Better evidence for a better world

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Better evidence for a better world
Better evidence for a better world

Better evidence for a better world (169)

Additional Info

  • Authors David Wilson, Charlotte Gill, Ajima Olaghere, Dave McClure
  • Published date 2016-03-23
  • Coordinating group(s) Crime and Justice
  • Type of document Review Plain language summary
  • Library Image Library Image
  • See the full review https://onlinelibrary.wiley.com/doi/10.4073/csr.2016.3
  • Records available in English, Spanish
  • English

    PLAIN LANGUAGE SUMMARY

    Juvenile curfews are not effective in reducing crime and victimization

    The evidence suggests that juvenile curfews do not reduce crime or victimization.

    What is this review about?

    Curfews restrict youth below a certain age – usually 17 or 18 – from public places during night time. For example, the Prince George’s County, Maryland curfew ordinance restricts youth younger than 17 from public places between 10 p.m. and 5 a.m. on weekdays and between midnight and 5 a.m. on weekends. Sanctions range from a fine that increases with each offense, community service, and restrictions on a youth’s driver’s license. Close to three quarters of US cities have curfews, which are also used in Iceland.

    A juvenile curfew has common sense appeal: keep youth at home during the late night and early morning hours and you will prevent them from committing a crime or being a victim of a crime. In addition, the potential for fines or other sanctions deter youth from being out in a public place during curfew hours.

    This review synthesizes the evidence on the effectiveness of juvenile curfews in reducing criminal behavior and victimization among youth.

    What is the aim of this review?

    This Campbell systematic review assesses the effects of juvenile curfews on crime and victimization. The review summarizes findings from 12 studies.

    What are the main findings of this review?

    What studies are included?

    Included studies test the effect of an official state or local policy intended to restrict or otherwise penalize a juvenile’s presence outside the home during certain times of day. This must have been a general preventive measure directed at all youth within a certain age range and not a sanction imposed on a specific youth.

    Twelve quantitative evaluations of the effects of curfews on youth criminal behavior or victimization are included in the review.

    Do curfews reduce crime and victimization?

    The pattern of evidence suggests that juvenile curfews are ineffective at reducing crime and victimization. The average effect on juvenile crime during curfew hours was slightly positive - that is a slight increase in crime - and close to zero for crime during all hours. Similarly, juvenile victimization also appeared unaffected by the imposition of a curfew ordinance.

    However, all the studies in the review suffer from some limitations that make it difficult to draw firm conclusions. Nonetheless, the lack of any credible evidence in their favor suggests that any effect is likely to be small at best and that curfews are unlikely to be a meaningful solution to juvenile crime and disorder.

    Other studies have suggested curfews may be ineffective as juvenile crime is concentrated in hours before and after school, and that under-resourced police forces focus on more urgent demands than enforcing curfews.

    What do the findings in this review mean?

    Contrary to popular belief, the evidence suggests that juvenile curfews do not produce the expected benefits. The study designs used in this research make it difficult to draw clear conclusions, so more research is needed to replicate the findings. However, many of the biases likely to occur in existing studies would make it more, rather than less, likely that we would conclude curfews are effective. For example, most of these studies were conducted during a time when crime was dropping

    throughout the United States. Therefore, our findings suggest that curfews either don’t have any effect on crime, or the effect is too small to be identified in the research available.

    How up-to-date is this review?

    The search for this review was updated in March 2014.

  • Spanish

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Additional Info

  • Authors Carol Rivas, Jean Ramsay, Laura Sadowski, Leslie Davidson, Danielle Dunne, Sandra Eldridge, Kelsey Hegarty, Angela Taft, Gene Feder
  • Published date 2016-01-04
  • Coordinating group(s) Social Welfare
  • Type of document Review Plain language summary
  • Library Image Library Image
  • See the full review https://onlinelibrary.wiley.com/doi/10.4073/csr.2016.2
  • Records available in English, Spanish
  • English

    PLAIN LANGUAGE SUMMARY

    Limited evidence and limited effects of advocacy to reduce intimate partner violence

    Intensive advocacy may improve everyday life for women in domestic violence shelters and refuges, and reduce physical abuse. There is no clear evidence that intensive advocacy reduces sexual, emotional, or overall abuse, or that it benefits women’s mental health. It is unclear whether brief advocacy is effective.

    What is the review about?

