Impact Pathway Analysis Research Articles

Local mortality and costs from ship-related emissions in three major Portuguese ports

Local models have the advantage of accounting for specific characteristics of the local environment and population, potentially improving the accuracy of results compared to regional and global models. An impact pathway analysis was conducted to estimate the years of life lost (log-linear functions based on WHO-HRAPIE relative risks) and external costs (using the statistical value of a life year) related to PM2.5 and NO2 emissions from ships in three Portuguese municipalities, where three maritime ports are located. In-port ship-related PM2.5 emissions caused 90 (95% CI: 59–118), 130 (95% CI: 86–170) and 11 (95% CI: 8–15) years of life lost for Matosinhos, Setúbal and Sines, respectively. In-port ship-related NO2 emissions in Matosinhos were responsible for 64 (95% CI: 37–89) years of life lost. Setúbal had the highest total costs, with PM2.5 emissions costing €4.0 million (95% CI: 2.7–5.2). Although Sines had the lowest total costs, the costs per capita were higher than in Matosinhos and almost the same as in Setúbal. The findings demonstrate that in-port ship-related emissions reduce the average life expectancy of populations living near port areas and result in high societal costs. The results can serve as a benchmark for assessing the benefits of implementing shore side electricity and can be used by port authorities and policymakers to justify the need for financial or organisational support programs for infrastructure investments.”

Interventions to change antimicrobial use in livestock: A scoping review and an impact pathway analysis of what works, how, for whom and why.

Antimicrobial resistance (AMR) is a public health threat responsible for 700,000 deaths per year worldwide. Antimicrobial use (AMU) in livestock contributes to AMR in animal and public health. Therefore, it is essential to implement effective interventions towards better AMU in livestock. However, there is a lack of evidence to inform decision-makers of what works, how, for whom and why and how effective interventions can be adapted to different contexts. We conducted a scoping review and an impact pathway analysis to systematically map the research done in this area and to inform evidence-based and context-appropriate policies. We followed the PRISMA-ScR requirements and searched Web of Science, PubMed and Scopus databases to identify studies in English or French languages, in open access and published between 2000 and 2022. We selected thirty references addressing twenty-eight different interventions that were successful in changing AMU in livestock. We used an impact pathway logic model as an analytic framework to guide the technical aspects of the scoping review process and to identify the complex relationships between outputs, outcomes, impacts and contextual factors. A majority of interventions managed to improve AMU by changing herd and health management practices (ni=18). We identified intermediate outcomes including change in the veterinarian-farmer relationship (ni=7), in knowledge and perception (ni=6), and in motivation and confidence (ni=1). Twenty-two studies recorded positive impacts on animal health and welfare (ni=11), technical performances (ni=9), economic performances (ni=4) and AMR reduction (ni=4). Interventions implemented different strategies including herd and health management support (ni=20), norms and standards (ni=11), informational and educational measures (ni=10), economic support (ni=5). Studies were mainly in European countries and in pig and large ruminants farming. Most interventions targeted farmers or veterinarians but we identified other major and influential actors including authority and governmental organizations, academics and research, organization of producers or veterinarians, herd advisors and technicians, laboratories, and public opinion. Key success factors were knowledge and perception (ni=14), social factors (ni=13), intervention characteristics (ni=11), trajectory and ecosystem of change (ni=11), economic factors (ni=9), herd and health status (ni=8), data access and monitoring (ni=4). This review describes a paucity of impact assessment of interventions towards better AMU in livestock. There is no one-size-fits-all transition pathway but we inform decision-makers about the most successful interventions that work, how, for whom and why. The impact pathway analysis provided a holistic view of the successful change processes and the complex relationships between outputs, outcomes, impacts and contexts.

Brazilian Strategy for Breastfeeding and Complementary Feeding Promotion: A Program Impact Pathway Analysis.

