COVID-19 vaccination willingness in peri-urban Tanzanian communities: Towards contextualising and moving beyond the individual perspective

With only 5.1% of the population fully vaccinated against COVID-19, Tanzania has one of the lowest vaccination rates in the world and after two years of changing policies regarding the disease, the country struggles to get its vaccination campaign on the rails. In this study, we identify the determinants of COVID-19 vaccination willingness in two villages of the Mvomero district in Eastern Tanzania. Based on survey data, we performed univariate analyses to assess differences in vaccination intention for various social groups, and built a four-dimensional multivariate ordered logistic regression model that comprises respondents' personal and socioeconomic characteristics, the channels through which they get their information, their attitudes and perceptions towards COVID-19, and their social network embeddedness. Only 37.0% of the respondents indicated that they would be willing to get vaccinated against COVID-19. Vaccination willingness differed significantly according to gender, age, educational attainment and religion; with men, the elderly, people with post-secondary education and Catholics and Muslims more likely to accept a vaccine. Predictors of vaccination willingness were gender, age, social media and informal contacts as information sources, perceived effectiveness of the vaccine and of alternative medicine, fear of side effects, a general dislike of vaccines, and the proportion of vaccinated people and the highest value of trust in international organisations in one's network. Although people's attitudes and perceptions have the largest share of the explanatory value, our model shows that all four of our model's building blocks were imperative in explaining vaccination willingness. Therefore, our paper presents a compelling case for the inclusion of respondents' social embeddedness as a common dimension for exploratory models of vaccination willingness.

Theory-based evaluation of the impact of Master's programmes in development studies: Insights from a mixed-methods and multicultural alumni action research project

To understand the impact of the international Master's programmes offered at the Institute of Development Policy (University of Antwerp), a theory-based evaluation was undertaken. In the first phase, a Theory of Change (ToC) was elaborated, distinguishing between three levels of impact (individual, organisational and societal), four learning dimensions (knowledge, skills, attitudes and networks) and five implicit pathways (change agent, social network, widening access, academic diversity, international understanding). Given the multifaceted and vague nature of the 'impact' concept under study, we selected an international, gender-balanced, multi-sectoral team of alumni researchers who fostered inclusiveness of different perspectives, at the same time capitalising on their depth of understanding, having gone through the study experience themselves. A mixed-methods approach was adopted to validate the ToC, combining a Most Significant Change approach, categorisation and text analysis of 101 alumni impact stories. Our findings demonstrate the importance of the three levels of impact and four learning dimensions in capturing graduate impact. While the impact stories confirmed the dominant 'change agent' pathway, they also hinted at the importance of hybrid complementary configurations of pathways to fully grasp how impact materialises.

Interventions for improving male involvement in maternal and child healthcare in Uganda: A realist synthesis

This study aimed at understanding how, when, and under what circumstances interventions succeed (or fail) to improve male involvement in maternal and child healthcare in Uganda. A realist synthesis approach was used to unpack the complexity of these health interventions to explain their theories and applications in specific circumstances. Our review of 19 studies revealed that men were specifically approached as clients, partners or agents for behavioural change. Broadly, mechanisms of education, training, restriction, environmental restructuring, modeling, enablement, persuasion, incentivization and coercion were used to involve men in maternal and child healthcare. Education, training, modeling, enablement and environmental restructuring mechanisms were more effective in 'cultivating' a sustained will of men to get involved as couples. However, unintended outcomes were inevitable in circumstances where mechanisms did not match specific contexts. Using coercion, restriction or incentivization is more likely to result in short-term and negative outcomes because of context heterogeneities.

Adolescent Dating Violence Among Nicaraguan Youth

This study examines the rates of victimization and perpetration of physical, sexual, and psychological dating violence among a sample of 193 ever-partnered Nicaraguan adolescents. Findings reveal high levels of partner violence, with 20% of students experiencing physical violence, 27% experiencing sexual violence, and 45-83% experiencing different types of psychological violence. For both victimization and perpetration, physical and sexual abuse were found to be positively correlated with psychological abuse, most notably for girl victims. We analyze the gender dynamics of the findings, contextualize them in a sociocultural analysis, and provide directions for prevention and future research.

To evaluate or not: Evaluability study of 40 interventions of Belgian development cooperation

Due to an increasing importance of evaluations within development cooperation, it has become all the more important to analyse if initial conditions for quality and relevant evaluations are met. This article presents the findings from an evaluability study of 40 interventions of Belgian development cooperation. A study framework was developed focusing on three key dimensions (i.e. theoretical evaluability, practical evaluability and the evaluation context) and subdivided over the different OECD/DAC criteria. Drawing upon a combination of desk and field research, the study framework was subsequently applied on a set of 40 interventions in Benin, DRC, Rwanda and Belgium. Findings highlight that the context dimension scores remarkably better than the theoretical and practical evaluability in particular. The large majority of the interventions have the conditions in place to satisfactorily evaluate effectiveness and efficiency while the opposite holds for sustainability and impact in particular. These findings caution against commissioning of evaluations that ritually focus on all OECD/DAC criteria regardless of their readiness. It underscores the usefulness of a flexible 'portfolio' approach towards evaluations, in which a more systematic use of evaluability assessment from the start of interventions could play a role.

