In a BMC Series blog, JNHealth and DrJNiffHall explain their recent paper that adapted the Ripple Effects Mapping framework to complex public health interventions.
Ripple Effects Mapping, or REM, is a participatory and qualitative form of impact evaluation. When we learned of this method, we thought that it would be invaluable in helping understand some of the complex public health interventions we were evaluating – particularly the elements that were deemed hard-to-measure. However, to make it more suited to our needs, we adapted it further. It is this adapted method that we talk more about here.
The second and third sections are perhaps the most important. Small groups of 4-6 people are formed, and groups are asked to start writing down and discussing what they were involved in and what the impacts have been. They capture this on flip chart paper which has a timeline in its centre . A facilitator can guide participants through the activity by asking probing questions. They also make sure that everyone has an equal opportunity to contribute to the activities.
The fourth section is a reflective one. Now that activities and impacts are visualised, the facilitator can ask participants to reflect on what they deem to be the most significant and why. But often, a more interesting conversation happens around the least significant impacts.
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The effect of COVID-19 on public confidence in the World Health Organization: a natural experiment among 40 countries - Globalization and HealthBackground At a time when a highly contagious pandemic and global political and economic turmoil are intertwined, worldwide cooperation under the leadership of an international organization has become increasingly important. This study aimed to estimate the effect of COVID-19 on public confidence in the World Health Organization (WHO), which will serve as a reference for other international organizations regarding the maintenance of their credibility in crisis management and ability to play a greater role in global health governance. Methods We obtained individual data from the World Values Survey (WVS). A total of 44,775 participants aged 16 and older from 40 countries in six WHO regions were included in this study. The COVID-19 pandemic was used as a natural experiment. We obtained difference-in-differences (DID) estimates of the pandemic’s effects by exploiting temporal variation in the timing of COVID-19 exposure across participants interviewed from 2017 to 2020 together with the geographical variation in COVID-19 severity at the country level. Public confidence in the WHO was self-reported by the respondents. Results Among the participants, 28,087 (62.73%) reported having confidence in the WHO. The DID estimates showed that the COVID-19 pandemic could significantly decrease the likelihood of people reporting confidence in the WHO after controlling for multiple covariates (adjusted OR 0.54, 95% CI: 0.49–0.61), especially during the global outbreak (0.35, 0.24–0.50). The effect was found in both younger individuals (0.58, 0.51–0.66) and older adults (0.49, 0.38–0.63) and in both males (0.47, 0.40–0.55) and females (0.62, 0.53–0.72), with a vulnerability in males (adjusted P for interaction = 0.008). Conclusion Our findings are relevant regarding the impact of COVID-19 on people’s beliefs about social institutions of global standing, highlighting the need for the WHO and other international organizations to shoulder the responsibility of global development for the
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