Background: The Brazilian Breastfeeding and Complementary Feeding Strategy (Estratégia Amamenta e Alimenta Brasil—EAAB) aims to improve Primary Health Care (PHC) workers’ counseling skills to promote and support infant and young children feeding (IYCF). However, the maintenance and scaling up of the EAAB has been challenging. The theory-driven Program Impact Pathway (PIP) is recommended to assess and enhance the large-scale implementation of IYCF programs. The purpose of this study was to document barriers and facilitators to scale up the EAAB using a PIP analysis. Methods: First, we reviewed EAAB documents to develop an initial PIP diagram. Then, we interviewed EAAB key informants to identify Critical Quality Control Points (CCP) in the PIP. We revised and analyzed the PIP to inform the EAAB core functions and pathways. Results: Six CCPs for EAAB maintenance were identified: CCP1—Definition and strengthening of the coordination in states and municipalities; CCP2—Maintenance of tutors’ work; CCP3—Feasibility of the certification process; CCP 4—Quality improvement of IYCF activities in PHC units; CCP 5—Adequate use of monitoring systems; and CCP 6—Consistent implementation monitoring. Four implementation pathways and seven core functions identified may assist with scaling up the EAAB in Brazil. Conclusion: The PIP analysis proved to be useful for documenting the factors that influence the maintenance and scaling up of the EAAB.

Knowledge systems approaches for enhancing project impacts in complex settings: community fire management and peatland restoration in Indonesia

Knowledge systems approaches for enhancing the impact of research are well established and tend to focus on the ways in which researchers can adapt their engagement with stakeholders to achieve a better “fit” between research and action agendas. Yet, these approaches are often based on explicit or implicit assumptions of a skilled and willing research team, and stable and well-defined stakeholders, who have consistent and reasonably well-defined needs. This paper discusses how knowledge systems approaches were developed and deployed in the first phase of the Gambut Kita (Our Peatland) project on community fire management and peatland restoration in Indonesia (2017–2021). This was a complex project with a large multi-disciplinary team situated across dynamic institutions in Indonesia and Australia, and addressing a politically controversial topic. To capture the diverse experience of the researchers, and to focus on the needs of stakeholders, we developed a sequence of whole-of-project approaches comprising the following: (i) stakeholder mapping exercises at three nested scales combining stakeholder analysis, knowledge systems mapping and impact pathways analysis; (ii) a project coordinating committee of high-level Indonesian policy-makers and policy-influencers; (iii) a stakeholder engagement forum and (iv) online policy dialogues. We demonstrate its effects through the case of developing an Indonesian Peat Fire Danger Rating System (Peat FDRS), as a core project deliverable. Over 4 years, these structured stakeholder engagement processes gave rise to a Peat FDRS Stakeholder Engagement Network (a multi-institutional working group), which is making significant progress in navigating the complexity inherent in realising an accurate Indonesian Peat FDRS.

Abstract 2358: Impact pathway analysis of FOXC2-correlated genes in melanoma: A meta-analysis approach to understand the tumor-promoting functions of the FOXC2 transcription factor

Abstract Melanoma is a cancer that arises from pigment-producing melanocytes in the skin. Because of the increasing incidence of melanoma and its resistance to many therapies, insights into melanoma progression are needed. FOXC2, a member of the forkhead box family of transcription factors, has been shown to have oncogenic activity in many epithelial cancer types, and we have recently reported a role for FOXC2 in melanoma progression as well. To gain insight into the role of FOXC2 in melanoma progression, we analyzed publicly available RNA-sequencing data from tumor biopsies of melanoma patients, including a cohort of 479 patients catalogued in The Cancer Genome Atlas as well as additional cohorts from other independent studies. We performed Spearman correlation analyses to identify genes positively and negatively co-expressed with FOXC2, and we performed Impact Pathway Analysis and Gene Ontology Analysis to determine which biological pathways and processes are most impacted by FOXC2-associated genes in melanoma. Our data highlight critical pathways impacted by the expression of FOXC2, and they identify specific genes influenced by this transcription factor that provide mechanistic insight into the oncogenic activity of FOXC2 in melanoma and potentially other cancers. Citation Format: James B. Wall, Kristian M. Hargadon. Impact pathway analysis of FOXC2-correlated genes in melanoma: A meta-analysis approach to understand the tumor-promoting functions of the FOXC2 transcription factor [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 2358.

Integrating Gender Into Data Services: A Flexible, Multidisciplinary and Reflexive Approach

Drawing on the concepts of Theory of Change and Participatory Impact Pathways Analysis, and our own experience of integrating gender and social inclusion in the Community Resilience Forest Management System in Nepal, we develop a five-step framework, which we call flexible, multidisciplinary and reflexive (FMR) approach to mainstreaming gender and social inclusion in the given context of data services. In this study, we demonstrate how this newly devised concept can be effectively implemented at different project stages—planning, monitoring and evaluation—to integrate gender and social inclusion in data services. As reflected in a Climate Resilient Forest Management System in Nepal, we present how the project has successfully harnessed an approach that has transformed a project team, improved understanding of the interface between the two disciplines and helped integrate gender and social inclusion in data services. This study contributes to many ongoing discussions and debates within academic literature about interdisciplinary research projects, and the integration of gender and social inclusion particularly into climate related research and data services.