    Partner abuse or domestic violence includes physical, emotional, and sexual abuse; threats; withholding money; causing injury; and long lasting physical and emotional health problems. Active support by trained people, which is called ‘advocacy’, may help women make safety plans, deal with abuse, and access community resources.

    Advocacy may be a stand-alone service, accepting referrals from healthcare providers, or part of a multi-component, and possibly multi-agency, intervention. It may take place in the community, a shelter, or as part of antenatal or other healthcare, and vary in intensity from less than an hour to 80 hours.

    Advocacy may contribute to reducing abuse, empowering women to improve their situation by providing informal counselling and support for safety planning and increasing access to different services.

    What is the aim of this review?

    This Campbell systematic review assesses the effects of advocacy interventions on intimate partner violence and women’s wellbeing. The review summarizes findings from 13 studies.

    What were the main findings of the review?

    What studies are included?

    This review summarizes evidence from 13 clinical trials comparing advocacy for 1,241 abused women with no care or usual care. Most studies followed up on the women for at least a year.

    Does advocacy reduce intimate partner violence and improve women’s wellbeing?

    Physical abuse: After one year, brief advocacy had no effect in two healthcare studies and one community study, but it reduced minor abuse in one antenatal care study. Another antenatal study showed reduced abuse immediately after brief advocacy, but women were also treated for depression, which may have affected results. Two studies provided weak evidence that intensive advocacy reduces physical abuse up to two years after the intervention.

    Sexual abuse was reported in four studies, which found no effects.

    Emotional abuse: One antenatal care study reported reduced emotional abuse at 12 months after advocacy.

    Depression: Brief advocacy prevented depression in abused women attending healthcare services and pregnant women immediately after advocacy. Intensive advocacy did not reduce depression in shelter women followed up at 12 and 24 months. The moderate-to-low quality evidence came mostly from studies with a low risk of bias.

    Quality of life: Three trials of brief advocacy trials no benefit on quality of life. Intensive advocacy showed a weak benefit in two studies in domestic violence shelters and refuges, and a primary care study showed improved motivation to do daily tasks immediately after advocacy.

    What do the results mean?

    Intensive advocacy may improve everyday life for women in domestic violence shelters and refuges in the short term, and reduce physical abuse one to two years after the intervention. There is no clear evidence that intensive advocacy reduces sexual, emotional, or overall abuse, or that it benefits women’s mental health. It is unclear whether brief advocacy is effective, although it may provide short-term mental health benefits and reduce abuse, particularly in pregnant women and those suffering less severe abuse.

    Several studies summarised in this review are potentially biased because of weak study designs. There was little consistency between studies, with variations for advocacy given, the type of benefits measured, and the lengths of follow-up periods, making it hard to combine their results. So it is not possible to be certain how much or which type of advocacy interventions benefit women.

    How up-to-date is this review?

    The search for this review was updated in April 2015.

  • Spanish

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Additional Info

  • Authors Caio Piza, Tulio Antonio Cravo, Linnet Taylor, Lauro Gonzalez, Isabel Musse, Isabela Furtado, Ana C. Sierra, Samer Abdelnour
  • Published date 2016-01-04
  • Coordinating group(s) International Development
  • Type of document Review Plain language summary
  • Library Image Library Image
  • See the full review https://onlinelibrary.wiley.com/doi/10.4073/csr.2016.1
  • Records available in English, Spanish
  • English

    PLAIN LANGUAGE SUMMARY

    Business support services to small and medium enterprises seem to improve firm performance

    Support to small and medium enterprises (SMEs) can improve their revenue and profits, their ability to create jobs, labour productivity and their ability to invest. But these effects are not large, and the cost effectiveness of the interventions not known. The effects on innovation are unclear.

    What is the review about?

    Large amounts of funding are going towards programmes to support small and medium enterprises (SMEs) in low- and middle-income countries in order to increase revenue and profits, generate employment, and, so, create economic growth and reduce poverty.

    The Campbell review summarizes evidence of the impact of these programmes on measures of SME performance including revenues, profits, and productivity, as well as the firms’ ability to generate employment and increase their labour productivity.

    What is the aim of this review?

    This Campbell systematic review assesses the effects of business support services in low- and middle-income countries on firm performance and economic development. The review summarizes findings from 40 studies.

    What were the main findings of the review?

    What studies are included?

    Included studies examine interventions targeted at SMEs (up to 250 employees) involving tax simplification, exports and access to external markets; support for innovation policies; support to local production systems; training and technical assistance, and SME financing and credit guarantee programmes.

