Van Belle
Dados Biográficos
| ID | 38320 |
|---|---|
| NOME | Van Belle |
| SOBRENOME | Van Belle |
| ASSINATURA | VAN BELLE |
| AFILIAÇÕES | Instituut voor Tropische Geneeskunde |
| ORCID | 0000-0003-2074-0359 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 45 |
| TOTAL DE CITAÇÕES | 43 |
| TOTAL COMO AUTOR | 45 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 2012 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2026 |
| ÍNDICE H | 3 |
Youth collective action for accountability towards sexual and reproductive health (SRH) rights
In the field of sexual and reproductive health and rights (SRHR), there is a growing consensus that participation is critical to ensuring that the voices of youth are heard and their agency is exercised in a way that enables them to practice active citizenship. This includes collective action to hold duty bearers and power holders to account for their rights. Youth are increasingly being seen as important constituents; however, despite the growth…
Between rhetoric and reality
Despite national and regional efforts toward universal health coverage, Adivasi communities like the Soligas in Karnataka in India, continue to face barriers to dignified health care. This analysis explores how human dignity is upheld or neglected within formal, State-regulated health care services. It highlights the health care experiences of Soliga Adivasi communities in the Chamarajanagar district of Karnataka, Southern India, as they navigate…
A realist evaluation of the implementation of a national tobacco control programme and policy in India
There is a growing interest in studying and unpacking the implementation of policies and programmes as it provides an opportunity to reduce the policy translation time lag taken for research findings to translate into policies and be implemented and to understand why policies may fail. Realist evaluation is a theory-driven approach that embraces complexity and helps to identify the mechanisms generating the observed policy outcomes in a given con…
Stakeholder involvement in realist evaluation
As a theory-driven evaluation design grounded in the critical realism philosophy, realist evaluation relies on eliciting the assumptions of stakeholders about how programmes are expected to produce outcomes. Little is known about key principles for involving stakeholders in realist evaluations. In this scoping review of realist evaluation studies, we explored how stakeholders were involved in the conduct of realist evaluation. A total of 26 ‘part…
Context and generalizability in health policy and systems research
In this article, we address the conundrum of context in health policy and systems research, zooming in on research on implementation of programmes, policies, and interventions. We review how the field draws on non-linear paradigms to better take into account ‘context’ in causal explanation, and we compare paradigms and the way in which they can inform more context-sensitive research, policies, and programmes. We propose a theorizing praxis that i…
Evaluation study of the urban governance of the Covid-19 crisis in the city of Antwerp
Local governments are important to develop tailored strategies and organise a locally relevant crisis response in cities. They need expertise and agency, with enough flexibility to experiment. To harness promising practices and avoid repeating errors in future crises, it is crucial to develop a system that better evaluates and monitors local responses, before, during and after crises
Using the multiple streams model to elicit an initial programme theory
INTRODUCTION: The 'SCale-Up diaBetes and hYpertension care' Project aims to support the scale-up of integrated care for diabetes and hypertension in Cambodia, Slovenia and Belgium through the co-creation, implementation and evaluation of contextualised roadmaps. These roadmaps offer avenues for action and are built on evidence as well as stakeholder engagement in policy dialogues. Roadmaps and policy dialogues are very much intertwined and consid…
Understanding why and how youth-friendly health services improve viral load suppression among adolescents and young people living with HIV in Nigeria
INTRODUCTION: Youth-friendly health service (YFHS) approaches are essential to better outcomes for young people. We evaluated attainment of viral load suppression among young people living with HIV (YPLHIV) enrolled in an HIV treatment programme implementing YFHS models in Nigeria. METHODS: A realist evaluation using qualitative and quantitative programme data from 10 implementing health facilities. We used qualitative information to explore how …
Making ‘resilience’ useful again
Why are they “unreached”? Macro and Meso determinants of health care access in hard to reach areas of Odisha, India
Background Reaching hard to reach populations is key to reduce health inequities. Despite targeted interventions, status of crucial public health indicators like neonatal and maternal mortality is still far from optimal. Complex interplay of social determinants can influence both communities and health care workers to effectively access each other. We argue that culturally sensitive and contextually relevant healthcare provision has potential to …
It’s like asking for a necktie when you don’t have underwear”
