“Welcome! Grab a packet of popcorn and have a seat,” our hostess said. We were here to watch a movie about Mandla, a South African miner who moonlighted as lead singer for a band called the Lucky Specials. About halfway through the movie, Mandla says, “actually, I don’t feel lucky or special right now.” I had to agree with him. Poor Mandla was sick with multidrug-resistant tuberculosis (MDR-TB). He had failed to complete his TB treatment which resulted in the bacteria mutating into a deadly microbe that the World Health Organization says caused approximately 250,000 deaths worldwide in 2015. Fortunately for him, by the end of the movie, Mandla had won back his health and landed an opportunity for his band to play at an international music festival.
The Lucky Specials was screened at a public engagement workshop I attended on March 6-8, 2017, in Naivasha, Kenya. The workshop was hosted by the Wellcome Trust Public Engagement division and had over 50 participants drawn from Africa, Asia and Europe. Participants were there to investigate the theme of complexity in modern science and explore different tools that public engagement practitioners can use to navigate complex scientific ideas in interactions with lay audiences.
Lucky Specials is one such tool that uses innovative methods to communicate messages to audiences. The movie masterfully blended information on TB including its propagation, impacts and treatment, with an engrossing storyline about Mandla and the band. Following its screening, workshop participants engaged in a discussion about the movie’s use in TB education campaigns around Africa. Then came the million-dollar question.
“How much was it to make this movie?” someone asked.
“Just over a million dollars,” replied Maureen Lemire from Discovery Learning Alliance, the organization behind the movie’s production. When combined with the efforts that went into outreach, distribution, measurement and evaluation, the total cost added up to US$2 million.
Not many organizations have resources like that to use in public engagement. Fortunately, the workshop also showcased low-cost methods that can be used to communicate complex scientific concepts. For instance, Alex Adadevoh from Lightyear Foundation in Ghana demonstrated how they have used a balloon, coins, a set of keys and a water tumbler to teach school children about why ships float. Brian Mackenwells from the Wellcome Trust Center for Human Genetics used a set of playing cards to communicate the link between malaria and genetics. These concepts may seem complicated but the two were able to convey the information in a clear and engaging manner. They demonstrated that effective public engagement does not have to be expensive.
The timing of this workshop could not have been better. At a time when the world is said to be moving into a post-truth era characterized by ‘alternative facts’ and mistrust of experts by the public, communication that conveys factual information and also connects with mass audiences is sorely needed. The world contains countless complexities, which are reflected in science. Public engagement has a crucial role to play in ‘simplifying the complex’ and making science accessible.
But there is a fine line between simplification and over-simplification, which can result in a loss of core scientific tenets. Navigating that fine line is a skill that those involved in public engagement have to master when communicating with communities and lay audiences.
The workshop was an eye-opening experience for me in many senses. I learned about the different tools that can be used in public engagement, ranging from the low-cost to multi-million dollar items. It also offered many wonderful opportunities to connect with a group of people who are passionate about effective science communication. The biggest take-away for me was to think boldly and imaginatively when preparing to engage lay audiences with scientific research – I certainly hope to apply this in future APHRC public engagement sessions.
By Alex Ezeh
-As part of his proposed first budget, US President Donald Trump has threatened to cut US aid to levels not seen since the 1970s and 1990s. This could have a devastating effect on healthcare in Africa. Alex Ezeh spoke to The Conversation Africa about Trump’s decision and what it means.
How important is US aid been to health?
It’s impossible to overstate the historic importance of US development assistance to Africa. The US provides aid to more than 100 countries to support global peace, security, development efforts and to provide humanitarian relief. Foreign assistance is run through more than 20 different US government agencies.
The US also contributes to various international organisations such as the Global Fund, which aims to end AIDS, tuberculosis and malaria as epidemics, as well as the United Nations agencies. The reality is that this support has made a significant impact.
Health is particularly vulnerable. For instance, the Global Fund and the US president’s Emergency Plan for AIDS Relief (commonly known as PEPFAR) have jointly turned the tide on the epidemic of HIV/AIDS – in sub-Saharan Africa as well as the rest of the world.
Since it was created in 2002 the Global Fund to Fight AIDS, Tuberculosis (TB) and Malaria has contributed to saving an estimated 22 million lives worldwide. Its greatest impact has been in sub-Saharan Africa, which shoulders the world’s highest burdens of the three diseases.
The Global Fund has invested some US$30 billion over the past 15 years, about 65% of which has been directed to the continent. Even so, the epidemics continue to take an unacceptably high toll in terms of health and economic development.