Program Impact Pathway of the Positive Deviance/Hearth Interactive Voice Calling Program in a Peri-Urban Context of Cambodia

ABSTRACTBackgroundPositive Deviance/Hearth (PDH) is an internationally recognized nutrition rehabilitation program. However, nutritional improvements are inconsistent across contexts. It is unclear if variations are due to differences in program design, implementation, utilization, or other contextual factors. Furthermore, few PDH programs have addressed the high time and work burdens of caregivers and volunteers. To address this, the study integrated interactive voice calling (IVC) with PDH.ObjectivesA program impact pathway (PIP) analysis was used to evaluate the secondary outcomes of facilitators, barriers, and contextual factors that influenced the design, implementation, and utilization of a Positive Deviance/Hearth-Interactive Voice Calling program to improve the nutritional status of children in Cambodia.MethodsA PIP analysis was done on data collected through in-depth interviews with caregivers (n = 32), key informant interviews with volunteers (n = 16) and project staff (n = 3), and surveys of project staff (n = 5).ResultsIn the design phase, facilitators included quality training, technical support and design tools, community mobilization, and linkage to existing health services. Barriers included poor community mobilization. For the implementation phase, facilitators were good volunteer knowledge, follow-up tools and guidance, supervision, and spot checks of volunteers. Barriers were lack of time and overworked older caregivers. For the utilization phase, facilitators included family and volunteer support and access to phones, whereas barriers were lack of support, time, and financial resources; low levels of education and old age of caregivers; and inconsistent phone use. Contextual factors included food insecurity and increased childcare responsibilities of grandmothers due to migration of mothers.ConclusionsThe PIP analysis identified facilitators, barriers, and contextual factors that may affect the design, intervention, and utilization of IVC interventions for health and nutrition behavior change and elements to consider when designing and implementing them. When implementing child nutrition programs in Cambodia, supporting interventions addressing mental health and time and resource constraints of elderly caregivers should also be included.This trial was registered at clinicaltrials.gov as NCT03399058.

Architectural and cultural heritage as a driver of social change in rural areas: 10 years (2009–2019) of management and recovery in Huete, a town of Cuenca, Spain

Suitable management and recovery of architectural and cultural heritage contribute to promote the development of rural towns. This was the case of the work done for 10 years by the Fundación Huete Futuro (the Huete Future Foundation; FHF) in the town of Huete in Cuenca (Spain). This study intended to identify the drivers of impact and the social changes that this heritage management led to. To do so, two methodological approaches were employed: Participatory Impact Pathway Analysis (PIPA) and Positive Social Change (PSC). The main obtained results corresponded to the physical restoration of buildings of historic interest for Huete and the promotion of activities of cultural interest. Moreover, the integration of and social participation in the planning and management process for recovering heritage were also promoted. This heritage management and its revaluation promoted tourist activities that favoured rural development and encouraged a change in social behaviour. The population began to perceive its heritage as a means towards empowerment and innovation.

Pathways to Diverse Diets-a Retrospective Analysis of a Participatory Nutrition-Sensitive Project in Kenya.

ABSTRACTBackgroundThere is a current need for better understanding the impact of nutrition-sensitive agriculture interventions. This study is based on a community-based participatory project that diversified diets of women and children by making use of local food biodiversity. This retrospective impact pathway analysis aims at explaining why and how impact was reached.ObjectivesThis study aimed to understand how a nutrition-sensitive agriculture project improved people's diets by analyzing the pathways from agriculture to nutrition. It also aimed to test theoretical pathways by comparing the documented pathways with those from a widely used framework from the literature.MethodsA qualitative study was conducted in 2019 through 10 semistructured focus group discussions with community members engaging in the project and 5 key informant interviews with local authorities that worked with these communities during the project. Summative content analysis was used to identify pathways through which the project affected diets of beneficiaries. The defined pathways were compared with the pathways of the widely used Tackling the Agriculture–Nutrition Disconnect in India (TANDI) framework from the literature.ResultsOut of the agriculture–nutrition pathways that are presented in the literature, 3 were found in the responses: 1) food from own production; 2) income from sale of foods produced; and 3) women's empowerment through access to and control over resources. In addition, 5 other pathways were identified and indicated spillover effects from the intervention to the control participants, increased nutrition knowledge, improved health, savings, and empowerment and harmony in the household.ConclusionsPathway analysis in nutrition-sensitive agriculture can provide valuable understanding on how and why dietary improvements have been achieved in an intervention. The approach can hence be instrumental in addressing the current demand within the field on understanding the progress and impact of interventions. Pathway analysis also helps to address knowledge gaps regarding theoretical frameworks, as in the present study, concerning women empowerment pathways.