The empirical findings on the local expression of patient rights in the discourses allowed for theoretical insights on the translation of conceptual understandings of patient rights to practice in the everyday lives of health system actors and care-seeking individuals. The CDA approach was helpful to identify the problematic aspects of discourses and discursive practices on patient rights where health facility administrators and care-providers wi…
Scaling up integrated care
Background: The ‘SCale-Up of diaBetes and hYpertension care’ (SCUBY) project aims to support the scale-up of integrated care for diabetes and hypertension in Cambodia, Slovenia, and Belgium through the co-creation, implementation, and evaluation of contextualized roadmaps. These roadmaps offer avenues for action and are built on evidence as well as stakeholder engagement in policy dialogues. These two implementation strategies – roadmaps and poli…
How to develop a realist programme theory using Margaret Archer’s structure–agency–culture framework
Realist evaluation is in essence a theory-building and testing approach. We argue that in practice, the theory-building potential of realist evaluation, review and research is not fully exploited in the field of global health. Our assumption is that the Structure-Agency-Culture explanatory framework of critical realist Margaret Archer could stimulate realist evaluators to conceptualize and systematically explore how structural and cultural condit…
Factors Related to Police Reporting in Sexual Assault Care Centers
Few victims of sexual assault (SA) report to the police. Research on the role of support persons in victims' reporting is sparse. We address this gap by examining the association of victim, assailant, victimization incident, and support characteristics with reporting rates among victims attending sexual assault care centers (SACCs). Logistic regression results show that type of SA, delay between SA and presentation at SACC, and presence of an inf…
Decolonisation initiatives at the Institute of Tropical Medicine, Antwerp, Belgium
In a global context, the pernicious effects of colonialism and coloniality are increasingly being recognised in many sectors. As a result, calls to reverse colonial aphasia and amnesia, and decolonise, are getting stronger. This raises a number of questions, particularly for entities that acted as agents of (previous) colonising countries and worked to further the progress of the colonial project: What does decolonisation mean for such historical…
‘Writing budgets for meetings and teas?’
INTRODUCTION: Coordination across policy domains and among government agencies is considered critical for addressing complex challenges such as inequities, urbanisation and climate change. However, the factors influencing coordination among government entities in low-income and middle-income countries are not well known. Although theory building is well suited to explain complex social phenomena, theory-based health policy and systems studies are…
Crying baby gets the milk? The governmentality of grievance redressal for patient rights violations in Karnataka, India
BACKGROUND: Patient rights aim to protect the dignity of healthcare-seeking individuals. Realisation of these rights is predicated on effective grievance redressal for the victims of patient rights violations. METHODS: We used a critical case (that yields the most information) of patient rights violations reported in Karnataka state (South India) to explore the power dynamics involved in resolving grievances raised by healthcare-seeking individua…
A perspective on urban health systems and research for equitable healthcare in Africa
Key messages Urbanisation in Africa poses complex challenges for health due to ill-informed planning and governance, worsening gaps in the built environment and the quadruple burden of disease. Achieving equitable urban (health) benefits requires a framework for understanding how urban health systems are conceptualised, planned and governed. Five approaches and frameworks for analysing or implementing urban health strategies in sub-Saharan Africa…
Using social network analysis to understand multisectoral governance in district-level tobacco control programme implementation in India
INTRODUCTION: Interest in multisectoral policies has increased, particularly in the context of low-income and middle-income countries and efforts towards Sustainable Development Goals, with greater attention to understand effective strategies for implementation and governance. The study aimed to explore and map the composition and structure of a multisectoral initiative in tobacco control, identifying key factors engaged in policy implementation …
What are the tools available for the job? Coordination instruments at Uganda’s national government level and their implications for multisectoral action for health
Managing sectoral interdependences requires functional tools that facilitate coordinated multisectoral efforts. The pursuit of multisectoral action for health is intrinsically linked to broader efforts in many governments to achieve greater internal coordination. This research explores the nature of coordination instruments for multisectoral action at the national level in Uganda and the complexities of how these tools play out in implementation.…
