In the context of the Sustainable Development Goals and the shifting global burden of disease, this systematic review analyses the evidence from rigorously evaluated programmes that seek to transform ...the gendered social norms undermining the health and wellbeing of children, adolescents, and young adults. The aim of this study was threefold: to describe the landscape of gender-transformative programmes that attempt to influence health-related outcomes; to identify mechanisms through which successful programmes work; and to highlight where gaps might exist in implementation and evaluation.
We systematically reviewed rigorous evaluations published between Jan 1, 2000, and Nov 1, 2018 of programmes that sought to decrease gender inequalities and transform restrictive gender norms to improve the health and wellbeing of 0–24 year olds. We included rigorously evaluated health programmes that met the Interagency Gender Working Group definition of gender-transformative programming, regardless of where in the world they were implemented and what area of health they focused on.
Among 22 993 articles identified by our search, 61 evaluations of 59 programmes met review criteria. Programmes were concentrated in sub-Saharan Africa (25 42%), south Asia (13 22%), and North America (13 22%) and mainly measured health indicators related to reproductive health (29 48%), violence (26 43%), or HIV (18 30%). Programmes most frequently focused on improving the individual power of the beneficiaries, rather than working on broader systems of inequality. 45 (74%) of the evaluations measured significant improvements in health-related and gender-related indicators; however, only ten (16%) showed evidence of, or potential for, broader norm change. These ten programmes worked with sectors beyond health, included multiple stakeholders, implemented diversified strategies, and fostered critical awareness and participation among affected community members.
This review can accelerate efforts to improve global health by leading to more strategic investment in programmes that promote gender equality and target restrictive gender norms among young people. Such programmes can lead to a lifetime of improved health and wellbeing by challenging not only attitudes and behaviours related to gender at an early age, but also the gendered systems that surround them.
Bill & Melinda Gates Foundation.
Value-added (VA) models are used for accountability purposes and quantify the value a teacher or a school adds to their students' achievement. If VA scores lack stability over time and vary across ...outcome domains (e.g., mathematics and language learning), their use for high-stakes decision making is in question and could have detrimental real-life implications: teachers could lose their jobs, or a school might receive less funding. However, school-level stability over time and variation across domains have rarely been studied together. In the present study, we examined the stability of VA scores over time for mathematics and language learning, drawing on representative, large-scale, and longitudinal data from two cohorts of standardized achievement tests in Luxembourg (N = 7,016 students in 151 schools). We found that only 34-38% of the schools showed stable VA scores over time with moderate rank correlations of VA scores from 2017 to 2019 of r = .34 for mathematics and r = .37 for language learning. Although they showed insufficient stability over time for high-stakes decision making, school VA scores could be employed to identify teaching or school practices that are genuinely effective-especially in heterogeneous student populations.
Evidence that gender inequalities and restrictive norms adversely affect health is extensive; however, far less research has focused on testing solutions. We first comprehensively reviewed the ...peer-reviewed and grey literature for rigorously evaluated programmes that aimed to reduce gender inequality and restrictive gender norms and improve health. We identified four mutually reinforcing factors underpinning change: (1) multisectoral action, (2) multilevel, multistakeholder involvement, (3) diversified programming, and (4) social participation and empowerment. Following this review, because little research has investigated the effects of national-level law and policy reforms, we conducted original quasi-experimental studies on laws and policies related to education, work, and income, all social determinants of health in which deep gender inequalities exist. We examined whether the laws and policies significantly affected health outcomes and gender norms, and whether law-induced and policy-induced changes in gender norms mediated the health effects, in areas for which longitudinal data existed. Laws and policies that made primary education tuition-free (13 intervention countries with the law and/or policy and ten control countries without) and that provided paid maternity and parental leave (seven intervention and 15 control countries) significantly improved women's and their children's health (odds ratios OR of 1·16–2·10, depending on health outcome) and gender equality in household decision making (OR 1·46 for tuition-free and 1·45 for paid maternity and parental leave) as a proxy indicator of gender norms. Increased equality partially mediated the positive effects on health outcomes. We conclude by discussing examples of how improved governance can support gender-equitable laws, policies, and programmes, immediate next steps, and future research needs.
