a series of discussions to identify lessons learned and eventually developed a framework called the Asia Pacific Strategy for Emerging Diseases, to guide countries and WHO on how to prepare for and respond to emerging infectious disease threats. We have been implementing this framework for more than a decade, and as a result, the system to detect and respond to infectious diseases has significantly improved.” Dr Kasai also recalls his time fondly serving as WHO Representative in Vietnam, from 2012 to 2014. “I was very proud to receive a medal from the Vietnamese government in recognition of my contributions, particularly to their health insurance reforms.”

In October 2018, Dr Kasai was nominated by WHO’s Member States in the Western Pacific Region to the next WHO Regional Director for the Western Pacific. His nomination will be considered by WHO’s global Executive Board in January, and if approved, he will take office as Regional Director on 1 February 2019.

In this role, Dr Kasai will lead WHO’s work in the Western Pacific Region, and hopes to help make the Region one of the safest and healthiest in the world. “I believe that we can do that with fullest cooperation from ordinary people, the community, leaders, partners, and of course WHO’s Member States. While many countries in our Region have experienced rapid economic development in recent years, there are emerging challenges, including unplanned urbanization, an increase in non-communicable diseases (NCDs), ageing populations, the health impact of climate change and development, and increases in inequity, just to name a few. I will use all my knowledge, including what I gained at LSHTM, as well as my experience, management skills, and leadership to work with countries and support them in addressing those challenges.”

Dr Kasai told us that he received a lot of support from LSHTM graduates over the years, and he has tried to support fellow alumni wherever possible. His advice to current students is to “grow beyond your previous limitations. At LSHTM there are stimuli all around you. Not just the LSHTM knowledge base, but the faculty, classmates with different backgrounds, and of course, London.”

Images courtesy of Dr Takeshi Kasai.

Would you like to share your experience of studying at the School on the Alumni Blog?

Whether you did a short course, studied distance learning, graduated last year or years ago, we would love to hear from you!

Get in touch with the Alumni Office at 

Removing duplicates from an EndNote library

If you have done any systematic review searching, you will have spent time removing duplicate references from your results. Faced with the prospect of deduplicating 26k results, I put out a plea/rant on twitter.

AS often happens, lovely library colleagues came to the rescue. Naila Dracup (@nailadracup) sent me a link to a guide written by Judy Wright (@jmwleeds) and the AUHE Information Specialists at the University of Leeds.

Wichor Bramer (@wichor) has also written a paper about how to do this, which he pointed out on twitter.

You can find Wichor’s paper at Bramer WM, et al. De-duplication of database search results for systematic reviews in EndNote. J Med Libr Assoc. 2016;104(3): 240-3. doi:10.3163/1536-5050.104.3.014.

Below I’ve re-written the instructions provided by Leeds University Library as I have tested them myself. I’ve not had a chance to try Wichor’s technique. Let me know in the comments if you have given it a try.

1. Importing your references into EndNote

1.1 Import your results in the correct order

Did you know that the order that you import your references can have an impact on the quality of the information your EndNote library contains? This is because when EndNote removes duplicates, it automatically leaves the first copy added to your library and removes subsequent copies. So if you import your results from a database which doesn’t have abstracts (for example), then import results from one which does, the copy with the abstract will automatically be deleted.

It is recommended you import your references in the following order:

  1. Medline
  2. Embase
  3. Medline in process (if included)
  4. Other databases from OvidSP (PsycInfo, EconLit etc)
  5. PubMed
  6. Cinahl Plus
  7. Other databases from Ebsco
  8. Web of Science databases
  9. Scopus
  10. ProQuest databases
  11. Cochrane databases
  12. CRD databases
  13. Any other databases
  14. Clinical Trials websites

If you haven’t searched one or more of these databases, that’s fine. Just go to the next on the list. There is instructions on the LAS Databases page on how to import results from most of these databases to EndNote.

Always import all results into EndNote.

1.2 Organizing your imported references

I also recommend you organize your results into groups and add keywords so that you can keep track of where each reference has come from. I create a group for each database and drag and drop my results into the group as i’m importing. I also add a keyword to each reference which details the database the reference has been retrieved from. ITS EndNote training can tell you more about creating groups and editing fields in EndNote.

