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Good Research, Great Video: What’s the Best Way to Motivate Community Health Workers?

Duncan Green's picture

Some more innovative work from the London School of Economics. This genuinely thought-provoking 8 minute video describes a collaboration between the LSE-hosted International Growth Centre and Zambia’s Ministry of Health. The background academic paper is here.

Researchers and officials worked together to answer an important question: to motivate people in rural villages to become rural community health workers (CHWs), is it best to appeal to their community spirit, or to their hopes for individual career development? If you do the latter, will people lose their link to the community, and replicate the problem with more standard professional health workers, many of whom hate working in rural areas, and head for the city?

To do that, they divided up 160 villages targeted for recruitment. In half they put up posters that stressed ‘come and serve your community’, in the rest they put the emphasis on careers (see above: figures 1a and 1b of the paper). Sure enough, the posters attracted different kinds of people to apply for CHW training.

Quote of the Week: Yuval Noah Harari

Sina Odugbemi's picture

"Everybody since the ‘60s has been saying the nation is a fiction, the nation is an imaginary unity, but people didn’t connect the dots and say all human endeavors sprang from the same principle.” 

- Yuval Noah Harari, author of the international bestseller Sapiens. He is a professor and lectures at the Department of History, Faculty of Humanities, Hebrew University of Jerusalem.

Theories of Change, Stakeholders, Imagined Beneficiaries, & Stealing from Product Design. That is, Meet ‘Mary.’

Heather Lanthorn's picture

I have been thinking a lot about ‘theories of change’ this week (as I was here).  Actually, I have been thinking more about ‘conceptual models,’ which was the term by which I was first introduced to the general idea* and the term I still prefer because it implies more uncertainty and greater scope for tinkering than does ‘theory.’ (I accept that ‘theory of change’ has been branded and that I have to live with it, but I don’t have to like it.)

Regardless of the term, the approach of thinking seriously about how behavioral, social and economic change happens is important but often overlooked during the planning stages of projects/programs/policies and linked evaluations. Moreover, they are glossed over in the analysis and reporting stages, left to academic speculation in the discussion section of an evaluation paper and not informed by talking systematically to those people who were intended to benefit from the program.

I think there is growing recognition that building a theory of change is something that should happen, at least in part, backwards (among other places where this is discussed is in ‘evidence-based policy’ with the idea of a ‘pre-mortem‘ and ‘thinking step-by-step and thinking backwards‘).  That is, you start with the end goal, usually some variant of ‘peace,’ ‘satisfaction,’ ‘wellbeing,’ ‘capabilities,’** etc., in mind and work backwards as to how you are going to get there from here.

Weekly Wire: The Global Forum

Roxanne Bauer's picture

These are some of the views and reports relevant to our readers that caught our attention this week.

Facebook Reaches a Landmark 100-Million Users in Africa Through Mobile
AllAfrica
Thanks to mobile connectivity, half of Africa's 200-million internet users were accessing Facebook on a monthly basis in June 2014, indicating that the social media giant's efforts at penetrating emerging market are paying off. There's explosive growth and incredible momentum across Africa. "We now have 100-million people coming to Facebook every month across the African continent with more than 80% using mobile devices," says Nicola Mendelsohn, Facebook vice president for Europe, Middle East and Africa.

UNICEF's Hidden in Plain Sight report details child homicides, domestic violence in 190 countries
Radio Australia
One in five homicide victims worldwide are children, a report by UN children's agency UNICEF has revealed. The Hidden in Plain Sight report analyses data from 190 countries and lists alarming statistics on child homicides, domestic violence and rape. The report found violence against children was most common in the home and with caregivers.  UNICEF spokesman for Eastern and Southern Africa, James Elder, said the report may not even capture the full extent of the problem.   "Violence is a very difficult thing often to detect, it goes grossly unreported, so one of the terrifying things from this report is knowing that in fact the numbers would be lower than the reality," he said.

The Best Evidence Yet on How Theories of Change are Being Used in Aid and Development Work

Duncan Green's picture

If you are interested in Theories of Change (ToCs), you have to read Craig Valters’ new paper ‘Theories of Change in International Development: Communication, Learning or Accountability’ or at least, his accompanying blog. The paper draws on the fascinating collaboration between the LSE and The Asia Foundation, in which TAF gave LSE researchers access to its country programmes and asked them to study their use of ToCs. That means Craig has been able to observe their use (and abuse) in practice.