2 Side-stepping the question of reparations, the Methodists responded six months later by announcing their program for Black empowerment, which included donations to several Black, Mexican-American, ...and Indian-American religious and civil rights organizations, along with $550,000 to Black colleges. 3 At the time, few paid attention to what was, in effect, an appropriation of Black Power. In 1966, while protesting racism in Mississippi, the chairman of the Student Non-Violent Coordinating Committee, Stokely Carmichael, gave a speech calling for “Black Power,” giving rise to a popular slogan repeated by activists across the globe, including as far away as Palestine and India. 4 With deep roots in the history of Black radicalism and Black militancy, the global Black Power movement confronted white supremacy in all of its varied manifestations, from all-white unions that refused to admit Black workers; from government agencies that simultaneously provided welfare to working class and poor whites, while denying those same benefits to tax-paying Black citizens; and from different geographies—the urban ghetto to the multinational corporation. 5 In this context, Black entrepreneurs, corporate executives, government officials, and other civic leaders joined together in forging a politics of Black empowerment that mirrored a selection of demands stemming from the global Black Power movement, while endeavoring to preserve those institutions central to the perpetuation of American capitalism. Building on work by Tiffany Gill, Marcia Chatelain, and others on the commercial dimensions of the Black freedom struggle, “Black Power, Inc.” analyzes Black empowerment’s ascension in conversation with and in response to the radical demands made by Black activists across the United States and the African diaspora more broadly. 10 In doing so, it makes clear the contributions made by the global Black Power movement to the development of the multinational corporation, and vice versa, in ways too often elided by the separation of Black Studies and Business History. Drawing on the unique insights made available in the private collections of Black business people, including confidential correspondence, board meeting minutes, and financial records, the dissertation reveals the crucial role played by Black entrepreneurs like Sullivan as mediators, negotiating the terms of Black Power with white corporate executives and other business professionals.
Significant population declines in Acropora cervicornis and A. palmata began in the 1970s and now exceed over 90%. The losses were caused by a combination of coral disease and bleaching, with ...possible contributions from other stressors, including pollution and predation. Reproduction in the wild by fragment regeneration and sexual recruitment is inadequate to offset population declines. Starting in 2007, the Coral Restoration Foundation™ evaluated the feasibility of outplanting A. cervicornis colonies to reefs in the Florida Keys to restore populations at sites where the species was previously abundant. Reported here are the results of 20 coral outplanting projects with each project defined as a cohort of colonies outplanted at the same time and location. Photogrammetric analysis and in situ monitoring (2007 to 2015) measured survivorship, growth, and condition of 2419 colonies. Survivorship was initially high but generally decreased after two years. Survivorship among projects based on colony counts ranged from 4% to 89% for seven cohorts monitored at least five years. Weibull survival models were used to estimate survivorship beyond the duration of the projects and ranged from approximately 0% to over 35% after five years and 0% to 10% after seven years. Growth rate averaged 10 cm/year during the first two years then plateaued in subsequent years. After four years, approximately one-third of surviving colonies were ≥ 50 cm in maximum diameter. Projects used three to sixteen different genotypes and significant differences did not occur in survivorship, condition, or growth. Restoration times for three reefs were calculated based on NOAA Recovery Plan (NRP) metrics (colony abundance and size) and the findings from projects reported here. Results support NRP conclusions that reducing stressors is required before significant population growth and recovery will occur. Until then, outplanting protects against local extinction and helps to maintain genetic diversity in the wild.