At the interface between the formal and informal, the actual and the real
The methodological approach is geared towards building robust case-based explanation with due attention to context and the roles of different actors. The combination of different social science methods will lead us to a better grasp of the inherently political nature of social accountability
Community-Based ART Service Delivery for Key Populations in Sub-Saharan Africa
HIV positive key population (KP) often face health system and social barriers to HIV care. KP include sex workers, men who have sex with men, persons who inject drugs, transgender people, and people in prisons and other closed settings. Community-based ART service delivery (CBART) has the potential to increase access to antiretroviral treatment (ART) and enhance retention in care. This scoping review summarized the evidence on the effect of CBART…
Not for us, without us
The Ministry or Department of Health (M/DoH) is the mandated government agency for health in all countries. However, achieving good health and wellbeing requires the health sector to coordinate with other sectors such as the environment, agriculture and education. Little is known about the coordination relationship between MoH and other sectors to advance health and development goals in low- and middle-income countries (LMICs). Our study examined…
A Realist-Informed Review of Digital Empowerment Strategies for Adolescents to Improve Their Sexual and Reproductive Health and Well-being
The use of digital technologies for health has been rapidly gaining ground in the last decade, including as a strategy to empower adolescents living in urban resource-constrained settings. Nevertheless, unclarity and incoherence remain regarding which programme strategies generate which outcomes, as well as regarding the importance of context. We set out to answer the question “How do digital empowerment strategies work to improve adolescent heal…
Applying the Realist Evaluation Approach to the Complex Process of Policy Implementation—The Case of the User Fee Exemption Policy for Cesarean Section in Benin
Realist evaluation is making inroads in the field of health policy and systems research to a large extent because of its good fit with complex issues. Until now, most realist studies focused on evaluating interventions or projects related to health care delivery, organization of health services, education, management, and leadership of health workers in high income countries. With this paper, we apply the realist approach to the study of national…
Using the realist interview approach to maintain theoretical awareness in realist studies
Realist evaluation submits that theories and models of how, why, for whom and under what circumstances programs work could be formulated by conceptualizing the relational links between the context within which programs are implemented, the generative mechanisms the programs trigger, and the outcomes of interest. Qualitative and quantitative data collection and analysis allow for the description of the relevant context, the generative mechanisms, …
Realist RCTs of complex interventions - An oxymoron
What role can health policy and systems research play in supporting responses to Covid-19 that strengthen socially just health systems
To say that we live in turbulent times is a massive understatement. COVID-19 ruthlessly exposes the fault lines of health services and systems, and the responses put in place to prevent its spread or mitigate its effects may affect people more than the actual infection. The outbreak in Wuhan quickly grew to a pandemic that has affected countries and regions all over the world in many, and as of yet, little understood ways. This is a global infect…
Patients Are Not Following the [Adherence] Club Rules Anymore
There is growing evidence that differentiated care models employed to manage treatment-experienced patients on antiretroviral therapy could improve adherence to medication and retention in care. We conducted a realist evaluation to determine how, why, for whom, and under what health system context the adherence club intervention works (or not) in real-life implementation. In the first phase, we developed an initial program theory of the adherence…
How to develop a realist programme theory using Margaret Archer’s structure–agency–culture framework
Realist evaluation is in essence a theory-building and testing approach. We argue that in practice, the theory-building potential of realist evaluation, review and research is not fully exploited in the field of global health. Our assumption is that the Structure-Agency-Culture explanatory framework of critical realist Margaret Archer could stimulate realist evaluators to conceptualize and systematically explore how structural and cultural condit…
Decolonisation initiatives at the Institute of Tropical Medicine, Antwerp, Belgium
In a global context, the pernicious effects of colonialism and coloniality are increasingly being recognised in many sectors. As a result, calls to reverse colonial aphasia and amnesia, and decolonise, are getting stronger. This raises a number of questions, particularly for entities that acted as agents of (previous) colonising countries and worked to further the progress of the colonial project: What does decolonisation mean for such historical…
