Australian Agency For International Development Research Articles

International mediation and Australian foreign policy: building institutional capacity to respond to overseas conflict

ABSTRACTIn October 2012, Australia's parliamentary Joint Standing Committee on Foreign Affairs, Defence and Trade recommended that a mediation support unit should be created within the Australian Agency for International Development, a department now amalgamated with the Department of Foreign Affairs and Trade. The question is: Does Australia possess the motivation and capacity to implement active and effective international mediation by building the capacity of intermediaries to deploy various peacemaking methods to hasten de-escalation at different stages of a conflict? If not, is a mediation support unit an appropriate initiative to address this capability gap? This article draws on quantitative conflict data sets and an expert panel to conclude that Australia's track record demonstrates significant capacity to undertake international mediation, but that the mediation personnel and processes available to government are insufficiently resourced and coordinated to readily provide policymakers with accessible tools to undertake the diverse range of mediation strategies advocated by conflict scholars. While a mediation support unit would address some of these issues, at present it conflicts with the Department of Foreign Affairs and Trade's institutional philosophy based on diffused expertise.

Introduction: children and knowledge in India

The editors gratefully acknowledge the following sponsors who funded the conference, ‘Childhoods in South Asia: Contemporary and Historical Perspectives’, held at The Australian National University (ANU), Canberra, July, 2013: The South Asia Research Institute, ANU College of Asia and the Pacific; The Australia–India Council, DFAT (The Australian Government Department of Foreign Affairs and Trade); ANU College of Arts and Social Sciences; AusAID (The Australian Agency for International Development), DFAT; and the ANU Gender Institute.

Assessing the quality of HIV Counselling, Testing and STI Consultation services for vulnerable populations in Nigeria

supports other findings in which decreased educational years (p1⁄40.019, Fisher’s Exact test) and decreased BMI of the mother (p1⁄4 0.009, Fisher’s Exact test) relates to more severe childhood malnutrition. Interpretation: Due to small sample size, low power of the analysis, and other limitations, we cannot draw conclusions on the relationship between maternal age at marriage and childhood malnutrition, but we do see that, even with this underestimated number, 62.96% of the mothers married under the age of 18 (the legal marrying age for Bangladeshi females). The child, mother, and household characteristics we studied allow us to have a holistic perspective on the social situations of hospitalized children at icddr,b. Future study with large sample and adequate power may help in further understanding the health of the mother in obtaining gravidity and parity and the child through collecting health outcomes of the hospitalized children. Funding: Provided by the Stanford Medical Scholars Fellowship Program. Core Donors of icddr,b financially support the hospital and patient care and include: Australian Agency for International Development (AusAID), Government of the People’s Republic of Bangladesh (GoB), Canadian International Development Agency (CIDA), TheDepartment for International Development, UK (DFID), and Swedish International Development Cooperation Agency (Sida). Abstract #: 02SEDH016

Who are the custodians of Pacific ‘post-2015’ education futures? Policy discourses, education for all and the millennium development goals

This article discusses influences of Education for All (EFA) and the education Millennium Development Goals (MDGs) on education policies in the Pacific sub-region in the context of ongoing ‘post-2015 development agenda’ deliberations, focusing on Papua New Guinea and Vanuatu. It is based on doctoral work undertaken as a component of an Australian Research Council Linkage grant, partially supported by the former Australian Agency for International Development (AusAID), and continuing postdoctoral research.Pacific postcolonial nations’ engagement with EFA and the MDGs was compared through a critical discourse analysis of multi-scalar education policy formation processes. The research identified paradoxical influences of global approaches, and multi-level processes. While such frameworks at once facilitated educational debate and legitimized broader education policy participation, they also supported a status quo in mainstream donor and state dominance of educational development agendas. There is some evidence of wider national participation in the emerging ‘post-2015′ policy processes, but the extent of its influence on multi-level policy deliberations globally and regionally is yet to be seen. Many of the education issues currently being raised in both nations, and regionally, have endured since colonial occupation and independence. This article focuses on educational relevance and gender issues in education, and positions them in relation to the concept of ownership within post-colonial political dynamics and multilevel discursive contexts for participation, which I interpret as being of continued importance to understanding these enduring education concerns.