Ample evidence has demonstrated that gender inequality and restrictive gender norms wield significant influence over health outcomes. While gender-transformative programmes have grown with the aim of ...challenging these norms and promoting gender equality, their effectiveness in driving sustainable norm change remains a subject of debate. This paper introduces a comprehensive analytical framework designed to assess the impact of these programmes.Drawing from extensive literature reviews of rigorously evaluated health programmes, this framework identifies four key dimensions that are instrumental in determining a programme’s potential for transformative change. These dimensions are multiplicative effect, sustainability, spread and scalability. Multiplicative effect emphasises the interconnected nature of societal systems, positing that altering one element can trigger cascading effects throughout the entire system. Sustainability recognises that change within a system is less likely to revert once the structure has shifted. Programmes that facilitate norm change are more likely to sustain the changes brought about by their interventions. Spread acknowledges the importance of engaging entire networks that share the targeted norms. Successful programmes should demonstrate evidence of gender-related outcomes extending beyond the immediate beneficiaries, progressively diffusing through the broader population. Finally, scalability emphasises the need to bring gender-transformative initiatives to a larger scale to effect broader norm change.By aligning programme design and evaluation with these four dimensions, the proposed framework provides a standardised approach for assessing gender-transformative programmes. It shifts the focus from individual-level change to systemic transformation, bridging the gap between programmatic aspirations and the ability to measure genuine progress.
Purpose: Gene expression profiling identified receptor tyrosine kinase ROR1, an embryonic protein involved in organogenesis, as a
signature gene in B-cell chronic lymphocytic leukemia (B-CLL). To ...assess the suitability of ROR1 as a cell surface antigen
for targeted therapy of B-CLL, we carried out a comprehensive analysis of ROR1 protein expression.
Experimental Design: Peripheral blood mononuclear cells, sera, and other adult tissues from B-CLL patients and healthy donors were analyzed qualitatively
and quantitatively for ROR1 protein expression by flow cytometry, cell surface biotinylation, Western blotting, and ELISA.
Results: ROR1 protein is selectively expressed on the surface of B-CLL cells, whereas normal B cells, other normal blood cells, and
normal adult tissues do not express cell surface ROR1. Moreover, cell surface expression of ROR1 is uniform and constitutive,
i.e., independent of anatomic niches, independent of biological and clinical heterogeneity of B-CLL, independent of B-cell
activation, and found at similar levels in all B-CLL samples tested. The antibody binding capacity of B-CLL cell surface ROR1
was determined to be in the range of 10 3 to 10 4 molecules per cell. A portion of B-CLL cell surface ROR1 was actively internalized upon antibody binding. Soluble ROR1 protein
was detectable in sera of <25% of B-CLL patients and a similar fraction of healthy donors at concentrations below 200 ng/mL.
Conclusions: The restricted, uniform, and constitutive cell surface expression of ROR1 protein in B-CLL provides a strong incentive for
the development of targeted therapeutics such as monoclonal antibodies.
...there is growing recognition of the concept of gender as identity—ie, a deeply held personal sense of one's self as male, female, transgender, non-binary, fluid, genderqueer, or any of many other ...gender identities. SHa has received a grant from Stanford University related to the Series; a grant from UNFPA for development of a conceptual framework for mainstreaming gender into UNFPA's key areas; a grant from the WHO Tobacco Control programme to develop a review of the relationship between tobacco control and gender-responsive policies; and a grant from the WHO Gender, Equity and Rights programme to develop a conceptual framework of the relationship between gender and health inequities. The work of the Series on gender equality, norms and health was supported by the Gender Equality, Integrated Delivery, HIV, Nutrition, Family Planning, and Water Sanitation and Hygiene Program Strategy Teams at the Bill & Melinda Gates Foundation, and the United Arab Emirates Ministry of Foreign Affairs and International Cooperation, through grants to Stanford University.