Monetary Health Co-Benefits and GHG Emissions Reduction Benefits: Contribution from Private On-the-Road Transport.

This is the first study to provide a systematic monetary benefit matrix, including greenhouse gas (GHG) emissions reduction benefits and air pollution reduction health co-benefits, for a change in on-the-road transport to low-carbon types. The benefit transfer method is employed to estimate the social cost of carbon and the health co-benefits via impact pathway analysis in Taiwan. Specifically, the total emissions reduction benefits from changing all internal combustion vehicles to either hybrid electric vehicles, plug-in hybrid electric vehicles, or electric vehicles would generate an average of USD 760 million from GHG emissions reduction and USD 2091 million from health co-benefits based on air pollution reduction, for a total benefit of USD 2851 million annually. For a change from combustion scooters to light- or heavy-duty electric scooters, the average GHG emissions reduction benefits would be USD 96.02 million, and the health co-benefits from air pollution reduction would be USD 1008.83 million, for total benefits of USD 1104.85 million annually.

Estimation of Damage Cost to Building Façades per kilo Emission of Air Pollution in Norway

This work reports marginal damage costs to façades due to air pollution exposure estimated “bottom up,” for Norway and Oslo (Norway) by the use of exposure response functions (ERFs) and impact pathway analysis from the emission to the deteriorating impact. The aim of the work was to supply cost estimates that could be compared with reported damage costs to health, agriculture, and ecosystems, and that could be used in cost-benefit analysis by environmental authorities. The marginal damage costs for cleaning, repair, and in total (cleaning + repair) were found to be, in Norway: eight, two, and 10, respectively, and for a traffic situation in Oslo: 50 (77), 50 (28), and 100 (105), (×/÷ 2.5) Euro/kg emission of PM10, SO2, and NO2 in total. For Oslo, the values represent a recorded façade materials inventory for 17–18th century buildings, and in the brackets the same façade inventory as for Norway. In total, 5–10% of the marginal damage cost was found to be due to NO2. The total marginal cost was found to be shared about equally between the impact of PM10 and SO2 in Norway (50 and 42% of the impact) and for the 17–18th century buildings in Oslo (45% and 49% of the impact), but for a similar façade materials inventory in Oslo as Norway, the total marginal cost due to PM10 was about two-thirds and that due to SO2 about one-third of the total, with about 5% of the cost still being due to NO2. The division of the costs between the separate pollutant influences on the cleaning and repair was, however, found to be significantly different in Norway and Oslo. In Norway, about 60% of the marginal cleaning cost was found to be due to PM10, 30% due to SO2, and 10% due to NO2. In Oslo, about 85% of the marginal cleaning costs were found to be due to PM10, 10% due to SO2, and 5% due to NO2. For the marginal repair cost, the opposite situation was found, in both Norway and Oslo, with 80–90% of the cost being due to SO2, 5–10% being due to PM10, and 5–10% due to NO2. As other factors than air pollution deteriorates façades and influences maintenance decisions, the expenses that can be attributed to the air pollution could be significantly lower.

Re-analysis of SARS-CoV-2-infected host cell proteomics time-course data by impact pathway analysis and network analysis: a potential link with inflammatory response.

Coronavirus disease 2019 (COVID-19), caused by an outbreak of the severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) in Wuhan, China, has led to an unprecedented health and economic crisis worldwide. To develop treatments that can stop or lessen the symptoms and severity of SARS-CoV-2 infection, it is critical to understand how the virus behaves inside human cells, and so far studies in this area remain scarce. A recent study investigated translatome and proteome host cell changes induced in vitro by SARS-CoV-2. Here, we use the publicly available proteomics data from this study to re-analyze the in vitro cellular consequences of SARS-CoV-2 infection by impact pathways analysis and network analysis. Notably, proteins linked to the inflammatory response, but also proteins related to chromosome segregation during mitosis, were found to be altered in response to viral infection. Upregulation of inflammatory response proteins is in line with the propagation of inflammatory reaction and lung injury that is observed in advanced stages of COVID-19 patients and which worsens with age.