2. Set up your EndNote library for accurate duplicates removal

Once you have all of your references uploaded and organised in groups, display the following fields in EndNote so that you can accurately spot duplicates.

  • Record number
  • Author
  • Year
  • Title
  • Journal/Secondary Title
  • Pages
  • Volume

Do this by going to Edit > Preferences then clicking the ‘Display Fields’ option.

3. Find duplicates

Finding duplicates is a multi-stage process. This is because each database formats the information slightly differently, making accurate machine spotting of duplicates very difficult.

3.1 Step 1

Set the ‘find duplicates’ preferences to Author, Year, Title, Journal. Make sure ‘Ignore spacing and punctuation’ is checked.

Sort all references by Journal and highlight those with a journal title in the journal field (ignore those with a blank journal field). Run ‘Find Duplicates’ and click ‘Cancel’ in the resulting dialog box. You will see a new group has appeared called ‘Duplicates’ with duplicates highlighted. Click ‘Delete’ on the keyboard to move the highlighted items to the trash. These do not need to be checked.

3.2 Step 2

Set the ‘find duplicates’ preferences to Author, Year, Title, Pages. Make sure ‘Ignore spacing and punctuation’ is checked.

Sort all references by Pages and highlight those with a page number in the pages field (ignore those with a blank pages field). Run ‘Find Duplicates’ and click ‘Cancel’ in the resulting dialog box. You will see the duplicates group has been updated with a new group of duplicates. Click ‘Delete’ on the keyboard to move the highlighted items to the trash. These do not need to be checked.

3.3 Step 3

Set the ‘find duplicates’ preferences to Title, Journal, Pages. Make sure ‘Ignore spacing and punctuation’ is checked.

Sort all references by Pages. Run ‘Find Duplicates’ and click ‘Cancel’ in the resulting dialog box. You will see the duplicates group has been updated with a new group of duplicates. Manually check the references with no page numbers or page numbers beginning with 1, and select/deselect duplicates by holding the Ctrl key while selecting or deselecting. Click ‘Delete’ on the keyboard to move the highlighted items to the trash.

Step 4

Set the ‘find duplicates’ preferences to Year, Title, Pages. Make sure ‘Ignore spacing and punctuation’ is checked.

Sort all references by Pages. Run ‘Find Duplicates’ and click ‘Cancel’ in the resulting dialog box. You will see the duplicates group has been updated with a new group of duplicates. Manually check the references with no page numbers or page numbers beginning with 1, and select/deselect duplicates by holding the Ctrl key while selecting or deselecting. Click ‘Delete’ on the keyboard to move the highlighted items to the trash.

Step 5

Set the ‘find duplicates’ preferences to Title, Pages. Make sure ‘Ignore spacing and punctuation’ is checked.

Sort all references by Pages. Run ‘Find Duplicates’ and click ‘Cancel’ in the resulting dialog box. You will see the duplicates group has been updated with a new group of duplicates. Manually check the references with no page numbers or page numbers beginning with 1, and select/deselect duplicates by holding the Ctrl key while selecting or deselecting. Click ‘Delete’ on the keyboard to move the highlighted items to the trash.

Step 6

Set the ‘find duplicates’ preferences to Author, Year, Journal, Pages. Make sure ‘Ignore spacing and punctuation’ is checked.

Sort all references by Pages. Run ‘Find Duplicates’ and click ‘Cancel’ in the resulting dialog box. You will see the duplicates group has been updated with a new group of duplicates. Manually check the references with no page numbers or page numbers beginning with 1, and select/deselect duplicates by holding the Ctrl key while selecting or deselecting. Click ‘Delete’ on the keyboard to move the highlighted items to the trash.

Step 7

Set the ‘find duplicates’ preferences to Author, Year, Title Make sure ‘Ignore spacing and punctuation’ is checked.

Sort all references by Title. Run ‘Find Duplicates’ and click ‘Cancel’ in the resulting dialog box. You will see the duplicates group has been updated with a new group of duplicates. Manually check the references with no title, and select/deselect duplicates by holding the Ctrl key while selecting or deselecting. Click ‘Delete’ on the keyboard to move the highlighted items to the trash.