This article presents evidence supporting the hypothesis that promoting gender equality and women ’s and girls’empowerment (GEWE) leads to better health and development outcomes. We reviewed the ...literature across six sectors—family planning (FP); maternal, newborn and child health (MNCH); nutrition; agriculture; water, sanitation and hygiene; and financial services for the poor— and found 76 studies from low and middle-income countries that met our inclusion criteria. Across these studies, we identified common GEWE variables that emerged repeatedly as significant predictors of sector outcomes. We grouped these variables into 10 thematic categories, which we termed ‘gender-related levers’. These levers were then classified by the strength of evidence into Wedges, Foundations and Facilitators. Wedges are gender-related levers that had strong associations with improved outcomes across multiple sectors. They include: ‘control over income/assets/ resources’, ‘decision-making power’and ‘education’. Elements of these levers overlap, but combined, they encapsulate agency. Increasing female agency promotes equality and broadly improves health and development for women, their families and their communities. The second classification, Foundations, displayed strong, positive associations across FP, MNCH and nutrition. Foundations have a more proximal relationship with sector outcomes and include: ‘equitable interpersonal relationships’, ‘mobility’ and ‘personal safety’. Finally, the third group of levers, Facilitators, was associated with improved outcomes in two to three sectors and include: ‘access to information’, ‘community groups’, ‘paid labour’and ‘rights’. These levers make it easier for women and girls to achieve their goals and are more traditional elements of development programmes. Overall, gender-related levers were associated with improvements in a variety of health and development outcomes. Furthermore, these associations were cross-sectoral, suggesting that to fully realize the benefits of promoting GEWE, the development community must collaborate in coordinated and integrated ways across multiple sectors. More research is needed to identify the mechanisms by which gendered interventions work and under what circumstances.
Le présent article présente des éléments de preuve en faveur de l’hypothèse selon laquelle la promotion de l’égalité des sexes et l’autonomisation des femmes et des filles (GEWE) aboutissent à de meilleurs résultats en matière de santé et de développement. Nous avons examiné la littérature à travers six secteurs – planning familial (PF); santé maternelle, néonatale et infantile (SMNI); nutrition; agriculture; l’eau, l’assainissement et l’hygiène; ainsi que les services financiers pour les personnes démunies -, et avons trouvé 76 études de pays à faible revenu et à revenu intermédiaire qui répondaient à nos critères d’inclusion. À travers ces études, nous avons identifiés des variables GEWE communes qui ont émergé à plusieurs reprises comme d’importants indicateurs des résultats dans ce secteur. Nous avons regroupé ces variables en 10 catégories thématiques que nous avons désignés sous l’appellation «leviers liés au genre». Ces leviers ont ensuite été classés suivant la solidité des faits en Facteurs, Fondements et Facilitateurs. Les facteurs sont des leviers liés au genre fortement associés à l’amélioration des résultats dans de multiples secteurs. Ils comprennent: «le contrôle sur le revenu/actifs/ressources», «le pouvoir de décision» et «l’éducation». Les éléments de ces leviers se chevauchent, mais rassemblés, ils constituent une synthèse du service. L’accroissement du r ôle actif des femmes favorise l’égalité et de manière générale, améliore la santé et le développement des femmes, de leurs familles et de leurs communautés. La deuxième classification, les Fondements, affiche un très fort lien positif à travers le PF, la SMNI et la nutrition. Les fondements ont une relation plus proximale avec les résultats du secteur et comprennent: «les relations interpersonnelles équitables», «la mobilité» et «la sécurité personnelle». Enfin, le troisième groupe de leviers, les Facilitateurs, a été associé à une amélioration des résultats dans deux à trois secteurs et comprend: «l’accès à l’information», «les groupes communautaires», «le travail rémunéré» et «les droits». Ces leviers facilitent l’atteinte des objectifs pour les femmes et les filles et sont des éléments plus traditionnels des programmes de développement. Dans l’ensemble, les leviers liés au genre ont été associés à des améliorations dans une variété de résultats de santé et de développement. En outre, ces associations étaient transsectorielles, suggérant que pour tirer pleinement profit de la promotion GEWE, la communauté du développement doit collaborer de manière coordonnée et intégrée dans de multiples secteurs. Il faut effectuer davantage de recherches pour identifier les mécanismes et les circonstances de travail des interventions sexospécifiques.