An evaluation of the cost-competitiveness of maritime fuels – a comparison of heavy fuel oil and methanol (renewable and natural gas) in Iceland

Alternative fuels have been proposed to ensure compliance with the increasingly more stringent emission standards proposed by the International Maritime Organization. In addition, the Icelandic government aims to introduce 10% renewable energy into the maritime sector before 2030, as well as eventually phasing out the use of heavy fuel oil (HFO). This paper conducts an extended cost-competitiveness comparison concerning three fuels: conventional methanol (NG), renewable methanol (RN) and HFO in the context of the Icelandic maritime sector. NG, RN and HFO are compared and evaluated under three scenarios (low, medium and high) for fuel prices between 2018 and 2050, and three scenarios (low, medium and high) for the external costs of fuel consumption. The methodology for estimating external costs involved Impact Pathway Analysis for emissions of sulphur dioxide, nitrous oxide, particulate matter and non-methane volatile organic compounds, and increasing shadow prices for the costs of greenhouse gas emissions. The application of this methodology provides new information about the economic and environmental trade-offs between the three fuel types. In our findings, excluding external costs, HFO emerges as the most cost-competitive option. However, when the externalities of fuel consumption are monetised and added to the fuel price, NG is the most cost-competitive option when high values are assumed for external costs. RN is the most expensive option according to all trajectories for fuel prices and external costs, not becoming more cost-competitive than HFO under any scenario until the 2040s. Therefore, on cost criteria alone, it is improbable that the fuel will contribute to Iceland's 10% renewable energy goal in the maritime sector before 2030 without subsidies or renewable marine fuel quotas.

Tailoring Process and Impact Evaluation of a "Cash-Plus" Program: The Value of Using a Participatory Program Impact Pathway Analysis.

ABSTRACTBackgroundEvaluations are often limited to affirming what impact health and nutrition interventions have, without providing enough insights into “how/why” impacts are achieved.ObjectivesThis article describes how a Program Impact Pathway (PIP) analysis was used to tailor theory-driven impact and process evaluation of a “Cash-Plus” program combining unconditional cash transfers with behavior change communication (BCC) activities, which was implemented to improve children's growth in Togo.MethodsA theoretical PIP diagram was developed using existing literature, program documentation, and interviews with the program's stakeholders at the central level. Next, the PIP diagram was refined through 2 regional participatory workshops, 6 mo after the program began. Workshop participants were multilevel field implementers and were asked to 1) discuss their vision of the program's objectives; 2) describe the “inputs–process–outputs–outcomes–impacts” flow; 3) reflect on modifiers that may arise along the PIP; and 4) report bottlenecks in the program's conception or implementation and suggest corrective actions. The PIP was used to determine research questions that should be investigated during impact or process evaluation and guided the choice of data collection methods and tools.ResultsThe PIP analysis identified 3 impact pathways, all based on the synergy between cash and raised women's knowledge. Along these pathways, the motivation and workload of frontline workers, along with issues in cash flow, were identified as factors that may affect the delivery of activities, whereas women's control over resources, time availability, support from relatives, and the presence of markets and health and school services were recognized as factors that may influence the uptake of activities. Improved communication between stakeholders and increased involvement of husbands were suggested for better impact achievement.ConclusionsThe participatory PIP analysis helped implementers and evaluators to share a common vision of the program's objective and logic, encouraged communication across sectors, and facilitated course-adjustments of the program.

