Scaling up the impact of agroforestry: Lessons from three sites in Africa and Asia

2004 ◽  
pp. 329-344 ◽  
Author(s):  
S. Franzel ◽  
G. L. Denning ◽  
J. P. B. Lillesø ◽  
A. R. Mercado
Keyword(s):  
Scaling Up ◽  
The Impact

scholarly journals Projecting the impact of nutrition policy to improve child stunting: A case study in Guatemala using the Lives Saved Tool

2021 ◽  
Author(s):  
Scott Tschida ◽  
Ana Cordon ◽  
Gabriela Asturias ◽  
Mónica Mazariegos ◽  
María F Kroker-Lobos ◽  
...  
Keyword(s):  
Scaling Up ◽  
Nutrition Policy ◽  
Nutrition Interventions ◽  
Historical Trends ◽  
Intervention Coverage ◽  
Child Stunting ◽  
Lives Saved Tool ◽  
Global Health Issue ◽  
The Impact

Background: Child stunting is a critical global health issue. Guatemala has one of the world′s highest levels of stunting despite sustained commitment to international nutrition policy best-practices endorsed by the Scaling Up Nutrition movement (SUN). Our objective was to use Guatemala as a case study by projecting the impact of a recently published national nutrition policy, the Great Crusade, that is consistent with SUN principles. Methods: We used the Lives Saved Tool (LiST) to project the scaling-up of nutrition interventions proposed in the Great Crusade and recommended by SUN. Our outcomes were changes in stunting prevalence, number of stunting cases averted, and number of cases averted by intervention in children under five years of age from 2020–2030. We considered four scenarios: (1) intervention coverage continues based on historical trends, (2) coverage targets in the Great Crusade are achieved, (3) coverage targets in the Great Crusade are achieved with reduced fertility risk, and (4) coverage reaches an aspirational level. Results: All scenarios led to modest reductions in stunting prevalence. In 2024, stunting prevalence was estimated to change by -0.1‰ (95‰ CI 0.0‰ to -0.2‰) if historical trends continue, -1.1‰ (95‰ CI -0.8‰ to -1.5‰) in the Great Crusade scenario, and -2.2‰ (95‰ CI -1.6‰ to -3.0‰) in the aspirational scenario. In 2030, we projected a stunting prevalence of -0.4‰ (95‰ CI -0.2‰ to -0.8‰) and -3.7‰ (95‰ CI -2.8‰ to -5.1‰) in the historical trends and aspirational scenario, respectively. Complementary feeding, sanitation, and breastfeeding were the most impactful interventions across models. Conclusions: Targeted reductions in child stunting prevalence in Guatemala are unlikely to be achieved solely based on increases in intervention coverage. Our results show the limitations of current paradigms recommended by the international nutrition community. Policies and strategies are needed that address the broader structural drivers of stunting.

Scaling up access to antiretroviral treatment for HIV infection: the impact of decentralization of healthcare delivery in Cameroon

AIDS ◽  
2010 ◽  
Vol 24 (Suppl 1) ◽  
pp. S5-S15 ◽  
Author(s):  
Sylvie Boyer ◽  
Fred Eboko ◽  
Mamadou Camara ◽  
Claude Abé ◽  
Mathias Eric Owona Nguini ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Antiretroviral Treatment ◽  
Healthcare Delivery ◽  
Scaling Up ◽  
The Impact

scholarly journals Investment case for two-year post university speciality training in family medicine in Tajikistan: how much is needed for continuing and scaling up the improved education of family doctors?

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jari Kempers ◽  
Leah F. Bohle ◽  
Alexandra Topa ◽  
Greta Ross ◽  
Zukhra Kasymova ◽  
...  
Keyword(s):  
Family Medicine ◽  
Clinical Skills ◽  
Scale Up ◽  
Scaling Up ◽  
Gradual Transition ◽  
Theoretical Knowledge ◽  
Family Doctors ◽  
International Support ◽  
Speciality Training ◽  
The Impact

Abstract Background A new two-year Post University Specialty Training (PUST) programme in family medicine was introduced to improve the quality of postgraduate speciality medical education in Tajikistan. Postgraduate education of family doctors (FDs) needs to be urgently scaled up, as 38% of FD positions in Tajikistan remained unfilled in 2018. Moreover, the international financial support for the PUST programme is ending. This investment case assesses the minimum funding needed for the continuation and scale-up of PUST and establishes the rationale for the investment in the light of a recent evaluation. Methods The costs of the programme were calculated for 2018 and a scale-up forecast made for the period 2019–2023. The impact of the scale-up on the shortage of FDs was assessed. An evaluation using a Multiple Choice Questionnaire and Objective Structured Clinical Examination (OSCE) assessed and compared theoretical knowledge, clinical skills and competencies of PUST trained and conventionally trained FDs. Results The annual costs of the programme were US$ 228,000 in 2018. The total investment needed for scaling up PUST from 31 new FDs in 2018 to 100 FD graduates each year by 2023 was US$ 802,000.However, when the retirement of FDs and population growth are considered, the scale-up will result only in maintaining the current level of FDs working and not solve the country’s FD shortage. The PUST FDs demonstrated significantly better clinical skills than the conventionally trained interns, scoring 60 and 45% of OSCE points, respectively. Theoretical knowledge showed a similar trend; PUST FDs answered 44% and interns 38% of the questions correctly. Conclusions The two-year PUST programme has clearly demonstrated it produces better skilled family doctors than the conventional one-year internship, albeit some enduring quality concerns do still prevail. The discontinuation of international support for PUST would be a major setback and risks potentially losing the benefits of the programme for family medicine and also other specialities. To guarantee the supply of adequately trained FDs and address the FD shortage, the PUST should be continued and scaled up. Therefore, it is essential that international support is extended and a gradual transition to sustainable national financing gets underway.

scholarly journals TO CONTROL OR NOT TO CONTROL: HOW DO WE LEARN MORE ABOUT HOW AGRONOMIC INNOVATIONS PERFORM ON FARMS?