Development of a shortened verbal autopsy instrument for routine surveillance

BackgroundVerbal autopsies (VAs) have been widely used to determine cause of death for research in developing countries, but their use in vital registration systems has been limited due to the interview time of VA instruments (VAIs). This study aimed to create a shortened VAI to address this issue by using the Population Health Metrics Research Consortium (PHMRC) gold standard VA validation dataset and the Tariff method to systematically reduce the size of the PHMRC VAI. MethodsThe Tariff method calculates a score for each symptom–cause pair to measure strength of association between the two. The effect on performance after low-ranking symptoms were deleted from the VAI was measured using cause-specific mortality fraction (CSMF) accuracy and chance-corrected concordance (CCC) as test statistics at population and individual levels, respectively. FindingsWith negligible effect on performance, we were able to reduce the number of items from 183 to 105 in the adult VAI, from 127 to 72 in the child VAI, and from 149 to 76 in the neonatal VAI. CSMF accuracy in adults decreased from 0·770 (95% CI 0·766–0·775) in the full VAI to 0·770 (0·765–0·775) in the reduced VAI, in children from 0·785 (0·776–0·789) to 0·783 (0·776–0·787), and in neonates from 0·827 (0·818–0·835) to 0·818 (0·812–0·827). Mean CCC in adults decreased from 50·5% (95% CI 50·3–50·6) to 49·7% (49·5–49·8), in children from 52·3% (51·5–52·5) to 51·9% (51·6–52·2), and in neonates from 48·2% (47·9–48·5) to 47·5% (47·2–47·7). InterpretationWe have been able to reduce the number of items by over 40% in the PHMRC VAI while retaining its performance characteristics, thus removing a major impediment to its routine use in vital registration systems. This shortened VAI is currently being piloted to determine the effects of reduced item number on survey time. FundingThe Health Information Systems Knowledge Hub of the University of Queensland, a strategic partnership initiative of the Australian Agency for International Development.

Asbestos and Asbestos-related Diseases in Vietnam: In reference to the International Labor Organization/World Health Organization National Asbestos Profile

This paper describes progress on formulating a national asbestos profile for the country of Vietnam. The Center of Asbestos Resource, Vietnam, formulated a National Profile on Asbestos-related Occupational Health, with due reference to the International Labor Organization/World Health Organization National Asbestos Profile. The Center of Asbestos Resource was established by the Vietnamese Health Environment Management Agency and the National Institute of Labor Protection, with the support of the Australian Agency for International Development, as a coordinating point for asbestos-related issues in Vietnam. Under the National Profile on Asbestos-related Occupational Health framework, the Center of Asbestos Resource succeeded in compiling relevant information for 15 of the 18 designated items outlined in the International Labor Organization/World Health Organization National Asbestos Profile, some overlaps of the information items notwithstanding. Today, Vietnam continues to import and use an average of more than 60,000 metric tons of raw asbestos per year. Information on asbestos-related diseases is limited, but the country has begun to diagnose mesothelioma cases, with the technical cooperation of Japan. As it stands, the National Profile on Asbestos-related Occupational Health needs further work and updating. However, we envisage that the National Profile on Asbestos-related Occupational Health will ultimately facilitate the smooth transition to an asbestos-free Vietnam.