    Findings from 40 studies are summarised in the review. These studies present evidence from 18 low- and middle-income countries, with 26 studies analysing programmes in Latin America, six from Asia and five from Africa.

    Do business support services work?

    On average, business support to SMEs seems to improve their performance, their ability to create jobs, their labour productivity and their ability to invest. The effects on innovation are unclear.

    Matching grants, technical assistance and tax simplification programmes can improve firms’ performance and job creation; with technical assistance also likely to improve labour productivity. Export promotion and innovation programmes positively affect exports and innovation, but there is no evidence that they improve performance or job creation.

    However, the effects of the programmes studied are not very large. Most studies do not include the required data to assess if the programmes are cost effective.

    What do the results mean?

    Overall SME support has a positive impact on various measures of firm performance, but with some caveats. Results for the interventions studied are limited due to a lack of evidence. And the evidence available was mainly about programmes in Latin American countries. There is a likelihood of bias in many studies. Most did not report programme implementation costs, so it is not possible to weigh costs against benefits. Research on these programmes in sub-Saharan Africa in particularly encouraged, as this would contribute to the understanding of the role that support to small Businesses may play in development processes there.

    How up-to-date is this review?

    The search for this review was updated in December 2014.

  • Spanish

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Additional Info

  • Authors Angela Higginson, Kathryn Ham Benier, Yulia Shenderovich, Laura Bedford, Lorraine Mazerolle, Joseph Murray
  • Published date 2015-11-02
  • Coordinating group(s) Crime and Justice, International Development
  • Type of document Review Plain language summary
  • Library Image Library Image
  • See the full review https://onlinelibrary.wiley.com/doi/10.4073/csr.2015.18
  • Records available in English, Spanish
  • English

    PLAIN LANGUAGE SUMMARY

    There are no rigorous studies of preventive interventions to reduce youth involvement in gangs in low- and middle-income countries

    Youth gang crime poses a serious problem for low and middle-income countries costing billions of dollars in harm, loss of life and social disruption. Preventive interventions are intended to stop crime before it occurs, but there is no evidence as to their effectiveness in low- and middle-income countries.

    What did the review study?

    Youth gangs are commonly associated with high levels of crime and violence in low and middle-income countries. Gangs are often linked to youth trying to overcome extreme disadvantage and marginalisation.

    Preventive interventions are intended to stop crime before it occurs, either by preventing youth from joining gangs or by reducing recidivism by rehabilitating gang members outside of the criminal justice system. This review examines the effectiveness of these preventive interventions in achieving their aims, as well as identifying factors behind successful implementation in low and middle-income countries.

    What is the aim of this review?

    This Campbell systematic review examines why the implementation of preventive interventions to reduce youth involvement in gangs and gang crime may fail or succeed low and middle-income countries. The review summarises findings from four studies conducted in Latin America and the Caribbean. These include findings from field observations and interviews with 63 former gang members in Guatemala, Honduras and El Salvador, 940 respondents in 3 Jamaican communities, 24 participants in Nicaragua and 25 participants in Peru.

    What studies are included?

    Included studies reported on youth gangs with participants aged 10-29 and were located in a low- or middle-income country. Effectiveness studies had to use a valid experimental or non-experimental design.

    There were no studies that met the criteria for an evaluation of effectiveness.

    Four studies evaluating the reasons for implementation success or failure were included in this review. Two of the studies used a purely qualitative study design while the other two used a mixed method study design. All four studies were conducted in Latin America and the Caribbean.

    What are the main results in this review?

    It is not possible to make any conclusions regarding the effectiveness of preventive interventions.

    Four factors may be important for intervention design and implementation:

    1. Having a range of programme components that appeal to youth such as arts and sports.
    2. Active engagement of youths and gang leaders in forming and implementing the programme.
    3. Ensuring continuity of social ties outside the gang which are fragile and may not be preserved after short-term interventions.
    4. Ongoing violence and gang involvement limits successful implementation so needs to be addressed.

    What do the findings in this review mean?

    Preventive gang interventions may be more likely to be successfully implemented where the four factors listed above are present.

    The lack of rigorous evaluations of preventive gang interventions in low and middle-income countries means it is not possible to draw any conclusions about which interventions are most effective in reducing youth involvement in gangs in these contexts. More quantitative and qualitative research on the effectiveness of preventive gang programs is needed in order to determine the best intervention practice.

