From research to social norm change: Preventing sexual exploitation of children and adolescents – 2nd LINEA Network biennial meeting 2017

Thirty members of the Learning Initiative on Norms, Exploitation and Abuse (LINEA) Network and team gathered in Windsor for the second LINEA Network biennial meeting from 16th to 18th October 2017. Academics, practitioners and funders from across Africa, Latin America, South Asia, North America and Europe discussed results and insights from recent intervention-based research applying social norm change approaches to preventing sexual exploitation and abuse of children and adolescents and violence against women and girls. You can access the meeting report here, and the meeting resource page here.

Twenty talks and workshops explored:

  • LINEA activities since the 2015 meeting
  • Findings from LINEA Phase Two formative research in Uganda and Tanzania
  • Child-centred research, prevention and response to sexual exploitation and abuse of children and adolescents
  • Character narrative development in media for social norm change
  • Theories of change and measurement frameworks for social norm change interventions
  • Operationalising measurement of social norm change
  • Process insights from applying social norms theories in intervention design
  • Engaging men and boys to prevent sexual and gender-based violence
  • Adolescent girls’ development: Putting evidence into practice
  • Input to development of media content for the LINEA Tanzania intervention

The three-day meeting strengthened and expanded LINEA Network member sharing and collaboration as a community of practice. Participants learned from each other on strategies and methods to integrate social norms and gender theories in intervention design and evaluation for preventing sexual exploitation and abuse of children and adolescents. Participants widely described a “refreshingly candid, open and safe space” for grappling with the methodological and operational challenges. The full meeting report highlights key discussion points from each session.

“The LINEA meeting was a moment of insightful sharing around innovations for ending violence against children, particularly concerning transactional sex. The many ideas shared are important for opening a new chapter in our work with adolescent girls in the Mwanza context in Tanzania. It was really interesting to see how research findings from Brazil and from Tanzania illustrated similar situations adolescent girls face in intergenerational transactional sex with older men. We plan to incorporate insights from LINEA meeting into our current work with girls.” – Revocatus Sono, Amani Girls Home, Tanzania

“The meeting was intellectually stimulating and spurred additional opportunities. I am grateful for the opportunity to interact with such an esteemed and committed group of scholars, advocates, practitioners and even a bureaucrat or two!” – Dr Cari Jo Clark, Rollins School of Public Health, Emory University

by Jennifer Schulte and Lottie Howard-Merrill.
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Giving Tuesday 2017 Update

This #givingtuesday, thanks to the kindness and generosity of alumni, students, staff and friends of the School, we raised £1,300 for LSHTM Scholarships!

We sold sweet and savoury treats throughout the day that had been baked and donated in kind by students and staff. Our bake sales took place at both Keppel Street and Tavistock Place; the whole School community got involved, and as a result we raised £600.

We also received gifts throughout the day from our alumni community who donated towards scholarships from various parts of the world. We received a total of £700 through online donations, helping us to exceed our goal of raising £1000.

Thank you all for your gifts and support, we could not have done it without you!

Watch this video to find out why we get involved in #givingtuesday each year at LSHTM.

If you would like to make a gift to the School, there are various you can do so. Please see our Giving Page for more information.

Register your interest in the free online course “Diabetic eye disease”!

Learn about the partnerships, resources and procedures needed strengthen diabetic eye health services and reduce the risk of visual loss and blindness in people with diabetes

By 2040, just 20 years away, the number of adults with diabetes is expected to increase by more than 50% to 642 million people globally.

1 in 3 people with diabetes is likely to experience retinal disease at some point over their lifetime.

Register your interest now

Enter your email into the Google form below to receive a message when registrations open next year for the free online course, “Diabetic eye disease.”

Diabetic Eye Disease is a free online course from the International Centre for Eye Health at the London School of Hygiene & Tropical Medicine in partnership with FutureLearn.

Privacy statement: LSHTM is committed to protecting your personal information and respecting your privacy. For more information see the LSHTM data protection policy

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Had your flu shot?

In the USA, the first week of December is National Influenza Vaccination Week. With flu activity highest between December and February, the Week publicises the benefits of getting a flu shot in terms of reducing the risk of individuals getting sick themselves or of infecting those around them.

Although today’s flu vaccine is generally accepted as part of a modern public health system, the longer story of vaccination is one of vociferous disputation and resistance.

