Evidence Gap Maps

(25 June 2018) Despite a considerable reduction in child mortality, nearly six million children under the age of five die each year. Millions more are poorly nourished and in many parts of the world, the quality of education remains poor. Children are at risk from multiple violations of their rights, including child labour, early marriage, and sexual exploitation. Research plays a crucial role in helping to close the remaining gaps in child well-being, yet the global evidence base for effective interventions to meet these challenges is mostly weak, scattered and often unusable by policymakers and practitioners. Responding to the need for a more evidence-informed approach, a new Mega-Map, created by the Campbell Collaboration and co-funded by UNICEF Innocenti, encourages the generation and use of rigorous evidence on effective ways to improve child well-being for policy and programming.A child runs down an ancient path behind the Grand Mosque in Agadez, Niger. An evidence gap map alone, however, is insufficient to address the complex issues that remain. There is a concurrent urgent need to improve coordination among those interested in evidence-informed decision-making for children. An ‘Evidence for Children’ Roundtable in New York aims to ignite a conversation addressing this need, while the open source Mega-Map, launched at the Roundtable, will continue to facilitate collaboration among key stakeholders, long after the event.Mapping both systematic reviews and pre-existing gap maps, the Mega-Map provides an interactive overview of evidence that has already been synthesized. This creates a more balanced view and helps remove any potential bias derived from single studies. The Mega-Map identifies areas where there is ample evidence to guide policy and practice, and where there are gaps in the evidence base. What’s more, the tool is mapped against the five key goals of the latest UNICEF Strategic Plan 2018-2021, making it particularly relevant for the organization, providing accessible evidence which can be used to inform programming and policy-making."There is a lot of work to be done, both in synthesizing existing evidence and in generating new evidence to fill the remaining knowledge gaps."UNICEF Innocenti’s Chief of Research Facilitation & Knowledge Management, Kerry Albright, gave us an insight into some of the areas where evidence synthesis is most lacking, presented in the table below. Commenting on the results, Kerry says “there is a lot of work to be done, both in synthesizing existing evidence and in generating new evidence to fill the remaining knowledge gaps.” However, she reminds us that the Mega-Map looks only at evidence synthesis, so while there may not be any systematic reviews or other forms of synthesis, it is still possible that primary studies exist in these areas. The findings of the Mega-Map will help guide a broader conversation around child well-being at the ‘Evidence for Children’ event. Thanks to a varied audience - with representatives from development NGOs, the academic community, and UN staff - the Roundtable will facilitate discussions on evidence-informed decision-making, and the challenges involved with using evidence to inform policy and practice. The event also provides an opportunity to improve coordination among those with an interest in evidence for children, helping to ensure more efficient use of resources, preventing duplication of effort and ensuring high quality standards in reviews.A small section of the Mega-Map on Child Well-Being. Synthesizing evidence is a continuous process. The Roundtable will be followed with five Research Briefs relating to each of the goals of UNICEF’s Strategic Plan 2018-2021, as well as exploring an ongoing process for better review coordination. This constantly ‘in-flux’ nature of evidence generation and synthesis is perhaps best represented by one of the most useful features of the Mega-Map: it will be a ‘living map’. Thanks to the Bill and Melinda Gates Foundation, the map will be updated at least annually over the lifetime of the Strategic Plan and will be freely accessible to all, ensuring its relevance and utility to help improve child well-being for many years to come.In this podcast, hear Kerry Albright explain how the Mega-Map was created, where the biggest evidence gaps lie, and what she thinks is needed in order to close these gaps and improve child well-being all over the world. Explore the Mega-Map on Child Well-Being here. Links will be provided to the subsequent Research Briefs once available.The Mega-Map is being launched at an 'Evidence for Children' Roundtable in New York on 27 and 28 June 2018. You can sign up for the event here.  