What big funding programmes could face the chop?
The US has historically contributed one-third of the Global Fund’s budget, which flows to countries with high disease burden of HIV/AIDS, tuberculosis, and/or malaria, and the least ability to pay for services and health commodities for prevention, diagnosis and care. In August 2016 the US government said it would contribute up to US$4.3 billion to the Global Fund.
If the US doesn’t follow through on its pledge, one possible scenario is that other countries may step up more, including national governments in low and middle-income countries. But this may affect other development priorities as funds get shifted from other important programs to cover the huge shortfall.
In terms of big funding programmes at stake, the US has already announced that it’s withdrawing US$32 million in funding from the UN Population Fund which directs money to family planning.
The dramatic declines in maternal and child mortality since 1990 cannot continue without sustained investment in maternal and child health, of which family planning is a crucial element.
We know that when women are able to plan and space their children, it protects their lives and those of their children. Given the projected doubling of Africa’s population to 2.5 billion by 2050 and 4.4 billion by 2100, and the commitment of African governments to fast track investments in human capital to achieve the demographic dividend, now is the time to increase investments in family planning programmes in the region.
The US’s contribution amounts to just over 3% of the UN Population Fund’s total annual budget, so the immediate programmatic impact may be offset by other countries increasing their annual contributions, which has started to take place. For example, in March 2017 Sweden announced a US$22 million increase. The country is considered a top funder to the programme. The longer-term impact, however, could be more pervasive.
How can gaps in health financing be filled?
There’s evidence that aid has stifled domestic investment in health and other social sectors including education, and infrastructure. This must change.
There’s a critical need to meet the demand for full health funding. Donor aid helps, but countries on the continent must contribute more money, and must continue to increase funding more rapidly in coming years.
If aid is cut there’s an opportunity for African countries to make good on their pledges to increase domestic financing for health. (This is true regardless of what the US decides).
The Abuja Declaration, now 16 years old, saw African Union countries commit to dedicating 15% of their national budgets to health. Very few have met this target, and unfortunately, in some countries it’s difficult to know for sure whether funding has gone up or down due to poor quality data.
One thing is for sure: this is a rapidly shifting global health development landscape. Now is the time to explore innovative financing mechanisms and partnerships with traditional and non-traditional donors, and also for citizens of African countries and donor countries alike to hold their national decision-makers to account in honouring their commitments.
This article was first published on the Conversation – https://theconversation.com/africa
By Benta Abuya, via The Conversation Africa
Every child and parent in Kenya knows all too well that grades matter. During the final year of primary school, pupils sit to write a nationally administered exam that determines their progression to secondary school. Children have to attain high grades in the Kenya Certificate of Primary Education (KCPE) to secure places in the best secondary schools – public or private.
Here too, the teachers emphasise attainment of high grades, perhaps even more than back in primary school. Long hours in class are just a part of the preparation for the final exam which determines admission into university.
Private schools, which many parents opt for, have a financial incentive to pursue high grades for their students. When these schools attain a high mean grade, they draw more students into their ranks which translates into higher revenues.
This obsession with high exam grades means extra pressure on children to cram content in order to pass a series of internal exams leading up to KCSE. It also means that schools have little time to pay attention to learners who are struggling with the challenges of adolescence.
Learners received little guidance on appropriate coping mechanisms that would enable them to deal with the academic pressures and other life changes that they were experiencing. Those that became truant and undisciplined were eventually pushed out of the school because they weren’t meeting the minimum grades expected.
But a fundamental change is about to take place. A new education system is set to replace the 32 year-old 8-4-4 system which has come to symbolise much of what’s wrong with education in Kenya today. The current system of education starts with eight years of primary school followed by four years each for secondary school and university.
The changes mean that children will have an opportunity to be children. They will not be pressured to get high scores so that they can join the so-called ‘good schools’. Children will be able to learn at their own pace and not be pawns in an education system that’s obsessed with high mean scores.
The changes proposed in the new curriculum are aligned to the vision of the new curriculum reform and that is to
enable every Kenyan to become an engaged, empowered and ethical citizen. This will be achieved by providing every Kenyan learner with world class standards in the skills and knowledge that they deserve, and which they need in order to thrive in the 21st century
Children will be children
The new 220.127.116.11.3. curriculum is designed to place children’s needs before those of their teachers, schools and parents. It aims to enable every Kenyan child to be an engaged, empowered and ethical citizen. This will be accomplished by equipping teachers with the means to teach well, within school environments that have adequate resources for every learner.