The founder of vaccination is considered to be Edward Jenner – though earlier forms were practised in China, India and Turkey.  In 1796 Jenner used cowpox material to create immunity to smallpox and in 1798 he published An Inquiry into the Causes and Effects of the Variolae Vacciniae. Despite opposition within the medical profession and religious aversion to the use of animal material, by 1801 his report had been translated into other languages and widely disseminated. Many thousands of people were vaccinated.

Vaccination programmes since then have contributed to the control or eradication of smallpox, polio, diphtheria, tuberculosis, tetanus, whooping cough, measles, mumps, rubella, meningococcus and pneumococcus. Recent vaccination programmes are combatting rotavirus, human papillomaviruses, and shingles.


In LSHTM Library’s Barnard Classification Scheme, books on vaccination are found within classmark “H”.

Vaccinology : an Essential GuideBooks on the pharmacology and therapeutic use of vaccines are at “HG”, and include:

  • “Vaccinology : an essential guide” edited by Gregg N. Milligan and Alan D.T. Barrett (2015)

 

Books on the history and politics of the subject are at “HI”, and include:

  • History and politics of vaccination“Bodily Matters: the Anti-Vaccination Movement in England 1853-1907” by Nadia Durbach (2005)
  • “The Vaccine Controversy : the History, Use, and Safety of Vaccinations” by Kurt Link (2005)
  • “The Politics of Vaccination” by Deborah Brunton (2008)

 


If you’re interested in some truly impassioned writing on both sides of the vaccination debate, LSHTM Library has a collection of books and pamphlets from the 1800s.  Digitised as part of the Medical Heritage Library project and hosted on the Internet Archive, they are freely available online and can be downloaded as facsimiles, searched through as full-text or formatted for e-pub readers and Kindle.

Here are a few “for” vaccination:

and a few “against”:

Vaccination. A reply to the question is vaccination scientific? / by George S. Gibbs

 


ICED Newsletter: December 2017

Dear all,
 
Welcome to the last newsletter of 2017!  This time of a year gives us all an opportunity to look back, as well as forward. We have had a busy time in 2017!

We have focused a lot of our efforts on impact evaluations, including looking at the effectiveness of: Disability Allowance in the Maldives; a family support programme for parents of children with Cerebral Palsy in Ghanadistribution of hearing aids in Guatemalaphysical rehabilitation in Myanmar (with report launched last month!); club foot services in Africa, and primary eye care in Rwanda. We have also worked on two trials – assessing the effectiveness of violence prevention strategies in schools in Uganda and improvement in WASH in Malawi for people with disabilities. We have conducted research to evaluate the inclusion of people with disabilities in different areas of life, such as in health care services generally, health and rehabilitation services in Malawi; menstrual hygiene management in Nepal, humanitarian crises in Ukraine and Tanzania, and social protection in Nepal and Vietnam. We have also started an exciting project to further develop participatory methods for research with adolescents with disabilities, and are developing and testing an intervention for carers of children affected by Zika in Brazil.

Looking forward to 2018, we will carry on growing our research agenda. We are also excited about co-hosting the International Conference on Evidence in Global Disability and Health together with the Public Health Foundation of India on February 26-27, 2018 in Hyderabad, India. Our MOOC (online course) on Global Disability and Health will also launch at that conference, and will be freely available for all! We are planning an exciting programme of seminars at LSHTM – watch this space for more information!

Come and join us for the last of 2017 on Tuesday 5 December (17.30-18.30, John Snow Theatre B, LSHTM) to celebrate the International Day of Persons with Disabilities. We will host a Film Screening and Panel Discussion showing an excerpt from LISILOJULIKANA – The Unknown. Lisilojulikana is a drama about a Kenyan girl with Cerebral Palsy, and the event includes a special introduction by Purple Field Productions Associate Producer Colin Stevens. This will be followed by a panel discussion on projects that support inclusion of children with disabilities in low resource settings.

I would like to end by saying thank you to all our team members, colleagues, collaborators and funders in 2017. At ICED, we are looking forward to working together and engaging further in 2018. In the meantime, have a relaxing holiday and a wonderful New Year.
 
Best wishes,

Hannah Kuper
International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine

We have reached more than 1500 followers on Twitter – please follow us @ICED_LSHTM.

Publications 

Last month, we launched the report on “The Impact of Physical Rehabilitation in Myanmar”. This study was funded by the International Committee of the Red Cross, and led by Karl Blanchet and Islay Mactaggart. This research report tracks persons with lower limb amputations in Myanmar before and after they interacted with physical rehabilitation services. The study provides much needed evidence on the impact of these important services in people’s lives.