Program Impact Pathway Analysis Reveals Implementation Challenges that Limited the Incentive Value of Conditional Cash Transfers Aimed at Improving Maternal and Child Health Care Use in Mali

ABSTRACTBackgroundThe program “Santé Nutritionnelle à Assise Communautaire à Kayes” (SNACK) in Mali aimed to improve child linear growth through a set of interventions targeted to mothers and children during pregnancy and up to the child's second birthday. Distributions of cash to mothers and/or lipid-based nutrient supplement to children 6–23 mo of age were added to SNACK to increase attendance at community health centers (CHCs).ObjectivesThe aim of this study, which was embedded in a cluster-randomized impact evaluation of the program, was to assess the incentive value of the cash in relation to CHC attendance.MethodsWe used a mixed-methods approach. We collected quantitative data on cash receipt and CHC attendance in a midline survey of mother–child pairs (n = 3443). A program impact pathway analysis guided qualitative data collection and analysis. Twelve CHCs were purposively selected in study groups that received cash. We conducted semistructured continuous observations of cash distributions in 11 CHCs (n = 22) and semistructured qualitative interviews with frontline workers (FLWs) (n = 71) and mothers (n = 22) who were purposively selected from the midline survey.ResultsFLWs’ knowledge of the objective and implementation plan of the cash program component was limited. A challenging physical environment and insufficient cash available for each distribution were identified as causes of irregularities in cash distributions. Most mothers mentioned having to return several times to receive their cash. Child health was identified as the main motivation to attend CHCs and cash was described as an additional benefit.ConclusionImplementation constraints related to remoteness and inaccessibility may have undermined the incentive value of the cash transfers in the SNACK program. Additional research is needed to identify interventions that not only incentivize mothers to participate but that can be implemented effectively and with high quality in challenging contexts such as rural areas of Mali.

How does "Becoming Breastfeeding Friendly" work? A Programme Impact Pathways Analysis.

Becoming Breastfeeding Friendly (BBF) is an initiative designed to track country readiness and progress to effectively scale up breastfeeding programmes. BBF includes a policy toolbox that has three components: the BBF Index (BBFI), case studies, and a five-meeting process. Mapping pathways of how BBF was implemented and utilized enables contextually grounded interpretation of its impact on breastfeeding outcomes. We conducted a programme impact pathways (PIP) analysis to identify pathways and critical quality control points (CCPs) by which BBF can enable changes in policy, legislation, and implementation of breastfeeding programmes. A BBF PIP diagram was developed, and CCPs were identified through a literature review and an iterative interviewing process with BBF investigators. The PIP was revised after feedback from BBF's Technical Advisory Group. BBF pretesting in Ghana and Mexico informed the formative evaluation of the PIP. PIP analysis identified relevant pathways between BBF activities and outcomes. Eight CCPs that could facilitate or attenuate BBF to fully impact the scaling up of the breastfeeding programmes were identified: (a) committee formed and trained; (b) committee understands BBF and BBFI; (c) committee's ability to acquire data; (d) BBFI scores; (e) criteria used for prioritizing recommendations; (f) dissemination of recommendations; (g) policymaker's reactions and media coverage; (h) committee's motivation and effective teamwork throughout BBF. Ghana and Mexico's pretesting of BBF confirmed the CCPs and provided valuable insights on potential mechanisms of BBF impacts at the country level. To further validate the PIP, a policy analysis framework is being tested in Ghana and Mexico.

Engaging stakeholders: lessons from the use of participatory tools for improving maternal and child care health services

BackgroundEffective stakeholder engagement in research and implementation is important for improving the development and implementation of policies and programmes. A varied number of tools have been employed for stakeholder engagement. In this paper, we discuss two participatory methods for engaging with stakeholders – participatory social network analysis (PSNA) and participatory impact pathways analysis (PIPA). Based on our experience, we derive lessons about when and how to apply these tools.MethodsThis paper was informed by a review of project reports and documents in addition to reflection meetings with the researchers who applied the tools. These reports were synthesised and used to make thick descriptions of the applications of the methods while highlighting key lessons.ResultsPSNA and PIPA both allowed a deep understanding of how the system actors are interconnected and how they influence maternal health and maternal healthcare services. The findings from the PSNA provided guidance on how stakeholders of a health system are interconnected and how they can stimulate more positive interaction between the stakeholders by exposing existing gaps. The PIPA meeting enabled the participants to envision how they could expand their networks and resources by mentally thinking about the contributions that they could make to the project. The processes that were considered critical for successful application of the tools and achievement of outcomes included training of facilitators, language used during the facilitation, the number of times the tool is applied, length of the tools, pretesting of the tools, and use of quantitative and qualitative methods.ConclusionsWhereas both tools allowed the identification of stakeholders and provided a deeper understanding of the type of networks and dynamics within the network, PIPA had a higher potential for promoting collaboration between stakeholders, likely due to allowing interaction between them. Additionally, it was implemented within a participatory action research project. PIPA also allowed participatory evaluation of the project from the perspective of the community. This paper provides lessons about the use of these participatory tools.