Informing family planning research priorities: a perspective from the front line in Asia

Impressive reductions of up to 29% in maternal deaths may be expected from satisfying unmet need for contraception as shown in a recent analysis covering 172 countries (Ahmed et al. 2012). Despite the cost-effectiveness of family planning (Prata et al. 2010) investments remain low (Osotimehin 2012) a concern declared under Goal 5 on the UN Millennium Development Goals website ‘Inadequate funding for family planning is a major failure in fulfilling commitments to improving women’s reproductive health.’ Alongside investment and political commitment clear indicators for the coverage and quality of family planning services are required to design and implement strategies to improve family planning. However the evidence used in planning and monitoring of family planning is often suboptimal and poses a serious problem for effective efficient responses to scale up these services. The 2012 London Summit on Family Planning signalled renewed interest in this important intervention by the global community. Large investments were pledged and ambitious targets of access to contraception for 120 million women and girls by 2020 were set. This has also prompted the Alliance for Reproductive Maternal and Newborn Health to work with WHO and development partners to facilitate a prioritisation of the family planning research agenda. With a view to informing these discussions we were commissioned by the Australian Agency for International Development (AusAID) to identify the key knowledge gaps for evidence-based planning and budgeting for family planning. As part of a multicountry initiative working with policy makers to effect a more rational use of resources for reproductive maternal newborn and child health (Jimenez-Soto et al. 2012) we collated the data necessary to inform local decision-making on scaling up family planning services. Our work highlighted major evidence gaps that have the potential to undermine efforts to plan and invest in family planning and interfere with monitoring progress. The seven leading knowledge gaps identified are outlined in this short paper and provide an essential ‘front-line’ perspective to inform research priorities for effective scaling-up of family planning. We draw on examples from our study sites in four countries: two districts and two cities in Indonesia two provinces and one city in the Philippines three clusters of districts in Nepal two districts in the Indian state of Orissa and two districts in the state of Uttar Pradesh. We believe that this view from the front line provides a much-needed link between global agendas and the realities of implementation at a local level. (excerpt)

In Timor-Leste, a Bumpy, but Rewarding, Road to Hearing Healthcare

In Timor-Leste, a Bumpy, but Rewarding, Road to Hearing Healthcare

Building Neo-liberal Markets and Other Agendas: The Politics of Risk Management at AusAID

This article analyses emerging approaches by donors to risk management, focusing on the case of the Australian Agency for International Development (AusAID). It suggests that AusAID's understanding and management of risk are expressions of particular political and social interests and, subsequently, that its approach to risk management is inherently political in nature. While AusAID's policies and guidelines on risk management identify a wide range of risks as being relevant to the agency's work – including risks to poverty reduction and sustainable development – in practice it has focused on managing risks to the building of neo-liberal markets, both within Australia and in developing countries, and the Australian government's foreign policy objectives. To illustrate these points, we present an analysis of AusAID's approach to risk management in a major economic governance project, the Philippines-Australia Partnership for Economic Governance Reforms. We conclude by indicating ways in which donor approaches to risk management can be revised to give greater attention to the needs of the poor and civil society, while acknowledging that such revisions may be contingent upon prior changes in the structure of power and interest and/or institutional characteristics of aid policy-making processes in donor countries.

Assessing the impact of harm reduction programs on law enforcement in Southeast Asia: a description of a regional research methodology

For over 15 years the Australian Agency for International Development (AusAID) has been a leading donor for harm reduction projects in Southeast Asia. The recent AusAID-supported harm reduction projects of greatest significance have included the Asia Regional HIV/AIDS Project (AHRP), from 2002 until 2007,1 and the HIV/AIDS Asia Regional Program (HAARP), from 2007 until 2015.2 Both projects included in their design specific strategies for engaging with law enforcement agencies at country level. The main focus of these strategies has been to develop law enforcement harm reduction policy and curriculum, and the design and implementation of specific harm reduction training for law enforcement officers.In July 2008, the Australian Development Research Awards (ADRA) funded the Nossal Institute for Global Health at the University of Melbourne to establish a research project created to assess the influence of harm reduction programs on the policy and operational practices of law enforcement agencies in Southeast Asia, known as the LEHRN Project (Law Enforcement, Harm Reduction, Nossal Institute Project). The ADRA is a unique grant research mechanism that specifically funds development research to improve the understanding and informed decision making of the implementation of Australian aid effectiveness.While the need to engage law enforcement when establishing harm reduction programs was well documented, little was known about the impact or influence of harm reduction programs on policy and practices of law enforcement agencies. The LEHRN Project provided the opportunity to assess the impact of harm reduction programs on law enforcement in Southeast Asia, with a focus on Vietnam, Cambodia and Lao PDR.

