Mainstreaming Institutional Resilience and Systems Strengthening in Donor Policies and Programming

This rapid review synthesises evidence on key aspects of mainstreaming institutional resilience and systems strengthening in donor policies and programming in FCAS (Fragile and Conflict-affect States) contexts, particularly in nutrition (food security), health, WASH and the economic sector. Institutional resilience is the ability of a social system (society, community, organisation) to absorb and recover from external shocks, while positively adapting and transforming to address long-term changes and uncertainty. Investing in strong, well-functioning and adaptable social systems, such as health, education and social protection systems, can build resilience, as this help to cushion the negative economic and social effects of crises. While development actors have established guidance on how institutions can be made more effective, inclusive and accountable, there is much less literature on institutional resilience and how development actors can help to foster it. Much of the literature notes a lack of systematic evidence on applying the concept of resilience. These gaps extend to a dearth of guidance on how development actors can mainstream institutional resilience and systems strengthening into their policies and programmes. This rapid review draws on common factors discussed in the literature that are considered important to the strengthening of resilience and particular systems. These may, in turn, provide an indication of ways in which to mainstream institutional resilience and systems strengthening into development policy and programming

Stepping Stones or Second Class Donors?: a qualitative analysis of gay, bisexual, and queer men’s perspectives on plasma donation policy in Canada

Background Men who have sex with men (MSM) are not eligible to donate blood or plasma in Canada if they have had sex with another man in the last 3 months. This time-based deferment has reduced since 2013; from an initial lifetime ban, to five-years, one-year, and now three-months. Our previous research revealed that gay, bisexual, queer, and other MSM (GBM) supported making blood donation policies gender-neutral and behaviour-based. In this analysis, we explored the willingness of Canadian GBM to donate plasma, even if they were not eligible to donate blood. Methods We conducted in-depth interviews with 39 HIV-negative GBM in Vancouver (n = 15), Toronto (n = 13), and Montreal (n = 11), recruited from a large respondent-driven sampling study called Engage. Men received some basic information on plasma donation prior to answering questions. Transcripts were coded in NVivo following inductive thematic analysis. Results Many GBM expressed a general willingness to donate plasma if they became eligible; like with whole blood donation, GBM conveyed a strong desire to help others in need. However, this willingness was complicated by the fact that most participants had limited knowledge of plasma donation and were unsure of its medical importance. Participants’ perspectives on a policy that enabled MSM to donate plasma varied, with some viewing this change as a “stepping stone” to a reformed blood donation policy and others regarding it as insufficient and constructing GBM as “second-class” donors. When discussing plasma, many men reflected on the legacy of blood donor policy-related discrimination. Our data reveal a significant plasma policy disjuncture—a gulf between the critical importance of plasma donation from the perspective of Canada’s blood operators and patients and the feelings of many GBM who understood this form of donation as less important. Conclusions Plasma donor policies must be considered in relation to MSM blood donation policies to understand how donor eligibility practices are made meaningful by GBM in the context of historical disenfranchisement. Successful establishment of a MSM plasma donor policy will require extensive education, explicit communication of how this new policy contributes to continued/stepwise reform of blood donor policies, and considerable reconciliation with diverse GBM communities.

‘Idle minds’ and ‘empty stomachs’: youth, violence and religious diversity in coastal Kenya

This article analyses how concerns about youth and violence intersect with the politics of managing religious coexistence in the coastal Kenyan town of Malindi. During extensive ethnographic research, I noticed that Muslim, Christian and ‘Traditionalist’ leaders, politicians and NGO officials often fear that the ‘idleness’ of young people leaves them susceptible to various immoralities, including political violence and ‘violent extremism’, that threaten peaceful ethnic and religious coexistence. The article explores how these concerns motivate leaders’ attempts to incorporate youth in development and peace projects, and how youth respond to these interventions. These projects are funded by Western donors, who often see ‘radical’ religiosity, especially among Muslim youth, as a security threat. Yet, leaders in Malindi accommodate donor policies to the (coastal) Kenyan context, and tend to understand immoralities and violence as resulting from a lack of religiosity among youth. The article argues that perceptions of ‘idle youth’ as potentially violent threats to peaceful religious coexistence and morality allow leaders to develop a ‘moral religiosity’ that is shared across religious divides. However, the ways in which youth strategically resist or comply with interventions to pacify them demonstrate that they do not necessarily agree with dominant moral and political constellations.

Supporting National Transition in Myanmar with Development Assistance

Myanmar is undergoing significant political reforms and socio-political changes, which have been more rapid and broad than anticipated by most commentators. While ongoing reforms face significant obstacles and vested interests, and is far from assured, reform to date has already significantly altered the international relations of the state. From a development perspective, the growing international acceptability of the regime has begun to change donor attitudes, with development assistance rather than merely humanitarian aid now being discussed, and the conditionality attached to international assistance changing. This paper explores these changes in donor policies toward Myanmar, examining the prospects for development partnership with relevant government programs and agencies, and analysing the ways and sectors development assistance may be able to be used to strengthen the ongoing reform and national transition.

Recent advances in liver transplantation with HCV seropositive donors

The paradigm shift from interferon-based to direct-acting antiviral (DAA) therapy for the treatment of hepatitis C virus (HCV) infection has revolutionized the field of liver transplantation. These advances in effective HCV treatment, along with the persistent shortage in available liver grafts, have encouraged investigators to assess the need for adopting more inclusive donor policies. Owing to the poor outcomes following liver transplantation with recurrent HCV infection, liver transplantation using HCV seropositive donors (non-viremic and viremic) had been restricted. However, as a result of the growing supply of HCV seropositive donors from the recent opioid epidemic along with the advent of efficacious DAA therapy to treat HCV recurrence, there has been an increasing trend to use HCV seropositive donors for both HCV seropositive and seronegative recipients. The review aims to discuss recent advances and associated outcomes related to the use of HCV seropositive grafts for liver transplantation.