    How up-to-date is this review?

    The review authors searched for studies published until September 2013.

  • Spanish

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Additional Info

  • Authors Lana Augustincic Polec, Jennifer Petkovic, Vivian Andrea Welch, Erin Ueffing, Elizabeth Tanjong Ghogomu, Jordi Pardo Pardo, Mark Grabowsky, Amir Attaran, George A. Wells, Peter Tugwell
  • Published date 2015-11-02
  • Coordinating group(s) International Development
  • Type of document Review Plain language summary
  • Library Image Library Image
  • See the full review https://onlinelibrary.wiley.com/doi/10.4073/csr.2015.17
  • Records available in English, Spanish
  • English

    PLAIN LANGUAGE SUMMARY

    Free bednets increase ownership, and education can increase use

    Economic and educational strategies increase people’s ownership and appropriate use of insecticide-treated bednets (ITNs) in developing countries.

    What did the review study?

    Around 40 percent of the world’s population lives in areas affected by malaria, which is a life-threatening parasitic disease. Insecticide-treated bednets (ITNs) effectively prevent malaria. However, barriers to their use have been identified. This Campbell systematic review assesses the effectiveness of economic and educational strategies for ownership and appropriate use of insecticide-treated bednets in developing countries.

    What is the aim of this review?

    This Campbell systematic review assesses the effectiveness of economic, and educational strategies for ownership and appropriate use of insecticide-treated bednets in developing countries. The review also examines whether changes in ITN ownership and use affect malaria-specific morbidity rates. The review summarises findings from 10 studies, nine of which were conducted in rural Africa and one in rural India.

    What studies are included?

    Included studies tested different strategies to increase the ownership and correct use of ITNs among people living in areas affected by malaria. The study design had to have a comparison group, and include participants with permanent residence in malaria areas.

    Eight cluster randomised-controlled studies together with one randomised controlled and one controlled before-after study were included.

    What are the main results in this review?

    Do economic, and educational strategies increase people’s ownership and appropriate use of ITNs?

    Compared to providing ITNS at full market or a subsidized price, giving away ITNs for free increases the number of people owning an ITN. However, the provision of free ITNs increases their use only slightly or not at all.

    Providing education in the appropriate use of ITNs increases the number of people sleeping under bednets compared to a control group which didn’t receive the education.

    Combining these strategies with unspecified incentives does not increase ITN ownership, leading to little or no differences in their appropriate use. Embedding the promotion of ITNs within specific health- or finance-focused marketing messages only leads to small or no differences in bednet ownership and use.

    Do changes in ITN ownership and use affect malaria-specific morbidity rates?

    There is some evidence of improved malaria-specific morbidities among children and adults as a result of increased ITN ownership and use. However, the evidence supporting this finding is of low certainty and should be interpreted with caution.

    Are there any adverse effects from applying economic, educational or marketing strategies to increase the ownership and appropriate use of ITNs in malaria areas of developing countries?

    None of the included studies measured adverse side effects.

    What do the findings in this review mean?

    Providing ITNs for free can increase bednet ownership in malaria areas in developing countries. Combining this economic strategy with education in the appropriate use of ITNs can increase the number of people sleeping under ITNs.

    Further research is needed to compare the relative effectiveness of different ITN delivery and marketing strategies and of different educational approaches to ensure their appropriate use in malaria-infested areas. Future trials should also examine the sustainability of ITN interventions together with the impact of social and demographic factors on ITN ownership and use.

    How up-to-date is this review?

    The review authors searched for studies published until February 2013.

  • Spanish

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Additional Info

  • Authors Janice Tripney, Alan Roulstone, Nina Hogrebe, Carol Vigurs, Elena Schmidt, Ruth Stewart
  • Published date 2015-11-02
  • Coordinating group(s) Education, International Development
  • Type of document Review
  • See the full review https://onlinelibrary.wiley.com/doi/10.4073/csr.2015.20

Additional Info

  • Authors Carinne Brody, Thomas de Hoop, Martina Vojtkova, Ruby Warnock, Megan Dunbar, Padmini Murthy, Shari L. Dworkin
  • Published date 2015-11-02
  • Coordinating group(s) International Development
  • Type of document Review Plain language summary
  • Library Image Library Image
  • See the full review https://onlinelibrary.wiley.com/doi/10.4073/csr.2015.19
  • Records available in English, Spanish
  • English

    PLAIN LANGUAGE SUMMARY

    Economic self-help groups empower women

    Women’s economic self-help groups (SHGs) have positive effects on the economic, social and political empowerment of women in low-and middle-income countries.