PROTOCOL: Nutrition interventions and programs for reducing mortality and morbidity in pregnant and lactating women and women of reproductive age: a systematic review

PROTOCOL: Nutrition interventions and programs for reducing mortality and morbidity in pregnant and lactating women and women of reproductive age: a systematic review

The Alfred Trauma Team Training Program in India and Sri Lanka

Injury is a major global health problem. India suffers more deaths from vehicle collisions than any other country. Since 2004 The Alfred Hospital in Melbourne, Australia has established strong linkages with Christian Medical College (CMC) in Ludhiana, the Punjab, India and Teaching Hospital Karapitiya (THK) in Galle, Sri Lanka, supporting trauma care capacity-building. In response to the demand for a systematic approach to trauma care in India and Sri Lanka, The Alfred Trauma Team Training Program was developed, funded by the Australian Agency for International Development, The Alfred and its participating staff, CMC and THK. The aim of the programme was to enhance the understanding and skill in reception and resuscitation of critically injured patients in a cohort of providers of emergency care. Participants were selected from nine sites: CMC, five government hospitals across the Punjab, Delhi, THK and Teaching Hospital Peradeniya in Kandy, Sri Lanka. The programme was conducted at CMC, with follow-up visits to THK and Teaching Hospital Peradeniya, and focused on team-based scenarios. The faculty included emergency clinicians from The Alfred. Participants showed improvement in the knowledge and skills of trauma reception and resuscitation. Observed programme challenges included the variety of health systems from which the participants were sourced. The Trauma Team Training Program allowed Australian emergency clinicians to impart some skills towards improving the level of trauma reception and resuscitation by 26 participants from nine sites. The team-based systematic approach to the delivery of emergency trauma care was valued by the participants.

346 Implementing an Emergency Medicine Health Information System in Baghdad, Iraq

Prior to 2008, Iraq had a rudimentary and poorly functioning system of emergency medicine. Over the past 3 years, International Medical Corps (IMC), an international humanitarian aid organization, has implemented a development and capacity building project I-EMCD (Iraq Emergency Medical Care Development) via the generous support of AusAID (Australian Agency for International Development). In an effort to assist the Iraq Ministry of Health (MoH) in monitoring the newly instituted ambulance service and training of emergency department personnel (doctors, nurses, paramedics), the EM HIS was designed and introduced by IMC and expert medical consultants from the Harbor-UCLA Emergency Medicine Global Health Program for in-depth tracking of key clinical indicators. Additionally, a system-wide bed tracking system was created to help understand resource utilization and ED crowding for all hospitals in Baghdad. Data collection for the system began in February 2011 and is ongoing currently. To implement and measure the output of a novel Emergency Medicine Health Information System (EM HIS), an electronic data tracking system designed to meet the needs of the emergency care system in Baghdad, Iraq. The EM HIS system was created using a MySQL database with a Web-based user interface. JAVA and PHP were used to create interactive Web form versions of the charting documents to facilitate data entry into the system. Multiple authentication algorithms were used (including MD5 and SHA1 encryption) to reinforce security of the database. An Emergency Department Chart (EDC) and Ambulance Run Report (ARR) were created to track and store information which was subsequently uploaded to the electronic database. Paper versions of the EDC were distributed to all Baghdad emergency departments and paper versions of the ARR were distributed to all ambulance dispatch centers. By decree of the Iraqi MOH, the ED Chart (EDC) document has replaced a version of the chart formerly used for ED documentation, and the ARR is the first of its kind to document clinical information for ambulance transports in Iraq. For the EDC, 26,978 entries were collected in the first 8 weeks of the project. An average of 19 charts per day, per hospital have been uploaded to the database (range: 2-48 charts/day/hospital). During the initial collection period, completeness of the new chart has been an issue with essential variables such as chief complaint and discharge diagnosis being variably completed with %CC (avg =61%, range 0-99%) and %Diag (avg = 17%, range 1-70%). This study demonstrates that it is possible to launch a comprehensive EM HIS in a low to middle-income country that is emerging from conflict. Although there are numerous inherent difficulties working in Iraq given ongoing security concerns, political uncertainty, and institutional inertia, we were able to successfully achieve implementation of this novel EM HIS system. The impact of this system on improving emergency care in Baghdad is only beginning to be realized. A robust EM HIS will generate important information about key clinical indicators which will permit targeted interventions to improve the delivery of emergency care in Iraq.