Step 8

Set the ‘find duplicates’ preferences to Author, Year, Journal. Make sure ‘Ignore spacing and punctuation’ is checked.

Sort all references by Journal. Run ‘Find Duplicates’ and click ‘Cancel’ in the resulting dialog box. You will see the duplicates group has been updated with a new group of duplicates. Manually check all references by looking at the page numbers field, and select/deselect duplicates by holding the Ctrl key while selecting or deselecting. Click ‘Delete’ on the keyboard to move the highlighted items to the trash.

Step 9

Set the ‘find duplicates’ preferences to Author, Year. Make sure ‘Ignore spacing and punctuation’ is checked.

Sort all references by Journal. Run ‘Find Duplicates’ and click ‘Cancel’ in the resulting dialog box. You will see the duplicates group has been updated with a new group of duplicates. Manually check all references by looking at the page numbers field, and select/deselect duplicates by holding the Ctrl key while selecting or deselecting. Click ‘Delete’ on the keyboard to move the highlighted items to the trash.

Step 10

Set the ‘find duplicates’ preferences to Year, Title. Make sure ‘Ignore spacing and punctuation’ is checked.

Sort all references by Title. Run ‘Find Duplicates’ and click ‘Cancel’ in the resulting dialog box. You will see the duplicates group has been updated with a new group of duplicates. Manually check all references by looking at the page numbers field, and select/deselect duplicates by holding the Ctrl key while selecting or deselecting. Click ‘Delete’ on the keyboard to move the highlighted items to the trash.

Step 11

Set the ‘find duplicates’ preferences to Title. Make sure ‘Ignore spacing and punctuation’ is checked.

Sort all references by Ttile. Run ‘Find Duplicates’ and click ‘Cancel’ in the resulting dialog box. You will see the duplicates group has been updated with a new group of duplicates. Manually check all references by looking at the page numbers field, and select/deselect duplicates by holding the Ctrl key while selecting or deselecting. Click ‘Delete’ on the keyboard to move the highlighted items to the trash.

Step 12

Now, you can catch the final few duplicates by manually picking them out. Sort your entire EndNote library by title and make the title column very wide so that you can see lots of the title words. Carefully look at your titles and remove the duplicate with the highest reference number. Be aware that sometimes translated titles are displayed in [brackets].

Step 13

Repeat step 12 but this time sort on page numbers and remove any duplicates.

Now you should have removed your duplicates. Numbers of references remaining in the groups can be used to complete the PRISMA diagram. Your results can now be used in the screening process.

29 November – 05 December 2018

Cathy Zimmerman speaks to The Guardian about a new UCL-Lancet Commission on Migration and Health. Cathy was senior author on the report, which was developed over two years and led by 20 leading experts from 12 countries. Cathy said: ““Governments around the world are well aware that their economies depend on migrant workers, both for low-wage work in destination countries and for remittances in sending countries. Yet, states have done disappointingly little to assure the health and safety of migrant workers, or to stop the exploitation and human trafficking of millions of hard-working women and men who toil invisibly in every corner of the globe.”

Heidi Larson is interviewed by National Public Radio about increases in cases of measles after WHO publish a report showing significant rises in cases. On vaccination uptake and confidence, Heidi said: “Frankly measles is a really fascinating window on what’s going on both historically and currently. Outbreaks of measles are one of the first signs that vaccination programmes are not working. It’s very much about emotions, trust and distrust and a polarised society.” (online link unavailable).

On social media

This week’s social media highlight comes from the LSHTM Twitter page sharing news of the UK’s first-ever dedicated Vaccines Manufacturing Innovation Centre. LSHTM is a partner in the new Centre.

Posted in Uncategorized | Comments Off on 29 November – 05 December 2018

Informing design and implementation for early child development programmes

Archives of Disease in Childhood Series coming in 2019

This page will be updated over the next few months as the series is released. Read below for background information to the series and the programmes that made it possible. 

This is a critical moment for global action in early child development (ECD). Worldwide, an estimated 250 million children under the age of five are at risk of not reaching their developmental potential. The Sustainable Development Goals and the Global Strategy for Women’s, Children’s and Adolescents’ Health (2016-2030) envision that every child has the opportunity to thrive and the 2018 WHO & UNICEF Nurturing Care Framework provides a policy framework for this.