The crowded space of local accountability for maternal, newborn and child health
Global and national accountability for maternal, newborn and child health (MNCH) is increasingly invoked as central to addressing preventable mortality and morbidity. Strategies of accountability for MNCH include policy and budget tracking, maternal and perinatal death surveillance, performance targets and various forms of social accountability. However, little is known about how the growing number of accountability strategies for MNCH is receive…
Ebola, the epidemic that should never have happened
The Health System Dynamics Framework
Frameworks can clarify concepts and improve understanding of underlying mechanisms in the domain of health systems research and strengthening. Many existing frameworks have a limited capacity to analyze interactions and equilibriums within a health system overlooking values as an underlying steering mechanism. This paper introduces the health system dynamics framework and demonstrates its application as a tool for analysis and modelling. The adde…
Is realist evaluation keeping its promise? A review of published empirical studies in the field of health systems research
This overview aims to stimulate conceptual and practical discussions to help unlock the full potential of realist evaluation in health systems research. Based on a structured literature search, this review maps how the concepts of realist evaluation are applied in health systems research and which methodological problems are encountered. We found a great diversity in the depth of application of the philosophical concepts, use of terminology and s…
Realist RCTs of complex interventions - An oxymoron
Ebola, the epidemic that should never have happened
Theory and Realist Methods
India’s NCD strategy in the SDG era
BACKGROUND: The Sustainable Development Goals (SDGs) are seen in most corners as the embodiment of a more inclusive and holistic development approach, key to addressing the numerous and urgent challenges the world faces. In the health realm, a true SDG approach will require a five-fold paradigm shift according to Buse and Hawkes. This article explores whether early traces of this paradigm shift can already be witnessed in the Indian context, focu…
Beyond the template
The results of the study suggest a re-examining of the very approach to addressing maternal health in this community. The study calls for reorienting maternal health services, to be responsive to the requirements of tribal women, cater to their cultural needs, provide support to domiciliary deliveries, invest in building trust with the community, and preserve beneficial traditional practices
Patients Are Not Following the [Adherence] Club Rules Anymore
There is growing evidence that differentiated care models employed to manage treatment-experienced patients on antiretroviral therapy could improve adherence to medication and retention in care. We conducted a realist evaluation to determine how, why, for whom, and under what health system context the adherence club intervention works (or not) in real-life implementation. In the first phase, we developed an initial program theory of the adherence…
Global Health Research, Anthropology and Realist Enquiry
In this article, I set out to capture the dynamics of two streams within the field of global health research: realist research and medical anthropology. I critically discuss the development of methodology and practice in realist health research in low- and middle-income countries against the background of anthropological practice in global health to make claims on why realist enquiry has taken a high flight. I argue that in order to provide a con…
Multilevel modelling and multiple group analysis of disparities in continuity of care and viral suppression among adolescents and youths living with HIV in Nigeria
INTRODUCTION: Substantial disparities in care outcomes exist between different subgroups of adolescents and youths living with HIV (AYLHIV). Understanding variation in individual and health facility characteristics could be key to identifying targets for interventions to reduce these disparities. We modelled variation in AYLHIV retention in care and viral suppression, and quantified the extent to which individual and facility characteristics acco…
Confronting power in low places
INTRODUCTION: Interprofessional interaction is intrinsic to health service delivery and forms the basis of task-shifting and task-sharing policies to address human resources for health challenges. But while interprofessional interaction can be collaborative, professional hierarchies and discipline-specific patterns of socialisation can result in unhealthy rivalry and conflicts which disrupt health system functioning. A better understanding of int…
Perceptions and experiences of frontline health managers and providers on accountability in a South African health district
Providers and managers have well-established ideas about, and a language of, accountability. The lived reality of accountability by frontline managers and providers varies and is shaped by micro-configurations of enablers and constraints in local accountability ecosystems. A 'just culture', teamwork and collaboration between primary health care and hospitals and community participation were seen as promoting accountability, enabling collective re…