Our paper on “Childhood disability in Malawi: a population based assessment using the key informant method” was published in BMC Paediatrics. This paper reviews the methods and results of the key informant method to estimate the prevalence and type of impairments in children in Malawi, and how this information can help us to plan services. For more information on the Key Informant Method read the “Focus on” section below.

We also published “Disability, Social Functioning and School Inclusion Among Older Children And Adolescents Living With HIV In Zimbabwe” in Tropical Medicine and International Health. This paper describes the range of functional difficulties that children and adolescents with HIV experience, compared to their peers, and how this impacts on their school engagement and progress.

Since 2010, Andrew Smith, Daksha Patel and other ICED colleagues have led short courses on Public Planning for Hearing Impairment, including in Peru, Kenya, India, Pakistan, South Africa and beyond. A description of the aims, activities and achievements of this programme are reported in this month’s ENT & Audiology News.
 
The Ponseti method is widely used to correct club foot, but there is a lack of agreement on what constitutes a “good” result for this procedure. Tracey Smythe and colleagues conducted a systematic review, published in BMC Musculoskeletal Disorders, to determine and evaluate how success with the Ponseti method is reported in sub-Saharan Africa, and found a wide variation and lack of consistency in the methods used.
 
Trichiasis is a condition whereby the eye lashes turn inwards and scratch against the eye. Surgery is given primarily to prevent blindness, but also to relieve pain and discomfort. A longitudinal study from Ethiopia, published in Wellcome Open Research, shows that eyelid surgery leads to great improvements in the ability to perform productive and leisure activities without difficulties, regardless of vision gains.

Focus On: Key Informant Method

Door-to-door surveys are often used to identify children with disabilities in low resource countries – either as beneficiaries for an intervention, or in order to estimate numbers and plan services. These surveys can be costly and time consuming, and there is often a lack of comparability between them in methods and definitions used.

The Key Informant Method (KIM) is a method developed and validated by ICED, largely funded by CBM. It allows the identification of children with different types of impairment (hearing, vision, physical, intellectual) using trained, community volunteers in the place of a door-to-door survey. These children are then examined by clinicians, either at an examination clinic or by a visiting paediatrician, to determine the nature of the impairment, and the health and rehabilitation services that the child needs. This information can benefit the children directly, but also help countries to plan suitable policies and programs.

KIM has been used in: Pakistan, Bangladesh, Kenya and Malawi. A KIM is ongoing in Malaysia, and two are planned in West African settings during 2018.

See our resource page for information on how to conduct a KIM, and the studies conducted to date.

Upcoming Seminars and Events at LSHTM

Tuesday 5 December: International Day for Persons with Disabilities Celebration and Christmas Drinks. Film showing ”The Unknown” followed by panel discussion and drinks reception. Time: 17:30-18:30, Venue: John Snow Theatre B, LSHTM.
You can find audio with power-point of past seminars available on our website

Other Seminars of Interest

10 January 2018, 1-7pm Digital Content and Disability, Wilkins Building, UCL. Registration and refreshments in the South Cloisters; seminar in the Gustave Tuck Lecture Theatre

Work Experience Programme at ICED

We have launched our work experience programme for people with disabilities seeking experience in research. Please contact us if you would like to find out more about joining our team in this capacity: .

Upcoming Conferences

Other News of Interest

  • Disabled Village Children has been revised to include new and updated information on microcephaly, and other physical and developmental disabilities.
  • Register now for LSHTM’s short course in Gender Based Violence, running 12-16 February, 2018.
  • Plan International has just released its report “Let Me Decide and Thrive”, focusing on girls and young women with disabilities and the barriers they face when it comes to their sexual and reproductive rights and education.

Have you seen this?

Two fabulous videos for you to enjoy in celebration of International Day of People with Disability (both 1-2 minutes).

Weʼre raising £7,600 to provide one year of physical therapy assistance for 20 children and donate 40 orthoses to children affected by microcephaly. Abracoa Microcefilia Please support us by giving a donation to ICED runners are running!

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27 November – 3 December 2017

New World Health Organization research shows that 1 in 10 medical products circulating in low and middle-income countries is either falsified or substandard. The WHO estimates use an LSHTM model to address the question of the health and economic impact of sub-standard and falsified antimalarials. The findings were covered in more than 400 outlets around the globe, including Guardian, TIME, Boston Globe, and Daily Nation (Pakistan).