Offshore teaching practice in the Australia-Pacific Technical College: A case study in the South Pacific

This paper investigates teaching practices at the Australia-Pacific Technical College (APTC), which comprise a unique official development assistance (ODA) program funded by the Government of Australia (GoA) and managed through the Australian Agency for International Development (AusAid) with the aim of training and equipping workers from the Pacific Island Forum member countries with Australian technical qualifications that will be recognized by the industry and governments in the concerned countries. Using both an online survey and structured interviews with teachers who are currently working (or have worked) in the program in one of the four campuses of the APTC on the island countries, the research looks into off-shore teaching experiences, practices and identities of these teachers. Themes that are addressed include the professional development needs of VET teachers who are working on short and long-term overseas assignments, teaching practices in an aid/development context, and the identities of VET teachers who work on aid/development projects.

Communication for Development Interventions in Fragile States: a systematic review.

Communication for Development Interventions in Fragile States: a systematic review.

New partnerships and education policy in Asia and the Pacific

Forming more effective partnerships with national governments in the Asia-Pacific region has been an important policy focus for the Australian Agency for International Development (AusAID) since 2006. AusAID is increasingly engaging in sector-wide approaches and working through partner government systems. This paper explores how new partnerships are impacting education policy in the vastly different contexts of Lao PDR, Vanuatu, Indonesia, and the Philippines from 2006 to 2009. Conclusions are that policy discourse and current practice indicate an active effort to develop partnerships in education with donors and partner governments. But the reality in the field is that while sector-wide approaches are outlined in policy discourse, practice indicates loosely harmonized arrangements with like-minded donors, and slow progress toward sector-wide involvement.

Maximising Evaluation Influence in an International Development Donor Agency

This article examines how current theories of evaluation use and evaluation influence can assist an international development donor agency, namely the Australian Agency for International Development (AusAID), maximise the outcomes and track the consequences of evaluations of its country programs. It considers those theories most relevant to AusAID's evaluation interests and contexts, that is: instrumental use; conceptual (or enlightenment) use; process use; and evaluation influence. It finds that evaluation influence has much to offer in terms of linking evaluation outcomes to the achievement of program outcomes. By considering the mechanisms that can mediate evaluation influence, the framework underpinning evaluation influence theory builds on many of the central tenets identified in evaluation use theories and encourages the consideration of an evaluation as an intervention in itself. The principal benefit of doing so is to understand when, and why, some use of evaluation occurs and when and why it does not. Evaluation influence theory holds the potential for AusAID to maximise its evaluation efforts and strengthen its country programs. The systematic consideration of which mechanisms can influence the intermediate and long-term outcomes that lead to social betterment is the key to realising this potential. Empirical research into these mechanisms could both assist and be assisted by AusAID embracing an approach of valuing evaluations as an intervention in themselves.