To support the shift to large-scale implementation for ECD, policymakers and programmers require practicable suggestions for context-specific design and implementation interventions.

We are launching a series of papers, in partnership with collaborators from multiple institutions, sectors, and backgrounds, aimed at informing design and implementation of early child development programmes in low- and middle-income countries around the world.

Building on the evaluation of the Grand Challenges, Canada Saving Brains portfolio and additional analyses, we will discuss evidence to inform decision points encountered in scaling of early child development programmes.

The series is based around a programme cycle (shown above) and each paper addresses a specific link on the cycle. The papers include new data, analyses and case studies, covering;

  • situational assessment, including inter-sectoral partnerships
  • design choices such as targeted/universal, cadre and content
  • measurement of ECD including coverage and outcomes in routine programmes
  • trends in donor funding, and how to improve accountability
  • multi-stakeholder perspectives on scaling.

Updates:

12-13 December 2018: At the Partnership for Maternal, Newborn and Child Health, the Bernard van Leer Foundation and partners will be hosting a session, ‘Spotlight on the many voices of the early childhood workforce’. The session will focus on the ECD workforce now, what challenges it faces, and how it can be improved to better deliver the Nurturing Care Framework. Our series will support this learning, helping to provide evidence-based actions for an effective, multisectoral ECD workforce.
Follow the forum & conversation: @PMNCH #PMNCH2018 #PMNCHLive2018


Learning from Saving Brains: informing policies and scale-up for early childhood (Early Childhood Matters, 2018)

Saving Brains is a multi-institution, multi-donor partnership led by Grand Challenges Canada which awarded 84 grants to innovation projects across 31 low- and middle-income countries between 2011 and 2017. The overall aim of Saving Brains is to develop sustainable and scalable ways of nurturing healthy brain development in the first 1000 days. Through technical support and leadership development, Saving Brains provides an opportunity to demonstrate proof of concept, to ‘transition to scale’ grants, which progress selected interventions towards larger scale and sustainability.

As one of the largest investments in early childhood interventions in low- and middle-income countries, the Saving Brains portfolio has unique potential to inform understanding of processes towards scaling.

Read more about Saving Brains here.

Download the full article here.


The series has been made possible by funding support from the Bernard van Leer Foundation. The Saving Brains impact and process evaluation was funded by Grand Challenges Canada.


References:

  1. Milner, K.M., Kohli-Lynch, M.K., Tann, C.J. and Lawn, J.E. on behalf of the Expert Advisory Group and Saving Brains Platform Team. (2016, unpublished). Saving Brains Portfolio Impact and Process Evaluation Report. London: School of Hygiene & Tropical Medicine

Visit to CeSHHAR in Harare for Recency Study (December 2018)

Left to right:
Sitholubuhle Magutshwa: CeSHHAR – Recency Study Coordinator
Brenda Ashanda: UCSF/EDARP – Recency Study Coordinator
Mariken De Wit: LSHTM – Research Assistant

Mariken De Wit, Research Assistant at LSHTM reports on visit to Harare in November 2018.

The MeSH Consortium has been running three pilot studies in Kenya and Zimbabwe to assess the feasibility and utility of conducting HIV recency testing in routine settings. Implementing these tests has proven to be challenging. The pilot in Zimbabwe focusses on female sex workers and is conducted within the Sisters with a Voice programme run by CeSHHAR. To get a better understanding of the day-to-day work around the recency testing and to discuss analysis plans, I went to Harare to work with the CeSHHAR team.

During the first day, our focus was on data analysis. Our colleagues at CeSHHAR shared the recency data with me, and together we discussed what our analytical approach should be. The recency pilot aims to identify female sex workers with a recent HIV infection and explore potential sociodemographic and behavioural risk factors for a recent infection. HIV incidence estimates will also be calculated based on these data.