David Conway is interviewed by Voice of America on the World Health Organization World Malaria Report 2017, showing that progress in malaria control has stalled and we risk missing the global malaria targets for 2020 and beyond: “This latest World Health Organization report is a wake-up call. Although there are achievements to note in several countries that have aimed for malaria elimination, there are many causes for concern. In the last few years there has not been a decrease in the overall amount of malaria globally. Most worryingly, many of the countries that are most affected by malaria are reporting increases in numbers of cases.” An expert comment is published online.

Jo Lines is quoted by The Independent on a new study published in Nature Journal, which finds several rapidly evolving insecticide resistance genes between different regions of Africa: “Over the last 15 years, the increased use of tools such as insecticide-treated nets has prevented more than 400 million cases of malaria. Our ability to maintain these gains will be greatly weakened, and may be lost, unless we find effective ways to slow down the evolution of resistance. Although work is taking place to combat insecticide resistance, it remains a neglected area.”

On World AIDS Day the School in partnership with the charity Sentebale launch a new policy paper is launched to support governments, policy makers and NGOs in tackling the continuing high levels of HIV among adolescents in sub-Saharan Africa. Peter Piot: “To end HIV/AIDS it’s crucial we start engaging with young people in sub-Saharan Africa who are affected – interventions to improve their lives needn’t be complex and costly, just sustainable, targeted and developed closely with them.” Medical Express cover the story.

Peter also speaks to leading German paper Zeit online: “We’ve got everything we need to defeat #AIDS…but we must not give the impression that everything is good. We still have far too many new infections per year.”

Dr Nick Douglas writes a blog Trans sexual health – the invisible subject about why we must pay more attention to sexual health research of trans people in the UK if we are to reach HIV/AIDS goals: The research community urgently needs to step up and play its part in ending the exclusion and invisibility of trans people in UK sexual health research. We will never meet the 2017 World AIDS Day goals, ‘end isolation, end stigma, end HIV transmission’, if we leave trans people behind.

Thomson Reuters Foundation run a blog by Dr James Hargreaves highlighting the need to develop HIV measurement and surveillance data to effectively identify and respond to new HIV infections: “How much confidence should we have when told, each year at this time, that things are getting better, or are not doing so? How do countries know where to focus their efforts in the coming year?….traditional approaches to tracking the epidemic are no longer fit for purpose.”

Increase visibility, advocate for work–life integration and eliminate the pay gap. Heidi Larson co-authors a new Lancet commentary with calls to action following the first Women Leaders in Global Health Conference. The School is hosting next year’s event.

Heidi also provides comment for the Guardian on Riko Muranaka winning the 2017 John Maddox prize for her work in countering HPV vaccine misinformation: “It is important for young women who have not yet been vaccinated, and for their parents, to have more information on the number of girls around the world who have been successfully vaccinated without any negative reactions, and to understand better what it means to have cervical cancer.”

Stephen Evans is quoted in The Guardian on a new study published in Annals of Oncology, which finds that the cancer drug nivolumab can reduce the reservoir of dormant HIV cells in the body and boost the immune response of a patient: “We need larger randomised trials to see if this or similar anti-cancer drugs might have a notable effect on the HIV reservoir. Until we have such data, talks of cure are premature, but it could lead to new approaches in dealing with HIV.”

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II MeSH Scientific Symposium (December 2017)

In May, 2015 WHO & UNAIDS held their third global consultation meeting on HIV surveillance in Bangkok. Over four days, discussions focused on recognising priority gaps in current surveillance systems, identifying the surveillance data needed to monitor achievement of long term goals such as the 90-90-90 indicators, and consolidating a global surveillance agenda to guide global and national programmes. To reflect these discussions, the MeSH consortium, in close partnership with WHO & UNAIDS have released a theme edition in JMIR Public Health and Surveillance. The title of the theme edition is “Improving global and national responses to the HIV epidemic through high quality HIV surveillance data”. The theme edition will be released on Tuesday 5th December at the II MeSH International Scientific Symposium.

On Tuesday 5th and Wednesday 6th December, the MeSH Consortium is to convene an international scientific symposium entitled “Building confidence in the collection and use of quality HIV data”. The symposium is being held in the Cradle of Humankind near to Johannesburg, South Africa. Through a series of presentations, discussions and activities, participants will consider how best to respond to emerging threats to HIV surveillance efforts and provide a sustainable approach to tracking and responding to the HIV epidemic in sub-Saharan Africa. Dr Linda-Gail Bekker, president of the International AIDS Society and Deputy Director of the Desmond Tutu HIV Centre in South Africa, will open the symposium and Dr Anton Pozniak, president elect of the International AIDS Society, will make a video address. Among the expert group of public health practitioners who will present on innovative and efficient methods to use and improve routine HIV data, Dr Yogan Pillay, Deputy Director General of HIV/AIDS, TB and Maternal, Child and Women’s Health in the South African Department of Health, will present a keynote speech on using data to strengthen health systems.