    What is the review about?

    Women have limited access to financial resources, health care, education and political participation. Governments, development agencies and grassroot organisations support women’s self-help groups to address substantial inequalities.

    Economic self-help groups (ESHG) are group programs aiming to provide women access to capital, to empower them economically. ESHG begin with a period of collective savings to facilitate intragroup lending, gradually providing larger loans. Some ESHG also include a training component on life skills, business and financial skills, and community participation.

    This review examines ESHG’s impact on women’s individual empowerment in low-and middle-income countries. Adverse outcomes from ESHG on intimate partner violence, stigma, disappointment and individual well-being are assessed.

    Finally, the review describes mechanisms by which ESHG lead to women’s empowerment.

    What is the aim of this review?

    This Campbell systematic review examines the effectiveness of women’s economic self-help groups (ESHG) on individual women empowerment in low-and middle-income countries. It also examines the mechanisms that empower women through female participants’ experiences of ESHG membership. The review summarises findings from 23 quantitative studies and 11 qualitative studies. The vast majority of these studies was conducted in South Asia.

    Which studies are included in this review?

    Studies included in this review examine the impact of ESHG on the empowerment of women of all ages in low-and middle-income countries. Evidence comes from 23 quantitative studies, 17 of which are based in India and Bangladesh. Each of these studies compares the effect of ESHG with no intervention, or ‘business as usual’. Eleven qualitative studies (nine from India), used to explore the mechanisms that empower women through female ESHG participants’ perspectives are included.

    What are the main results in this review?

    ESHG have positive effects on women’s economic and political empowerment, as well as social empowerment - such as, women’s family size decision-making power and social mobility. There is no quantitative evidence to indicate positive effects on women’s psychological empowerment. However, the qualitative studies suggest that women participating in ESHG perceive themselves as psychologically empowered.

    ESHG with a training component, such as financial and business education or life skills training, have a larger effect than programs that do not involve training. Important mechanisms which facilitate empowerment are gaining financial skills (economic empowerment); gaining the capability to speak in front of others, access to household decision-making (psychological empowerment); improved networks and the experience of mutual support from and solidarity with fellow group members (social empowerment); and access to wider social participation combined with an increased understanding of political contexts and individual rights (political empowerment).

    There is no evidence of increased levels of domestic violence. Qualitative data indicate that ESHG may decrease domestic violence as women gain respect from their partners, families and access to household decision-making. Few qualitative studies report experiences of disappointment, mistrust and stigma among women who attended ESHG. ESHGs do not reach the poorest citizens. The ‘poorest of the poor’ do not participate for economic and religious reasons, and mechanisms of self-selection.

    What do the findings in this review mean?

    ESHG have the potential to empower women economically, socially, and politically. Training component should be considered as a part of ESHG design to strengthen ESHG’s empowering effect. The design of ESHG should also be tailored to the local context, and barriers to participation should be addressed to increase the likelihood that ESHG will reach the poorest.

    There is a need for more rigorous quantitative studies of ESHG. This includes a more comprehensive and detailed description of program and training components, as well as studies to provide a greater understanding of the pathways or mechanisms through which ESHG increase empowerment.

    How up-to-date is this review?

    The review authors searched for studies conducted between 1980 and January 2014.

  • Spanish

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Additional Info

  • Authors Trine Filges, Ditte Andersen, Anne-Marie Klint Jørgensen
  • Published date 2015-09-01
  • Coordinating group(s) Social Welfare
  • Type of document Review Plain language summary
  • Library Image Library Image
  • See the full review https://onlinelibrary.wiley.com/doi/10.4073/csr.2015.14
  • Records available in English, Spanish
  • English

    PLAIN LANGUAGE SUMMARY

    Little evidence on the effectiveness of FFT as a treatment for non-opioid drug use for young people

    Functional Family Therapy (FFT) is used as a treatment for young peoples’ use of cannabis, amphetamines, ecstasy, or cocaine. There is very little evidence of its effectiveness, so it should be used with caution and subject to further evaluation.

    What did the review study?