What this paper helps answer is the question I raised a while ago – will ToCs go the way of the logframe, starting out as a good idea, but being steadily dumbed down into a counterproductive tickbox exercise by the procedural demands of the aid business?

Media (R)evolutions: Mobile Games by Market

Roxanne Bauer's picture

New developments and curiosities from a changing global media landscape: People, Spaces, Deliberation brings trends and events to your attention that illustrate that tomorrow's media environment will look very different from today's, and will have little resemblance to yesterday's.

Mobile games, developed for smartphones and tablets, represent an incredibly lucrative industry that is expanding very fast! They are the fastest growing segment of the overall games market, boasting a Cumulated Annual Growth Rate of 19%.  Revenues are expected to reach $21.7 billion in 2014 and $35.4 billion by 2017. The growth in mobile games is fueled by both an increase in the number of players worldwide but also a greater willingness on the part of consumers to spend money on mobile games. 

The following infographic illustrates that with 56% of the global revenue, Asia Pacific is the biggest market, and revenue within the region is estimated to reach $12.2 billion this year. However, Latin America takes the lead in terms of growth, with a year-on-year growth rate of 60% between 2013 and 2014.


 

The Things We Do: Shame is a Powerful Thing

Roxanne Bauer's picture

Billions of dollars are spent each year on sanitation, healthcare, and good governance, but the results vary quite a bit from place to place.  What separates successful programs from the unsuccessful?
 
Those that achieve their goals try to change behavior alongside introducing new methods or making investments. One way to change behavior is to use shame— an overwhelmingly negative emotion —to emotionally link individuals to the communities in which they live.
 
Shame and Sanitation

Shame was, in fact, a central ingredient to a program in Bangladesh that reduced the percentage of Bangladeshis defecating out in the open from 19% in 2000 to only 3% in 2012.

The program utilized the Community-Led Total Sanitation (CLTS) method, which “focuses on instigating a change in sanitation behaviour rather than constructing sanitation infrastructure.” Changes in sanitation behaviors are accomplished through a process of deliberation and discussion within communities to build consensus on the need to end open defecation and clarify the hazards that open defecation poses.

Expanding Budget Literacy in Nepal

Deepa Rai's picture

In mid-July, when the Government of Nepal’s FY15 budget was announced live on TV, radio and social media, most Nepalis were keen to watch the latest game of the World Cup. However, in a country with a literacy rate of only 57%, where almost half of Nepalis can neither read nor write, analyzing complex GoN budgetary information would not have been their priority. The World Bank’s Program for Accountability in Nepal (PRAN), however, is hoping to change that and educate people how the GoN budget affects their lives.
 
PRAN, together with Institute for Governance and Development (IGD), has recently developed ready-to-use, neo-literate flip charts outlining the importance of the government budget, its priorities, and its processes. These new IEC materials have been officially approved by the Government of Nepal for use nationally. Used effectively, they can help Nepali citizens become much more aware of what is rightfully theirs.  
 
Since 2011, PRAN has promoted increased social accountability and transparency in Nepal. PRAN seeks to educate communities about their local budget process and content.  As part of this effort, these new flip charts will serve as an awareness-raising tool by offering a detailed visual explanation of how the budget is designed, reviewed and approved.
 

Quote of the Week: Raghuram Rajan

Sina Odugbemi's picture

Central bankers have had enormous responsibilities thrust on them to compensate, essentially, for the failings of the political system. And my worry is we don’t have sufficient tools to do that, but we’re not willing to say it. And, as a result, we push as hard as we can on the existing tools, and they may create more risk in the system.” 

- Raghuram Rajan, Governor of the Reserve Bank of India since 4 September 2013. Prior to his post at the Reserve Bank of India, Rajan was chief economic adviser to India's Ministry of Finance in 2012 and chief economist at the International Monetary Fund from 2003 to 2007.
 

What Agha the Pakistani Street Child Thinks About Terrorism Will Surprise You

Susan Moeller's picture
A small boy ekes out a daily meal of naan and curry by picking up garbage in the streets of Lahore. That’s the premise of “I am Agha,” a short documentary film posted by three Pakistani filmmakers on a site called Pakistan Calling.
 
Watch the film to find out what Agha says about his life and what he thinks about terrorism.  Then reconsider what you think are Pakistan’s greatest problems. 
 
I Am Agha

 

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