Publications

Review of a narrative report from the breastfeeding consortium on content & structure. Sida is funding this consortium and the narrative report was to inform Sida about the work that had been conducted.

Quality assurance is an important aspect of seed production and marketing. External quality assurance is often seen as the centre piece of the seed sector, and so when aiming to strengthen seed sector functioning, the automatic response is to improve seed certification systems. However, there is little evidence of well-functioning seed certification systems in sub-Saharan Africa.This paper investigates the different kinds of quality assurance mechanisms that are being used, and in which circumstances they work

Providing comments and feedback on a joint vision paper on UHC.

Agricultural research for development (AR4D) organizations can achieve greater impact by using complexity aware approaches, but for this to happen a more compelling case needs to be made to justify their use. Our contribution is to develop and test a generalizable complexity-aware theory of change of how AR4D fosters innovation.

Making a profit from seed production and marketing is clearly easier for some crops than for others. Farmers would benefit from a reliable availability of good quality seeds for crops and a continuous supply of varieties with different traits, adapted to continuously changing agro-ecological conditions and market demands. To achieve this, a functioning market with seed entrepreneurs seeking to make a profit out of seed production and marketing is needed.This paper addresses the question: ‘How can the production of crops with low profit margins on seed be turned into a business?’

Responsiveness is a key objective of national health systems. Responsive health systems anticipate and adapt to existing and future health needs, thus contributing to better health outcomes. Of all the health systems objectives, responsiveness is the least studied, which perhaps reflects lack of comprehensive frameworks that go beyond the normative characteristics of responsive services. This paper contributes to a growing, yet limited, knowledge on this topic. Herewith, we review the current frameworks for understanding health systems responsiveness and drawing on these, as well as key frameworks from the wider public services literature, propose a comprehensive conceptual framework for health systems responsiveness. This paper should be of interest to different stakeholders who are engaged in analysing and improving health systems responsiveness. Our review shows that existing knowledge on health systems responsiveness can be extended along the three areas. First, responsiveness entails an actual experience of people’s interaction with their health system, which
confirms or disconfirms their initial expectations of the system. Second, the experience of interaction is shaped by both the people and the health systems sides of this interaction. Third, different influences shape people’s
interaction with their health system, ultimately affecting their resultant experiences. Therefore, recognition of both people and health systems sides of interaction and their key determinants would enhance the conceptualisations of responsiveness. Our proposed framework builds on,
and advances, the core frameworks in the health systems literature. It positions the experience of interaction between people and health system as the centrepiece and recognises the determinants of responsiveness experience both from the health systems (eg, actors, processes) and
the people (eg, initial expectations) sides. While we hope to trigger further thinking on the conceptualisation of health system responsiveness, the proposed framework can guide assessments of, and interventions to strengthen, health systems responsiveness.

Background In India, the poor are increasingly forced to live in highly populated urban dwellings with inadequate living conditions including deficient service provision. This in turn affects their food security and negatively influences their health. In December 2012, Dilli Annashree Yojna (DAS), an unconditional cash transfer scheme was launched for the urban poor in Delhi to address food security and, ultimately, nutrition and health. Our study attempts to explore DAS for new elements like unconditionality and transfer to female head of family, use of benefits, operational issues and perceptions on its influence on health.

Reaching male youth through a multi-channel MI+ approach facilitates an open dialogue on SRHR issues among health care workers, peers and teachers.

Continuous, tailored SRHR information and education enable male youth to adopt healthy and positive attitudes to sexuality and to lead meaningful lives.

Is market concentration among large cocoa firms responsible for the widespread poverty among cocoa farmers? Probably not. While market concentration has increased, particularly among cocoa processors, the report does not find evidence that this concentration is excessive or that market power is being abused to keep prices artificially low.

Community health workers (CHWs) have a unique position between communities and the health sector. The strength of CHWs’ relationships with both sides influences their motivation and performance. This qualitative comparative study aimed at understanding similarities and differences in how relationships between CHWs, communities and the health sector were shaped in different Sub-Saharan African settings. 

There is a shortage of doctors working in rural areas all over the world, especially in low-income and middle-income countries. The choice to practise medicine in a rural area is influenced by many factors. Motivation developed as a medical student is one key determinant of this choice. This study explores influences on medical students’ motivation to practise in rural areas of low-income and middle-income countries following graduation.

Can agricultural extension systems deliver quality services to smallholder producers, often in remote areas? Yes, there is evidence that this is achieved in some developing and emerging economies. But this is by no means a common practice, and many extension systems continue to struggle with weak performance. This is paper 6 on this subject in a series of six: Incentives for enhanced performance of agricultural extension systems.

Assessing quality of health services, for example through supportive supervision, is essential for strengthening healthcare delivery. Most systematic health facility assessment mechanisms, however, are not suitable for routine supervision. The objective of this study is to describe a quality assessment methodology using an electronic format that can be embedded in supervision activities and conducted by council health staff.

Can agricultural extension systems deliver quality services to smallholder producers, often in remote areas? Yes, there is evidence that this is achieved in some developing and emerging economies. But this is by no means a common practice, and many extension systems continue to struggle with weak performance. This is paper 4 on this subject in a series of six: ICT in extension.

In India, over the last decade, a series of stewardship failures in the health system, particularly in the medical profession, have led to a massive erosion of trust in these institutions. In many low- and middle-income countries (LMICs), the situation is similar and has reached crisis proportions; this crisis requires urgent attention. This paper draws on the insights from the recent developments in India, to argue that a purely control-based regulatory response to this crisis in the medical profession, as is being currently envisaged by the Parliament and the Supreme Court of
India, runs the risk of undermining the trusting interpersonal relations between doctors and their patients. A more balanced approach which takes into account the differences between system and interpersonal forms of trust and distrust is warranted. Such an approach should on one hand strongly regulate the institutions mandated with the stewardship and qualities of care functions, and simultaneously on the other hand, initiate measures to nurture the trusting interpersonal relations between doctors and patients. The paper concludes by calling for doctors, and those
mandated with the stewardship of the profession, to individually and collectively, critically self-reflect upon the state of their profession, its priorities and its future direction.

The growth in private sector contributions to sustainable development, through investment, expertise and innovation, has led to calls for improved tracking and measurement of social and environmental impact. The CFC follows these developments closely and seeks to incorporate good impact measurement practices into its project appraisal and implementation process.

The WHO has approved a post-2015 Global End Tuberculosis Strategy for tuberculosis (TB) 50 prevention, care and control. Countries need to respond by adapting and enhancing their TB control activities. Justifying investment in effective TB control strategies in a country can be achieved in part by defining and monitoring the (MDR) TB epidemic to identify appropriate interventions.

In South Sudan, women disproportionately bear the burden of morbidity and mortality related to sexual and reproductive health, with a maternal mortality ratio of 789 deaths per 100,000 live births.