Keep up to date with discussions at the symposium by following our twitter account here.

 

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100&Change: countdown to final pitch to win $100 million grant

By Ninha Silva (MSc in Public Health Candidate)

The countdown to 100&Change final has started.  In exactly seven days, 11th of December 2017, the four finalists of the MacArthur Foundation’s competition will be presenting their final pitch to the judging panel. The winner of the $100 million grant will be announced, at a date to be confirmed, after a live presentation to an audience of funders, non-profit leaders, experts and MacArthur’s Board of Directors, in Chicago.

When the MacArthur Foundation announced the 100&Change competition in March 2016, they called for proposals promising to deliver meaningful and durable change in any part of the world. Nearly 2000 proposals were submitted in response to this call and only eight made it through the semi-finals in February 2017. The four finalists were announced on the 19h of September, following months of active work and engagement with their target communities and close work with the MacArthur Foundation.

Professor Joy Lawn, Director of the Maternal, Adolescent, Reproductive & Child Health (MARCH) Center, at LSHTM, is one of the four finalists. Professor Lawn entered the 100&Change competition with NEST360°, a proposal developed in collaboration with Rice University, University of Malawi College of Medicine; University of Malawi Polytechnic, Northwestern Kellogg School Management and 3Rd Stone Design.

The NEST360° team aims to reduce newborn deaths in African hospitals by 50%. According to UN’s data, approximately 7,000 newborns die every day around the world and over 1 million African babies are estimated to die in the first four weeks of life each year. The team led by Rice University, believes that these numbers can be reduced with Newborn Essential Solutions and Technologies (NEST).

NEST is a package comprising 17 affordable technologies that have the potential to tackle all the main causes of newborn deaths, and deliver quality and comprehensive care to newborns.

These technologies have been available in high income countries for the past 50 years. However, due to conditions such as intermittent electricity and harsh environmental conditions, their use is not sustainable in African hospitals and, additionally, the existing market does not ensure a reliable distribution of medical devices.

Copyright: Rice360 Institute for Global Health

According to the team, this problem could be averted in three steps:

  1. refined NEST package (NESTech) – including technologies but also health systems inputs required for use and maintenance- for both clinicians and biomedical engineers (NESTeach);
  2. establishing evidence of the effect of the package with a large-scale trial, resulting in more demand for technologies;
  3. developing a new non-profit distribution system for affordable delivery (NEST.org).

The programme is currently in the scale up phase throughout Malawi, which will be followed by a cost-effectiveness evaluation in Tanzania. Then, the team expects to focus on refining the market and service strategies in Nigeria and establishing a non-profit distributor in Tanzania and Nigeria.

Working towards the 100&Change’s requirement for sustainable solutions, the team also proposes to invest in and support the education of the next generation of biomedical innovators and clinicians able to lead systems change to improve newborn health in Africa.

Competing against NEST360° for the chance of winning $100 million grant are:

Catholic Relief Services: targeting the 8 million children around the world that live in orphanages. They propose to change the way society cares for children that are sent to orphanages and to build infrastructure to reunite them with their families and transforming orphanages into family service providers.

HarvestPlus: the team aims to eliminate hidden hunger by developing Biofortification, a process of enriching foods through conventional plant breeding. The team currently reaches 26 million around the world with this technique and they expect to reach 1 billion people globally by 2030.

Sesame Worksop and the International Rescue Committee: they propose to target the refugee crisis using the power of mass media, by delivering a care program delivered through home visits and mobile messages and through creation of an early learning program delivered in multi-platforms.

As the grand finale quickly approaches, the four teams are left with one last chance – the presentation in Chicago – to convince the Board of Directors that one of them has the best long-term solution and therefore, should win the $100 million award to implement the up to six years projects.

You can check video highlights and live updates via MARCH Centre twitter account – @MARCH_LSHTM – and follow the conversation using #100andchange #NEST360.

Project proposal page: http://bit.ly/2jTQtOK

NEST360: http://www.rice360.rice.edu/nest-360?id=84

YouTube video about NEST360: http://bit.ly/2AfHmMp