Alongside a colleague from one of the pilots in Kenya we visited the laboratory (where the recency tests are conducted) and one of the sex workers clinics in Mbare. The clinics are run by nurses who provide sexual health care and counselling specifically aimed at female sex workers. Clients are tested for HIV infection every three months, for which they can choose to either get tested or do a self-test. During the post-test counselling, and depending on their test result, they discuss how to stay HIV negative or how to be linked to ART treatment. They are also offered the option to participate in the recency study. This recency test will indicate when they are most likely to have become infected. If consent is given, a blood sample is taken and transported to the laboratory at the end of the day.

While the women are in the waiting room, I saw peer educators engage with them – explaining how to use male and female condoms, giving tips on how to please male clients, and discussing ways to prevent HIV infection and other STIs. During my visit to the clinic, the peer educators used well-known melodies to share sexual health information and by the end of the song, everyone was singing and dancing! A great example of how music and dance can contribute to HIV prevention education.

The rest of my time in Harare focused on the qualitative component of the pilot. I was presented with an opportunity to gain a thorough understanding of the challenges faced by the people working in the field in Zimbabwe, our colleague from Kenya and the local lab manager. This has provided invaluable insights into the day-to-day practices and the implementation to help assess the feasibility of the intervention.

My brief visit has highlighted to me how valuable it can be to go visit a study site and learn how the actual work is being done, how planned interventions are implemented in real world settings, and what challenges have arisen and been overcome; before everything is compiled into one database and a few lines of code.

Posted in Uncategorized | Comments Off on Visit to CeSHHAR in Harare for Recency Study (December 2018)

Health systems strengthening in the SDG era: integration and cross-sector linkage

By Susannah Mayhew (London School of Hygiene & Tropical Medicine)

There is a large body of robust scholarship on the impact and successful drivers of integrating sexual and reproductive health (SRH) and HIV services and their supporting health systems. This scholarship provides important lessons for understanding how to support the cross-sector linkages required if we are to make progress towards attaining the Sustainable Development Goals.

In November 2017 Health Policy and Planning published a Supplement on service and systems integration entitled ‘Integration for stronger health systems: lessons from integrating sexual and reproductive health and HIV services’.

This included some key results from the Integra Initiative, one of the world’s largest sexual and reproductive health (SRH) and HIV integration trials, as well as other integration initiatives and review papers. Collectively the Supplement synthesised evidence on the the nature and extent of the impact of integrated service delivery on key health behaviour and service outcomes and identified core drivers for successful integration. The Supplement’s Editorial and final Commentary paper reflect on the wider implications of findings and lessons learned from the SRH-HIV integration field in the context of the Sustainable Development Goals (SDGs). In particular, the Supplement papers ask:

  • What can SRH-HIV integration findings tell us about if and how it is possible to build flexible, integrated systems and services that are resilient to changing SRH and wider health needs?
  • What lessons can be learned from this body of scholarship that are important for integration of (any) services and systems in a multi-sector SDG context?

These bigger questions have taken on even greater importance in the past few months with increasing recognition of the need for health researchers and practitioners to engage across sectors, given at three major international conferences: the 22nd International AIDS Conference in July 2018, the Health Systems Global conference in October and the International Family Planning Conference in November 2018. At the AIDS conference, the Inter Agency Working Group on SRH-HIV Linkages (IAWG) co-convened by WHO and UNFPA, launched a Call to Action. In it, the IAWG calls for “innovative approaches” and “stronger multi-sectoral partnerships”. The Health Systems and Family Planning conferences both for the first time ever, had dedicated sessions on climate and environment which highlighted the need for innovative cross-sector partnerships for example with environmental and conservation groups.

Cross-sector linkages are challenging of course. Who designs, governs and funds joint (or linked) programmes? How do we design health systems that are able to successfully interact and engage with other sectors to advance health for all? The Integration Supplement papers provide a useful starting point. They find that the core drivers of successful integration include adaptive leadership and peer-teamwork that enabled facilities to provide integrated care, and achieve positive impact on health and service outcomes, even in the face of resource shortages or structural constraints. Successful integration also requires a systems approach – not a focus only on facility structures and resources, but also on the mechanisms for supporting and coordinating work across teams, programmes and sectors.

Strengthening health systems’ capacity to deliver health care for all in the SDG era is a shared aspiration. Success depends on how we reach beyond the health sector through creative partnerships to strengthen health systems’ reach and resilience. It is a challenge that integration scholars are well placed to take up.