Este artículo presenta la evidencia que apoya la hipótesis de que la promoción de la igualdad de género y el empoderamiento de las mujeres y de las niñas (IGEM) conduce a mejores resultados de salud y desarrollo. Revisamos la literatura a través de seis sectores -planeación familiar (PF); salud materna, neonatal e infantil (SMNI); nutrición; agricultura; agua, saneamiento e higiene; y servicios financieros para los pobres- y encontramos 76 estudios de países de ingresos bajos y medios que cumplieron los criterios de inclusión. A través de estos estudios, identificamos las variables comunes de IGEM que surgieron en repetidas ocasiones como pronosticadores significativos de los resultados del sector. Agrupamos estas variables en 10 categorías temáticas, que hemos denominado 0palancas relacionadas con el género’. Estas palancas fueron entonces clasificadas por la fuerza de la evidencia en Plataformas, Fundaciones y Facilitadores. Las Plataformas son palancas relacionadas con el género que tenían fuertes asociaciones con la mejora de los resultados a través de múltiples sectores. Estos incluyen: ‘control sobre los ingresos/activos/recursos’, ‘poder de toma de decisiones’ y ‘educación’. Los elementos de estas palancas se superponen, pero combinados, encapsulan la voluntad libre. Aumentando la voluntad libre femenina se promueve la igualdad y, en general se mejora la salud y el desarrollo de las mujeres, sus familias y sus comunidades. La segunda clasificación, las Fundaciones, muestran asociaciones fuertes y positivas a través de PF, SMNI y nutrición. Las Fundaciones tienen una relación más próxima con los resultados del sector e incluyen: ‘relaciones interpersonales equitativas’, ‘movilidad’ y ‘seguridad personal’. Finalmente, el tercer grupo de palancas, los Facilitadores, se asoció con mejores resultados en dos o tres sectores e incluyen: ‘acceso a la información’, ’grupos de la comunidad, ‘trabajo remunerado’ y ‘derechos’. Estas palancas hacen que sea más fácil para las mujeres y las niñas lograr sus objetivos y son los elementos más tradicionales de los programas de desarrollo. En general, las palancas relacionadas con el género se asociaron con mejoras en una variedad de resultados de salud y desarrollo. Además, estas asociaciones fueron intersectoriales, sugiriendo que para la plena realización de los beneficios de la promoción del IGEM, el desarrollo de la comunidad debe colaborar en formas coordinadas e integradas a través de múltiples sectores. Se necesita más investigación para identificar los mecanismos por los cuales las intervenciones de género funcionan y bajo qué circunstancias.
本文总结了促进性别平等和妇女及女童赋权(GEWE) 可改善 卫生和发展结果的证据。我们回顾了六个领域的文献:计划生 育, 孕产妇、新生儿和儿童健康(MNCH), 营养, 农业, 水源、 卫生与清洁, 以及为贫困人口提供的金融服务, 有 76 个符合 纳入标准的中低收入国家的研究。我们确定了在这些研究中 普遍作为重要结果预测变量的GEWE变量, 将其分为 10 个主 题种类, 称为“性别相关杠杆”。根据证据强度将这些杠杆分 为楔子、基础和辅助。楔子是指与多部门结果改善密切相关 的性别相关杠杆, 包括:“控制收入/资产/资源”, “决策能 力”和“教育”。这些杠杆的要素有重合部分, 但它们结合在 一起构成个体的能动性。增强女性的能动性可以促进平等, 广 泛改善女性及其家庭和社区的卫生与发展。第二类杠杆是基 础, 与计划生育、MNCH和营养密切正相关。基础与相关部门 结果的关系更近, 包括:“平等的人际关系”、“流动 性”和“个人安全”。第三类杠杆是辅助, 有助于改善 2~3 个部门的结果, 包括:“信息公开”、“社区团体”、“有偿 劳动”和“权力”。这些杠杆使妇女和女童更易实现她们的 目标, 是较为传统的发展项目要素。综上, 性别相关杠杆与多 个卫生和发展结果的改善相关, 且这种相关性是跨部门的, 提 示我们要充分了解促进GEWE的获益, 发展界必须以协调整合 的方式进行多部门合作。需要更多研究探讨性别干预发挥作 用的机制及环境。
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