The Science of Impact and the Impact of Agricultural Science

AbstractResearch impact and its measurement are of increasing importance. This is particularly significant for agricultural science, which is expected to produce solutions to future challenges that will arise from population growth, climate change and ecosystem degradation. Much econometric effort has been devoted to analysis of investment in agricultural research and its effects on farm productivity. This analysis, reviewed here, has produced a consensus suggesting that returns are high, although they are achieved only after long lags. However, policy‐makers perceive the occurrence of impacts as too few, and poorly targeted with respect to their needs. An attribution gap between the outcomes of agricultural research and how they reach farmers has motivated evaluation of the process of transmission and translation of agricultural research outputs into ultimate impacts. This gap can be narrowed by Participatory Impact Pathway Analysis, implemented mostly so far in low income countries. However, it is a costly and cognitively complex approach. Content analysis of the UK's 2014 REF Impact Case Studies uncovers the mind set of researchers and their managers regarding the description of impact and how it is supposed to occur. This reveals a nascent conservatism that focuses on research that can be shown to have impact, rather than research impact itself. From the overall discussion it can be concluded that the impact evaluation of agricultural science raises more profound issues than simply efficiency or transparency. Confirmation bias threatens impact evaluation, principally by distracting from other important stories about how and why the ultimate effects occur, but also by transforming the nature of the process itself. Methodological pluralism, with greater integration and triangulation between different evaluation approaches, is a promising means of resolving these problems.

Evaluation and monitoring of transdisciplinary collaborations

In this paper we focus on the governance, in particular evaluation and monitoring, of the growing number of transdisciplinary collaborations (TDC’s). Researchers and a variety of stakeholders collaborate in such TDC’s, the purpose of which is to address societal challenges, like renewable energy, healthy aging or better language teaching in schools. Commonly used practices for evaluation of scientific research (accountability, rankings and benchmarking, dedicated to scientific excellence) do not fit the goals of TDC’s. A bottom up or stakeholder oriented approach is better suited; one that stimulates mutual learning as well as the development of socially robust knowledge. We introduce the participatory impact pathways analysis (PIPA), as a method that suits the requirements. It has been developed in the context of development research. Two crucial features are the involvement of stakeholders from the start, and the joint development of a theory of change. This narrates what one wants to achieve and how that will be achieved. From this, stakeholders construct a logical frame that serves as a source for indicators. These indicators enable monitoring ex durante, during the TDC. We present evidence of the use of PIPA for a TDC. From this empirical evidence a number of issues with regard to evaluation, monitoring and indicators can be identified that require attention. Most prominent is the change of function of indicators. Instead of looking back and a focus on past performance, indicators look forward, in the short, intermediate and more distant future.

Implementation, utilization and influence of a community-based participatory nutrition promotion programme in rural Ethiopia: programme impact pathway analysis.

A community-based participatory nutrition promotion (CPNP) programme, involving a 2-week group nutrition session, attempted to improve child feeding and hygiene. The implementation, utilization and influence of the CPNP programme were examined by programme impact pathway (PIP) analysis. Five CPNP programme components were evaluated: (i) degree of implementation; (ii) participants' perception of the nutrition sessions; (iii) participants' message recall; (iv) utilization of feeding and hygiene practices at early programme stage; and (v) participants' engagement in other programmes. Habro and Melka Bello districts, Ethiopia. Records of 372 nutrition sessions, as part of a cluster-randomized trial, among mothers (n 876 in intervention area, n 914 in control area) from a household survey and CPNP participants (n 197) from a recall survey. Overall, most activities related to nutrition sessions were successfully operated with high fidelity (>90 %), but a few elements of the protocol were only moderately achieved. The recall survey among participants showed a positive perception of the sessions (~90 %) and a moderate level of message recall (~65 %). The household survey found that the CPNP participants had higher minimum dietary diversity at the early stage (34·0 v. 19·9 %, P=0·01) and a higher involvement in the Essential Nutrition Action (ENA) programme over a year of follow-up (28·2 v. 18·3 %; P<0·0001) compared with non-participants within the intervention area. Our PIP analysis suggests that CPNP was feasibly implemented, promoted a sustained utilization of proper feeding behaviours, and enhanced participation in the existing ENA programme. These findings provide a possible explanation to understanding CPNP's effectiveness.