    Functional Family Therapy (FFT) is a short-term, manual-based, intervention. It is delivered in outpatient settings and aims to modify interactions between family members to improve youth behavior. This review assesses the effectiveness of FFT as a treatment for young peoples’ use of cannabis, amphetamines, ecstasy, or cocaine.

    What is the aim of this review?

    This Campbell systematic review assesses the effectiveness of FFT to reduce drug abuse (cannabis, amphetamines, ecstasy, or cocaine) among young people aged 11 to 21 years. The review includes two randomised controlled trials, but summarises findings from only one study reporting on the outcome of drug use.

    What studies are included?

    The review includes controlled trials evaluating the effectiveness of FFT to reduce drug abuse among young people aged 11 to 21 years. Studies included in the review compare the effects of FFT on non-opioid drug use with no intervention, a waitlist condition or with alternative treatments.

    Two studies, reported in three papers, are included. Both were conducted in the U.S. Only one provides outcomes related to youth drug use. It compares the effectiveness of FFT with that of alternative treatments.

    What are the main results in this review?

    The results from the one study reporting on the effect of FFT on youth drug use shows a short-term (four month) reduction in the use of cannabis, an effect that disappears in the longer term.

    What do the findings in this review mean?

    There is a dearth of evidence on the effectiveness of FFT for the treatment of non-opioid drug use in young people. It is impossible to draw conclusions and as such, FFT should be used with caution when targeting youth drug use. Agencies supporting FFT should build studies of effectiveness into their programmes.

    How up-to-date is this review?

    The review authors searched for studies published until July 2013.

  • Spanish

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Additional Info

  • Authors Valentina Iemmi, Lorna Gibson, Karl Blanchet, Suresh Kumar, Santosh Rath, Sally Hartley, GVS Murthy, Vikram Patel, Joerg Weber, Hannah Kuper
  • Published date 2015-09-01
  • Coordinating group(s) International Development
  • Type of document Review Plain language summary
  • Library Image Library Image
  • See the full review https://onlinelibrary.wiley.com/doi/10.4073/csr.2015.15
  • Records available in English, Spanish
  • English

    PLAIN LANGUAGE SUMMARY

    Positive effects from community-based rehabilitation for people with disabilities and their carers in low- and middle-income countries

    Community-based rehabilitation has a beneficial effect on the lives of people with disabilities in low- and middle-income countries.

    What is the review about?

    People with disabilities include those who have long-term physical, mental, intellectual or sensory impairments. The World Health Organization endorses community-based rehabilitation interventions as the strategy for addressing the needs of people with disabilities in low- and middle-income countries. There are an estimated one billion people with disabilities globally, of which 80% live in low- and middle-income countries.

    This Campbell systematic review looks at the evidence from different types of community- based rehabilitation interventions in low- and middle-income countries targeting different types of physical and mental disabilities, including stroke, arthritis, chronic obstructive pulmonary disease, schizophrenia, dementia and intellectual impairment.

    These interventions aim to enhance the quality of life of people with disabilities and their carers, by meeting their basic needs and ensuring inclusion and participation using predominantly local resources. These interventions are composed of up to five components: health, education, livelihood, social and empowerment.

    What is the aim of this review?

    This Campbell systematic review looks at the evidence from different types of community- based rehabilitation interventions in low- and middle-income countries, which target different types of physical and mental disabilities. This review summarises findings from 15 studies, six which focus on physical disabilities and nine on mental disabilities.

    What studies are included?

    Studies included in this review cover a wide range of client populations, interventions and outcomes. The primary focus of 14 of the interventions is health, and one intervention is focused on education. Other components of community-based rehabilitation are a minor focus in some of the studies.

    Only one study concerned children. Most of the interventions targeted both people with disabilities and their carers, although most of the studies evaluated the effect of the intervention on the people with disabilities only. The majority of studies were undertaken in Asia, particularly in China. One study was from South Africa. The review highlights the need for studies from Sub-Saharan Africa.

    What were the main findings of the review?

    Moderate to high quality evidence shows that community- based rehabilitation has a positive impact on people with disabilities.

    Of six studies focusing on CBR for people with physical disabilities, three showed a beneficial effect of the intervention for stroke on a range of outcomes while one found a smaller effect; one study found a beneficial impact of CBR for arthritis; and one showed a positive impact of CBR for people with chronic obstructive pulmonary disease. The nine studies assessing the impact of CBR for people with mental disabilities showed a beneficial effect on schizophrenia (5 studies), dementia (3 studies) and intellectual disability (1 study).