Look Who's Talking. Explaining Water-Related Information Sharing and Demand for Action Among Ugandan Villagers

Many national water policies propagate community-based participatory approaches to overcome weaknesses in supply-driven rural water provision, operation, and maintenance. Citizen involvement is thought to stimulate bottom-up accountability and broaden the information base, which may enrich design and implementation processes and foster improved water accessibility and sustainability. Practices on the ground, however, are embedded in socio-political realities which mediate possible beneficial effects of participatory approaches. This paper builds on full social network data collected in a Ugandan village to study the social and political reality of two distinct levels of participation, i.e. local information sharing among citizens and a more active appeal to fellow citizens to improve water services. We use Logistic Regression Quadratic Assignment Procedure to explore what type of actor and network traits influence information sharing and whether the same factors are in play in the demand for action to remedy water-related problems. Whereas social aspects (social support relations) and homophily (using the same water source, the same gender) play an important role in information sharing, it is the educational level, in particular, of the villager who is called upon that is important when villagers demand action. Our findings also demonstrate that those most in need of safe water do not mobilize their information sharing ties to demand for action. This indicates that building local water policies and practice exclusively on locally existing demand for action may fail to capture the needs of the most deprived citizens.

Building national M&E systems in the context of changing aid modalities: the underexplored potential of national evaluation societies

Changes in the aid architecture have provided a renewed impetus for monitoring and evaluation (M&E), while simultaneously imposing a major reform agenda on the key players involved. More specifically, since 1999, aid-dependent countries have been facing pressure to strengthen their national M&E systems, while donors have been asked to refrain from using their own parallel systems and to rely instead on country systems. Surprisingly, attempts to strengthen national M&E frameworks have thus far largely overlooked the potential of national evaluation societies (NES). Similarly, NES have also remained off the academic radar. Our study aims to fill this gap by mapping key features of NES, as well as their perceived contributions to country-led M&E. In this effort, we rely upon evidence from our survey of 23 NES in Sub-Saharan African countries with Poverty Reduction Strategy Papers (PSRP). Our findings show that there is quite some diversity among NES. Overall, NES are active organisations, whose unique membership features a wide variety of national M&E stakeholders who potentially play key roles in country-led and localised M&E development. Major obstacles faced by NES include the lack of financial resources, donor support and political influence. Survey findings also demonstrate that the increasing interest of donors and governments in NES has yet to materialise into strategic support.

Taking stock of monitoring and evaluation systems in the health sector: findings from Rwanda and Uganda

In the context of sector-wide approaches and the considerable funding being put into the health sectors of low-income countries, the need to invest in well-functioning national health sector monitoring and evaluation (M&E) systems is widely acknowledged. Regardless of the approach adopted, an important first step in any strategy for capacity development is to diagnose the quality of existing systems or arrangements, taking into account both the supply and demand sides of M&E. As no standardized M&E diagnostic instrument currently exists, we first invested in the development of an assessment tool for sector M&E systems. To counter the criticism that M&E is often narrowed down to a focus on technicalities, our diagnostic tool assesses the quality of M&E systems according to six dimensions: (i) policy; (ii) quality of indicators and data (collection) and methodology; (iii) organization (further divided into iiia: structure and iiib: linkages); (iv) capacity; (v) participation of non-government actors and (vi) M&E outputs: quality and use. We subsequently applied the assessment tool to the health sector M&E systems of Rwanda and Uganda, and this article provides a comparative overview of the main research findings. Our research may have important implications for policy, as both countries receive health sector (budget) support in relation to which M&E system diagnosis and improvement are expected to be high on the agenda. The findings of our assessments indicate that, thus far, the health sector M&E systems in Rwanda and Uganda can at best be diagnosed as 'fragmentary', with some stronger and weaker elements.

Monitoring and evaluation under the PRSP: solid rock or quicksand?

Over the last few years a shift has taken place in the aid instruments advocated for low-income countries, characterised by a conversion from project to more programme-oriented aid and by the inclusion of 'broad-based civil society participation' as an aid conditionality. Poverty Reduction Strategy Papers (PRSPs) constitute a new framework for policy negotiations with the recipient government as well as a new set of rules for aid implementation. So far scant attention has been paid to strengthening monitoring and evaluation. This paper contributes to this under-exploited field of research by stocktaking and assessing different aspects of M&E systems for a selected number of Sub-Saharan African countries. Findings of our desk study confirm that M&E is among the weaker parts of the new aid architecture. The PRSP approach seeks improvements in M&E, but its unrealistic ambitions put embryonic national M&E systems under undue stress.