Non-government organisation engagement in the sanitation sector: opportunities to maximise benefits

Non-government organisations (NGOs) have long played a role in delivering sanitation services to communities in Southeast Asia and Pacific countries, particularly in rural areas. In contrast with large scale infrastructure focused initiatives, NGO programs commonly focus on building linkages between technical and social realms. Drawing on the breadth and depth of NGO experiences, there are opportunities for NGOs to play a greater role in the sanitation sector and to work in partnership with other actors including utilities and government agencies to ensure both 'hardware' and 'software' components of sanitation are built in to project design and delivery to maximise community benefits and ensure longer term system sustainability. This paper discusses these issues and considers how the contribution of NGOs to the sanitation sector in developing countries might be enhanced. The paper is based on recent research for the Australian Agency for International Development (AusAID) intended to guide investment in the water and sanitation sectors of Asia and Pacific partner countries, exploring the potential for increased NGO engagement. The paper presents findings of the research concerning NGO roles and approaches, discusses existing NGO activities in the sanitation sector in Vietnam and Timor Leste and identifies strategies for NGOs and for other sector actors including utilities and government agencies to maximise the benefits of NGO engagement in the sanitation sector.

Outcome evaluation of community health promotion intervention within a donor funded project climate in Papua New Guinea

The Australian Agency for International Development (AusAID) funded Women and Children's Health Project sought to improve the health of women and children throughout Papua New Guinea between 1998 and 2004. The project utilised education, community development and health promotion interventions aimed to increase community support for the health of women and children. An outcome evaluation in 2006 investigated the long-term impact of the project using a multi-methods approach and covering 10 selectively sampled provinces, 19 districts and 93 communities. Qualitative data were collected from 175 interviews (national to village level) and 77 community discussions. Quantitative data from national, provincial and district levels were examined to attempt to validate findings. The evaluation found new-health-knowledge initiated changes to lifestyle practices and improved physical health and social and economic well-being in villages where volunteers and staff had been trained. Factors influencing success were a health-motivated person acting as a catalyst for change, empowered leadership through new community governance structures, effective visual tools and village health volunteers linking community and rural health workers. Failure was attributed to poor understanding of community development, limited information sharing, a 'top down' approach to community development and weak community leadership. The project's community health interventions improved the interaction between the community and health system, and influenced improved use of maternal and child health services. Evaluation suggests sustainable improvements in health can be achieved through community led and maintained activity.

Incentives for retaining and motivating health workers in Pacific and Asian countries.

This paper was initiated by the Australian Agency for International Development (AusAID) after identifying the need for an in-depth synthesis and analysis of available literature and information on incentives for retaining health workers in the Asia-Pacific region. The objectives of this paper are to:1. Highlight the situation of health workers in Pacific and Asian countries to gain a better understanding of the contributing factors to health worker motivation, dissatisfaction and migration.2. Examine the regional and global evidence on initiatives to retain a competent and motivated health workforce, especially in rural and remote areas.3. Suggest ways to address the shortages of health workers in Pacific and Asian countries by using incentives.The review draws on literature and information gathered through a targeted search of websites and databases. Additional reports were gathered through AusAID country offices, UN agencies, and non-government organizations.The severe shortage of health workers in Pacific and Asian countries is a critical issue that must be addressed through policy, planning and implementation of innovative strategies – such as incentives – for retaining and motivating health workers. While economic factors play a significant role in the decisions of workers to remain in the health sector, evidence demonstrates that they are not the only factors. Research findings from the Asia-Pacific region indicate that salaries and benefits, together with working conditions, supervision and management, and education and training opportunities are important. The literature highlights the importance of packaging financial and non-financial incentives.Each country facing shortages of health workers needs to identify the underlying reasons for the shortages, determine what motivates health workers to remain in the health sector, and evaluate the incentives required for maintaining a competent and motivated health workforce. Decision-making factors and responses to financial and non-financial incentives have not been adequately monitored and evaluated in the Asia-Pacific region. Efforts must be made to build the evidence base so that countries can develop appropriate workforce strategies and incentive packages.