    None of the studies that met the review’s inclusion criteria included economic evaluations of community-based rehabilitation.

    What do the findings of this review mean?

    Each community-based rehabilitation programme is tailored to specific needs and settings. Furthermore, impact is measured in a variety of domains, including participation, quality of life and clinical outcomes. This means that establishing an evidence base for effectiveness of community- based rehabilitation is difficult.

    Economic evaluation, including cost effectiveness, is needed to understand whether resource allocation is appropriate given the challenges faced by low- and middle-income countries.

    To build stronger evidence, future studies will need to focus on broader client groups and include economic evaluations.

    How up-to-date is this review?

    The review authors searched for studies published between 1976 and 2012.

  • Spanish

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Additional Info

  • Authors Ruth Stewart, Laurenz Langer, Natalie Rebelo Da Silva, Evans Muchiri, Hazel Zaranyika, Yvonne Erasmus, Nicola Randall, Shannon Rafferty, Marcel Korth, Nolizwe Madinga, Thea de Wet
  • Published date 2015-09-01
  • Coordinating group(s) International Development
  • Type of document Review Plain language summary
  • Library Image Library Image
  • See the full review https://onlinelibrary.wiley.com/doi/10.4073/csr.2015.16
  • Records available in English, Spanish
  • English

    PLAIN LANGUAGE SUMMARY

    Training, innovation and technology interventions can improve livelihoods for smallholder farmers in Africa, but there are few rigorous studies

    Interventions that provide training or encourage adoption of new farming technology or practices show potential to improve the livelihoods of smallholder farmers in Africa. For example, supporting farmers to grow orange-fleshed sweet potatoes - a variety of sweet potato high in vitamin A - appears to lead to improved nutrition status. However, few rigorous studies have been conducted to assess the effects of such interventions.

    What is this review about?

    Many poor people living in Africa depend on their small farms for survival. There has been a lot of interest in trying to reduce poverty in the region by supporting these farmers to produce more and make a profit from their farms. Such interventions include training farmers and introducing them to new farming techniques and products, such as new crop types or fertilisers.

    Although a substantial amount of money has been invested in these approaches by governments and international donors, the effects of these interventions on food security and economic outcomes are unclear. This review examines the effectiveness of training, innovation and new technology interventions on the economic outcomes and food security of smallholder farmers in Africa.

    What is the aim of this review?

    This Campbell Systematic Review examines the effects of training, innovation and new technology on the economic outcomes and food security of smallholder farmers in Africa. The review summarises 19 studies that used experimental or quasi-experimental methods.

    What studies are included?

    To be eligible for inclusion in this review studies were required to: a) be conducted in Africa; b) feature smallholder farmers as the target population; c) evaluate a training programme and/or facilitation of innovation and new technology; d) measure the effects of these interventions on economic outcomes or food security; and e) use experimental or quasi-experimental methods.

    The review includes 19 studies: five studies of training programmes and 14 studies of innovation and new technology. Most of the innovation studies assessed the effects of new agricultural inputs.

    What are the main findings of this review?

    What are the effects of innovation and technology on smallholder livelihoods?

    Interventions that provide smallholders with new biological or chemical inputs, such as fertiliser or crop varieties, improve farmers’ income and food security. In particular, introducing farmers to orange-fleshed sweet potato increases their nutritional status. Few high-quality studies have been conducted to assess the effect of interventions to change farming practices, although some evaluations suggest such interventions may increase farmers’ income in the short term.

    What are the effects of training on smallholder livelihoods?

    Interventions that provide smallholders with training may increase farmers’ income, but few high-quality studies are available to evaluate such interventions.

    How has this intervention worked?

    The positive effects of these interventions suggest that smallholder farmers in Africa are willing and able to participate in training and adopt new agricultural inputs.

    What do the findings of this review mean?

    Interest has grown in interventions to support smallholder farmers because such interventions have the potential to improve both household income and food security. This review confirms providing smallholders with new biological or chemical inputs, particularly orange-fleshed sweet potato, can lead to improved income and nutrition status. More high-quality studies are needed to assess other types of training, innovation, and new technology interventions. Research is also needed to assess whether such interventions have sustainable, long-term effects and whether they may cause harm to farmers or their communities.

    How up-to-date is this review?

    The review authors searched for studies published between 1990 and February 2015.

  • Spanish

    Click on 'Download PDF' on the right to view the plain language summary in Spanish.

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