(18 December 2017) UNICEF Innocenti has just launched a new evidence gap map on adolescent well-being.  The research project maps evidence from evaluated interventions in in low- and middle-income countries against outcomes in three domains of adolescent well-being: protection, participation, and financial and material well-being.  The gap map helps to describe where evidence for programming and policy exists, where it is scarce, and where evidence is missing. Identifying the gaps helps UNICEF determine where more primary research or further synthesis is needed to improve programmes and policies for adolescents. The results of the mapping study include an in-depth report on the evidence gaps and an interactive online tool which visualizes the results of the mapping study, both informed by the study protocol.A group of high school girls in Lilongwe, Malawi puts up a performance during at a meeting to promote HIV and AIDS awareness. “Research syntheses are important for helping us make decisions based on a body of evidence rather than just on single studies,” said Nikola Balvin, the knowledge management specialist focusing on adolescent research at UNICEF Innocenti who developed and managed the Evidence Gap Map project.[Online tool: The Evidence Gap Map on Adolescent Well-being]“It is a mapping tool which synthesizes existing evidence on interventions targeting adolescents in these three domains (protection, participation, and financial and material well-being). We did it because there was nothing else focusing on these domains. This gap map brings together interventions focusing on adolescents in low- and middle- income countries and it maps what exists so we know where the gaps are,” she added.Methodology and FindingsThe evidence gap map identified 74 studies, including 71 impact evaluations and 3 systematic reviews, that met the inclusion criteria. The study found that evidence is most abundant at the individual and inter-personal level, and the most frequent intervention is financial support to individuals and households, with the majority of interventions including cash transfers.  “A lot of really interesting trends emerged. The most interesting is probably where the gaps are. The first thing you see when you look at the gap map is that there is hardly anything – hardly any evaluated interventions at the institutional and policy level – so that is a big gap,” Balvin said,  highlighting how the results point clearly gaps in evidence base. “In terms of outcome areas, another big gap is seen in information and communication technology – which is especially significant considering how much adolescents are plugged into the online world. So we know very little about the level of impact interventions using these online platforms are having on adolescents, which is a big gap” she added. PODCAST: Developing the Evidence Gap Map for Adolescent Well-Being VIDEO TUTORIAL: How to use the Evidence Gap Map Online Tool  Learn more:UNICEF Innocenti’s research on adolescent well-beingOnline tool: The Evidence Gap Map on Adolescent Well-beingReport: Bridging the gap to understand effective interventions for adolescent well-being: An evidence gap map on protection, participation, and financial and material well-being in low- and middle-income countriesStudy Protocol: An evidence gap map on adolescent well-being in low- and middle-income countries: A focus on the domains of protection, participation, and financial and material wellbeing

 (23 July 2020)  A new rapid review from UNICEF Innocenti collects and synthesizes the available evidence on the impacts of COVID-19 and previous pandemics, epidemics, and their control measures on child protection and offers key lessons learned for global and national responses to COVID-19 and recommendations for future research priorities.The rapid review was conducted between March and June 2020, led by UNICEF Innocenti’s Shivit Bakrania, who specializes in evidence synthesis.  To learn more about how this rapid review came about and what the most interesting, and importantly – relevant – findings are, we sat down (virtually) with Shivit to ask him 5 questions to help unpack this rapid research review. 1. Where did the idea to do a rapid research review on child protection in pandemics and epidemics come from?Shivit: At Innocenti, we are increasingly using evidence synthesis as an important tool to consolidate available knowledge, and build on what is already known in order to identify gaps and reduce duplication. In March 2020, when COVID-19 was declared a pandemic, there was not much in the way of robust empirical evidence on how COVID-19 affects the lives of children and adolescents. However, we were seeing various editorials and commentary on the socio-economic stresses that COVID-19 was creating for children, adolescents and their families. Some of this commentary was suggesting that competition for scarce resources, limited access to social supports, and safe spaces and parental stresses could all increase the vulnerability of children and adolescents to abuse, neglect, maltreatment, exploitation and violence. We thought it would be useful for UNICEF and other stakeholders interested in child well-being and protection to rapidly synthesize the evidence on the effects of major pandemics and epidemics on these outcomes. This could help predict some of the vulnerabilities we need to be addressing at an early stage of COVID-19, rather than waiting for new research specifically linked to COVID-19 which may take time.  The rapid review therefore aims to draw more attention to the often invisible but important protection issues that need to be a core part of  COVID-19 response and to determine where the response should be focused and strengthened. 