Effective delivery of the curriculum will require knowledgeable and professional teachers who can use appropriate teaching methodologies including coaching, facilitation, and mentoring. In this way, teachers will be viewed as role models who inspire learners to achieve their potential.
Moreover, teachers will need to adapt this curriculum to meet the requirements, interests, and talents of every child, while diagnosing the learner’s needs and collaborating with other significant people in the child’s life such as parents and members of the local and wider community.
Another change in the new curriculum is elimination of summative evaluation. This refers to exams that were done at the end of 8 years of primary school, four years of secondary school, and four years of high school, in the 8.4.4 system of education. Instead, it spreads out the evaluation throughout the duration of the child’s stay in school.
Children will be assessed based on their competencies, meaning their ability to apply knowledge and skills in performing various tasks within specific settings. This will help determine the individual strengths and weaknesses of the learners.
There will be two types of evaluation in upper primary. Formative assessment will be continuously administered from grades 4-6. This will enable the continuous monitoring of learning and provide regular feedback that teachers can use to improve their delivery.
Summative assessment for a group of randomly selected learners from across the country, will be administered at the end of grade 6. Their performance will be used to gauge the overall ability of all the students transitioning to Grade 7. In doing so, the new curriculum moves away from a one-off summative assessment and embraces an approach where all children’s abilities are recognised and appreciated.
Navigating life’s challenges
They will also be exposed to life skills from pre-primary in addition to all the other subjects that they will be taught. This will ensure that from an early age, children have the opportunity to acquire the necessary skills to help them navigate life’s challenges as they progress with their education.
According to UNICEF
life skills refer to both psycho social and interpersonal skills that can assist people to make informed decisions, communicate effectively and develop coping and self-management skills that would help lead to a healthy and productive life.
Children in senior secondary will be exposed to community service and physical education. The assessment of this level of education will be based on project work, national examinations and community service, in which parents and other stakeholders will be involved. Moreover, parents and other players will help in identifying opportunities for the learners to apply their competencies. Teachers will then document the learner’s achievement.
This emphasis on parental involvement reflects the importance that the curriculum places on the role of parents. Parental involvement has been a key component of two intervention studies conducted by the African Population and Health Research Centre (APHRC), in Nairobi’s informal settlements.
APHRC research has documented that the school is just one place where the teaching of life skills occurs. In the home and family setting, parents shape the attitudes, skills, and values that young people acquire. The project, Improving Learning Outcomes and Transition to Secondary School, showed that communication between parents and their children improved learning outcomes.
More research shows that parental communication with a child of the opposite gender (father to daughter and mother to son) significantly reduces risky behaviour and delays sexual activity among adolescents.
The new curriculum therefore offers parents the opportunity to be involved in their children’s education. These empowered parents will take the initiative to participate in school, at home and within the community. More importantly, the curriculum will help ensure the holistic development of children within a friendly learning environment.
Many cultures regard the issue of food and feeding the family as the role of the woman. Women are expected to source for food, prepare it and serve to their families. While society’s view on this issue may be changing, the Maasai community still considers matters related to food and nutrition primarily as a woman’s responsibility.
This was confirmed in a community engagement project implemented by the African Population and Health Research Center (APHRC) among the Maasai in Kajiado County, located southwest of the Kenyan capital, Nairobi. The project was carried out in two communities – Lenkobei and Oloika.
The project called Voices for Action, examined the vulnerability of Maasai women and children to food and nutrition insecurity as well as solutions that would enhance security. We initiated it following an earlier public engagement project in Kajiado which showed that food insecurity was one of the key factors influencing breastfeeding practices of women in the Maasai community.
While the common cultural perception is that improving household food and nutrition security is a woman’s responsibility, in reality, their ability to do so is limited by their perceived lower status in the Maasai community. Findings from the APHRC study show that gender inequality increases their individual and household vulnerability to food and nutrition insecurity.
Some of these findings include:
Women do not have the autonomy to make decisions about food that is bought for the household. Among the Maasai, men are the ones who primarily buy food for the household while the woman informs them on what is needed. The men indicated that depending on how far the market was, they would decide if it made sense to buy perishable foods like vegetables, or non-perishables like dried beans and maize. The only women who appeared to be able to make independent decisions on food purchases were those with small businesses as they earned an income which boosted their buying power.
Another issue was that of pregnant women not being allowed to eat “too much”. This is thought to prevent the baby getting big which may lead to delivery complications. Though this practice is declining in the community, APHRC research revealed that many pregnant women were overworked and underfed, leading to health complications. In many cases, the pregnant woman did not have a choice about the intensity of work done, she had to do as directed by her husband or mother-in-law. Overworking the pregnant woman was also seen as a way of keeping her from growing big which could lead to delivery complications. This decision was either made by the husband, the father- or the mother-in law.