2017 ◽  
Vol 55 (S1) ◽  
pp. 303-309 ◽  
Author(s):  
RIC COE ◽  
JOYCE NJOLOMA ◽  
FERGUS SINCLAIR
Keyword(s):  
Crop Yield ◽  
Real World ◽  
Crop Management ◽  
Maize Yield ◽  
Scaling Up ◽  
System Response ◽  
Main Concern ◽  
The Real ◽  
Important Variation ◽  
The Impact

SUMMARYOur paper ‘Loading the dice in favour of the farmer: reducing the risk of adopting agronomic innovations’ revealed mean increases but also large variation in the impact of four agroforestry practises on maize yield, as experienced by farmers in Malawi. This prompted a response from Sileshi and Akinnifesi that was critical of the data and methods used. Their main concern was that farmers did not necessarily manage crops identically in plots with and those without trees, so the yield differences that we measured may be partly caused by these differences in crop management. We argue here that it is valid and useful to look at the actual effect on crop yield of farmers having trees intercropped with maize, rather than controlling for how the crop is managed, because this is what happens in the real world. Farmers respond to having trees in their field by treating their crop differently, so this is part of the system response to having trees in fields. Attempts to eliminate this will result in measuring an artefact rather than the real impact of trees on crop yield. By doing this, we revealed important variation in the impact of trees on crop yield amongst farmers, and we argue that it is important to explore, assess and communicate to farmers and development actors the extent and implications of this variation. Understanding the contextual factors that determine who is likely to benefit most from an innovation and for whom it is less suitable can then be incorporated in scaling up, so that targeting of innovations and the appropriateness of messages given to farmers are continuously refined.

scholarly journals Innovation imperatives of global financial innovation and development of their matrix models

2021 ◽  
Vol 18 (3) ◽  
pp. 312-326
Author(s):  
Nataliia Savchuk ◽  
Tetiana Bludova ◽  
Dmytro Leonov ◽  
Olena Murashko ◽  
Nataliia Shelud’ko
Keyword(s):  
Financial Market ◽  
Financial Services ◽  
New Technologies ◽  
Financial Innovation ◽  
Scaling Up ◽  
Strategic Decisions ◽  
Financial Innovations ◽  
The Matrix ◽  
S Curve ◽  
The Impact

The global financial market is undergoing transformational changes under the growing influence of innovative factors. Such changes are due, in particular, to the concentration and scaling up and diversification of the structure of financial services, the renewal of the financial sector on the basis of FinTech operations and blockchain technologies. This requires taking into account the impact of innovation factors on the transformation of the financial market in the dimension of FinTech. The study aims to identify the imperatives of global financial innovation and show ways to develop innovative models in the interpretation of S-curves for next-generation products using new technologies when key technologies on the previous S-curve become obsolete. Also, the matrix of financial innovations is presented and the synergy of its innovation models is proved.The results of the study are to prove that each of the presented models is not independent, it evolves and develops itself, as well as affects other models. This made it possible to identify prognostic pathways for the development of innovative models in their synergy in the form of two-ring motion. Thus, the study emphasizes the need for further research aimed at developing innovative models that will determine strategic decisions in the formation of innovation imperatives.

scholarly journals Scaling up care for perinatal depression for improved maternal and infant health (SPECTRA): protocol of a hybrid implementation study of the impact of a cascade training of primary maternal care providers in Nigeria

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Oye Gureje ◽  
Bibilola Oladeji ◽  
Olatunde Olayinka Ayinde ◽  
Lola Kola ◽  
Jibril Abdulmalik ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Phase I ◽  
Maternal Care ◽  
Perinatal Depression ◽  
Post Partum ◽  
Scaling Up ◽  
Phase Iii ◽  
Level Of Care ◽  
Care Providers ◽  
The Impact

Abstract Background The large treatment gap for mental disorders in low- and middle-income countries (LMIC) necessitates task-sharing approaches in scaling up care for mental disorders. Previous work have shown that primary health care workers (PHCW) can be trained to recognize and respond to common mental disorders but there are lingering questions around sustainable implementation and scale-up in real world settings. Method This project is a hybrid implementation-effectiveness study guided by the Replicating Effective Programmes Framework. It will be conducted in four overlapping phases in maternal care clinics (MCC) in 11 local government areas in and around Ibadan metropolis, Nigeria. In Phase I, engagement meetings with relevant stake holders will be held. In phase II, the organizational and clinical profiles of MCC to deliver chronic depression care will be assessed, using interviews and a standardized assessment tool administered to staff and managers of the clinics. To ascertain the current level of care, 167 consecutive women presenting for antenatal care for the first time and who screened positive for depression will be recruited and followed up till 12 months post-partum. In phase III, we will design and implement a cascade training programme for PHCW, to equip them to identify and treat perinatal depression. In phase IV, a second cohort of 334 antenatal women will be recruited and followed up as in Phase I, to ascertain post-training level of care. The primary implementation outcome is change in the identification and treatment of perinatal depression by the PHCW while the primary effectiveness outcome is recovery from depression among the women at 6 months post-partum. A range of mixed-method approaches will be used to explore secondary implementation outcomes, including fidelity and acceptability. Secondary effectiveness outcomes are measures of disability and of infant outcomes. Discussion This study represents an attempt to systematically assess and document an implementation strategy that could inform the scaling up of evidence based interventions for perinatal depression using the WHO mhGAP-IG in LMIC. Trial registration This study was registered on 03 December, 2019. https://doi.org/10.1186/ISRCTN94230307.

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