2. How does the review help inform our responses to better protect children during COVID-19?Shivit: We identify the state of the evidence base on the effects of pandemics and epidemics, and their infection control measures, on different child protection outcomes. The outcomes include (but are not limited to): stigma, child labour, early and adolescent pregnancy, child marriage, orphanhood, intimate partner violence, sexual violence and exploitation, suicide and self-harm, and school enrolment, dropout and attendance. These are serious rights violations that children and adolescents experience, and epidemics often exacerbate those risks. By knowing the state of the evidence, we can identify likely risk areas and we can see where further research needs to be conducted. We draw some of the lessons from the literature. By identifying some of the key impacts and pathways toward impact, we can identify where responses can best be targeted in order to ensure the risks to children are reduced. The evidence suggests that the key areas to focus on are:Focus on children in vulnerable circumstances,­­ including orphans.Responding to stigmatization and discrimination: this is a key pathway toward other longer-term psychosocial and mental health effects.Investing in social protection: Social safety nets could reduce the participation of children in paid and exploitative labour and decrease the chances of school dropout. This may further decrease the chances of early marriage and teenage pregnancy. Promoting access to health and protective services: The evidence emphasizes the importance of prioritizing services to respond to issues of violence against women and girls, including within the health system.  Access to justice: The evidence finds that access to the police and formal justice was restricted in many locations. Particular attention could be given to the role of community leaders and customary justice systems, ensuring that cases of criminal sexual violence are recorded and referred to the formal justice system. Ensuring continued access to education. Download the research brief summarizing findings from the rapid reviewRead the full working paper: Impacts of Pandemics and Epidemics on Child Protection: Lessons learned from a rapid review in the context of COVID-19Learn about the process for conducting the rapid review from the study protocol View the interactive Evidence Gap Map on Pandemics, epidemics and outcomes on child protection and violence3. Can you walk us through the process for conducting this research review?  Shivit: A rapid review is a fast form of evidence synthesis. It takes the template for a systematic review, which involves a comprehensive, explicit, transparent and replicable approach to collating and synthesizing evidence, and adds certain shortcuts. This entails undertaking: systematic searches in a range of databases; screening the results for relevance; extracting relevant data from the included studies; and synthesizing the evidence from studies to draw out the key findings. Systematic reviews take on average 1-2 years to complete, but this is often too long for decision-makers who need evidence more quickly. Therefore, rapid reviews offer a compromise between comprehensiveness and timeliness.  4. What stood out to you or surprised you in the findings? Was anything unexpected or alarm-raising?Shivit: The findings underline many of the assumptions we were making at the beginning of the pandemic, but there was a distinct lack of evidence from previous pandemics on how children have been affected. Most of the evidence is clustered on HIV/AIDs (and its effects on stigma) and (to a lesser extent) the Ebola crisis in West Africa. There was very little research focusing on certain vulnerable sub-groups of children, such as street-connected children or those with disabilities. We found that the pathways between infectious disease outbreaks and child protection outcomes were complex and moderated by many factors. In many cases, outbreaks and their associated infection control measures amplified existing inequalities and vulnerabilities. The key pathways include:Being orphaned – by losing one or both parents – was a direct outcome of infectious disease outbreaks and also a key risk factor towards other negative child protection outcomes.Stigmatization and discrimination of infected children and adolescents, or of those living with infected individuals, were significant drivers of other negative outcomes for children and adolescentsReductions in household income and the illness or death of breadwinners meant that children were increasingly engaged in wage labour, meant that younger children and girls were less likely to be engaged in child labour, and lead to increases in child marriageEarly and adolescent pregnancy was associated with infection control measures such as quarantine and social isolation. Economic insecurity and a lack of food increased pressures on families and caregivers, and school closures increased the likelihood of girls spending more time with older men. Child abuse and maltreatment increased during and after pandemics and epidemics, both for those co-residing with infected adults and those living with caretaker families. Infectious disease outbreaks intensified the experience of sexual violence and abuse, particularly of women and girls. Quarantines and lockdown conditions presented higher risks, resulting in increased domestic stress, the exercise of controlling behaviors by perpetrators, and restricted access of victims to services and help.  5. What do you hope will come out of this review – next steps for research? Better policies and programmes?Shivit: By identifying the key pathways, we hope that policies can be better targeted to prevent risks to children and adolescents.  By identifying the state of the evidence and the gaps, we hope that future research can better prioritized. BONUS question: Walk us through the evidence gap map or EGM. What’s unique about it and how does it support research?Shivit: The EGM presents the evidence included in the rapid review in an interactive and visual manner. Users can see the clusters and gaps of evidence on child protection outcomes from different pandemics and epidemics. They can filter the evidence by infection control measure, by country and by different sub-groups of children and adolescents. By using these functions, users can access the evidence that is relevant to them, to inform decision making on policies or future research.