One of the Maasai woman’s main roles is fetching water for the household. During the dry season, women walk long distances to find this valuable resource. The women are not allowed to carry food while fetching water as it is taboo for them to be seen eating by members of other age groups. Instead they have to wait until they get home to eat, which in most cases would be after six to eight hours.
“We have water shortage, our source is far away and it is not clean. You can have food but no water to prepare it….the distance is about 6 hours to and from the dam,” said a young Maasai woman.
After all the hard work outside the home during the day, more work awaits the Maasai woman at home.
“You can see her (pregnant woman) looking after livestock, carrying water and she is probably expected to come back in the evening and cook. This is risky for the child and mother’s health. She needs to rest but she has no option,” explained a young mother.
During mealtimes, women are expected to eat last including pregnant and breastfeeding mothers. In cases where there is insufficient food, children are fed first and the adults either forgo eating or have reduced portions. In some cases, if the man has brought something like one bag of maize flour, the woman prepares ugali (starchy maize dish) for him and porridge for her and the children, so as to ensure the flour lasts for several meals.
Sometimes the man may leave the homestead to buy food and not return for several days. In such cases, women are not allowed to slaughter animals even if there was no food in the house. Instead, they would have to borrow from their neighbors who may be similarly impoverished.
The findings above show that Maasai women in the communities of Oloika and Lenkobei have little autonomy. This increases their individual and household vulnerability to food and nutrition insecurity.
In the midst of all the challenges that Maasai women face, there is a glimmer of hope as there is greater awareness within the community about the need for pregnant women to eat well. However, this knowledge is still not applied widely enough.
Our findings point to the need to empower women by providing support which would enable them to start businesses and strengthen their financial status. As noted earlier, women who ran a business and earned an income had greater autonomy in decision making on their household food needs. It will also be necessary to further increase awareness within the community on the importance of supporting pregnant women to ensure healthy pregnancy outcomes for both the mothers and their newborns.
Blog written by Carol Wangui Wainaina
Leading social scientists, non-governmental organizations, donors and policymakers from around the globe launched a collection of articles titled “The Social Realities of Knowledge for Development.” The collection that was launched at a high profile event convened by Institute of Development Studies, Overseas Development Institute and International Institute for Environment and Development highlights the implicit social nature of evidence-informed decision making.
APHRC contributed two chapters to the collection. Pamela Juma, Associate Research Scientist, wrote Evidence-informed decision-making: Experience from the design and implementation of community health strategy in Kenya with Dan Kaseje. Danielle Doughman, Policy Outreach Manager, contributed Using knowledge brokerage to strengthen African voices in global decision-making on HIV and AIDS with co-authors Kathy Kantengwa and Ida Hakizinka.
Jointly funded by the ESRC- DFID- Impact Initiative for international development research and the Institute of Development Studies, the collection also brings to the fore the importance of relationships and networks throughout the process of research impact, which can be scattered and intangible.
James Georgalakis the co-editor of the collection and Director of the Impact Initiative says, “While it has been easy to share significant successes of getting research into action through impact awards and case studies, it has proved much harder to institutionalize any learning from these. Put simply, the development sector has continued to struggle to repeat the trick of turning research into action.”
In their introduction, the co-editors, James Georgalakis, Nasreen Jessani, Rose Oronje and Ben Ramalingam, emphasize a key-takeaway message from the collection – that while technical capacities matter, research to policy processes are fundamentally social.
They indicate a number of factors that underpin the social realities of knowledge for development that include:
In her foreword to the collection Sarah Cook, Director, UNICEF Innocenti Research Centre highlights: “This useful collection illustrates the varied and complex pathways through which research, knowledge or evidence may (or may not) be taken up by policymakers and practitioners. Drawing on examples of research into policy/practice relationships, from context-specific action research, to engaging with embedded, national policy institutions and global processes.”
The trend for, and debates around, evidence-informed development has expanded considerably over the past three decades. It emerged in the 1990s in health as an outcome of evidence-based medical practice. However, despite this history, and as many commentators suggest, the progress in how well evidence informs development policy and practice is at best uneven.
The Social Realities of Knowledge for Development is the latest offering from the Impact Initiative’s Impact Lab. The Lab has been assessing the key barriers to research impact, documenting case studies and publishing a series of Learning Guides on evidence informed policy and practice.
To download the collection for free and access the Learning Lab’s other resources go to: www.theimpactinitiative.net