This article reviews 23 child marriage prevention programs carried out in low-income countries and employing a range of programmatic approaches and evaluation strategies. We document the types of child marriage programs that have been implemented, assess how they have been evaluated, describe the main limitations of these evaluations, summarize the evaluation results, and make recommendations to improve future prevention efforts. The evidence suggests that programs offering incentives and attempting to empower girls can be effective in preventing child marriage and can foster change relatively quickly. Methodological limitations of the reviewed studies, however, underscore that more needs to be learned about how the programs prevent child marriage and whether impact is sustained beyond program implementation.

The global response to AIDS has triggered unprecedented attention to gender inequality and the role it plays in shaping the vulnerability of women. Tragically, however, this attention has not yet led to wide-scale transformations in gender roles, or reductions in gender-related risk. This paper reviews both knowledge and action on the impact of gender inequality on women in the context of HIV prevention, and argues that, while much is known, and while effective strategies do exist, impact on a population level will not be achieved unless gender considerations are integrated into an evidence-informed comprehensive national strategy. Such a strategy must be implemented by national governments within an enabling policy and legal environment for change; be driven and owned as much as possible, by communities who are empowered with skills and resources to put their own ideas and capabilities into action; and include people living with HIV as equal partners.

BackgroundThis paper reports on the use of a “neighborhood method” to measure the nature and incidence of violence against women and girls in post-conflict Liberia.MethodsThe study population comprised females in Montserrado and Nimba counties. Study participants were randomly selected for interviews using multi-stage cluster sampling. 30 clusters of households were sampled in each county. Information on incidents of domestic violence and rape within the preceding 18 months was collected with regard to females of all ages in the respondent’s household, and those of her four closest neighbors to make up the full sample.FindingsHouseholds in the sample contained 7015 females (1687 girls, 4586 women, 742 age missing) in Montserrado and 6632 (2070 girls, 4167 women, 95 age missing) in Nimba. In the previous 18 months 54.1% (CI 53.1-55.1) and 55.8% (CI 54.8-56.8) of females in Montserrado and Nimba respectively were indicated to have experienced non-sexual domestic abuse; 19.4% (CI 18.6-20.2) and 26.0% (CI 25.1-26.9) of females in Montserrado and Nimba respectively to have been raped outside of marriage; and 72.3% (CI 70.7-73.9) and 73.8% (CI 72.0-75.7) of married or separated women in Montserrado and Nimba respectively to have experienced marital rape. Husbands and boyfriends were reported as the perpetrators of the vast majority of reported violence. Strangers were reported to account for less than 2% of the perpetrators of rape in either county. Incidents were most commonly disclosed to other family members or to friends and neighbors, and less often to formal authorities such as the police, court or community leaders. Incidents were approaching fifty times more likely to be reported to police if perpetrated by strangers rather than intimate partners.ConclusionsViolence against women and girls is widespread in the areas studied. Programming needs to address the fact that this violence is primarily occurring in the household, where most incidents go unreported outside the immediate family or social circle. Police and hospital reports severely under-represent these known perpetrators. Inter-interviewer variance and differences in reports for self and neighbors for some outcomes caution the precision and validity of some estimates. However, the potential utility of the neighborhood method for estimating prevalence rates with an accuracy suitable for programmatic purposes in conflict-affected and post-conflict settings is noted.

Individual behaviour change interventions and technological approaches to HIV prevention can only be effective over time if the broader social environment in which health-related decisions are made facilitate their uptake. People need to be not only willing but also able to take up and maintain preventive behaviours, seek testing, treatment and care for HIV. This paper presents findings and recommendations of the Social Drivers Working Group of the aids2031 initiative, which focus on how to ensure that efforts to address the root causes of HIV vulnerability are integrated into AIDS responses at the national level. Specific guidance is given on how to operationalise a structural approach.

The world is experiencing a critical shortage of RNs. As the number of nurses decreases, it is unclear how already vulnerable specialty areas, such as perioperative nursing, will be affected by the emerging workforce's career decisions. This descriptive, comparative study explores perioperative nurses' and nursing students' perceptions of the top 10 characteristics desired in a manager. Even with 70% congruency, significant differences were found in how nurses and students ranked the traits they valued. This study highlights the traits managers need to transform new graduate nurses into satisfied, productive members of the perioperative team.