The crowded space of local accountability for maternal, newborn and child health
Global and national accountability for maternal, newborn and child health (MNCH) is increasingly invoked as central to addressing preventable mortality and morbidity. Strategies of accountability for MNCH include policy and budget tracking, maternal and perinatal death surveillance, performance targets and various forms of social accountability. However, little is known about how the growing number of accountability strategies for MNCH is receive…
What role can health policy and systems research play in supporting responses to Covid-19 that strengthen socially just health systems
To say that we live in turbulent times is a massive understatement. COVID-19 ruthlessly exposes the fault lines of health services and systems, and the responses put in place to prevent its spread or mitigate its effects may affect people more than the actual infection. The outbreak in Wuhan quickly grew to a pandemic that has affected countries and regions all over the world in many, and as of yet, little understood ways. This is a global infect…
Opening the ‘implementation black-box’ of the user fee exemption policy for caesarean section in Benin
To improve access to maternal health services, Benin introduced in 2009 a user fee exemption policy for caesarean sections. Similar to other low- and middle-income countries, its implementation showed mixed results. Our study aimed at understanding why and in which circumstances the implementation of this policy in hospitals succeeded or failed. We adopted the realist evaluation approach and tested the initial programme theory through a multiple …
Using the realist interview approach to maintain theoretical awareness in realist studies
Realist evaluation submits that theories and models of how, why, for whom and under what circumstances programs work could be formulated by conceptualizing the relational links between the context within which programs are implemented, the generative mechanisms the programs trigger, and the outcomes of interest. Qualitative and quantitative data collection and analysis allow for the description of the relevant context, the generative mechanisms, …
Applying the Realist Evaluation Approach to the Complex Process of Policy Implementation—The Case of the User Fee Exemption Policy for Cesarean Section in Benin
Realist evaluation is making inroads in the field of health policy and systems research to a large extent because of its good fit with complex issues. Until now, most realist studies focused on evaluating interventions or projects related to health care delivery, organization of health services, education, management, and leadership of health workers in high income countries. With this paper, we apply the realist approach to the study of national…
How medical dominance and interprofessional conflicts undermine patient-centred care in hospitals
BACKGROUND: In Morocco's health systems, reforms were accompanied by increased tensions among doctors, nurses and health managers, poor interprofessional collaboration and counterproductive power struggles. However, little attention has focused on the processes underlying these interprofessional conflicts and their nature. Here, we explored the perspective of health workers and managers in four Moroccan hospitals. METHODS: We adopted a multiple e…
Multisectoral action for health in low-income and middle-income settings
There is consensus in global health on the need for multisectoral action (MSA) to address many contemporary development challenges, but there is limited action. Examples of issues that require coordinated MSA include the determinants of health conditions such as nutrition (malnutrition and obesity) and chronic non-communicable diseases. Nutrition, tobacco control and such public health issues are regulated separately by health, trade and treasury…
Multilevel governance framework on grievance redressal for patient rights violations in India
The notion of patient rights encompasses the obligations of the state and healthcare providers to respect the dignity, autonomy and equality of care-seeking individuals in healthcare processes. Functional patient grievance redressal systems are key to ensuring that the rights of individuals seeking healthcare are protected. We critically examined the published literature from high-income and upper-middle-income countries to establish an analytica…
Learning from intersectoral action beyond health
Intersectoral action (ISA) is considered pivotal for achieving health and societal goals but remains difficult to achieve as it requires complex efforts, resources and coordinated responses from multiple sectors and organizations. While ISA in health is often desired, its potential can be better informed by the advanced theory-building and empirical application in real-world contexts from political science, public administration and environmental…
‘Writing budgets for meetings and teas?’
INTRODUCTION: Coordination across policy domains and among government agencies is considered critical for addressing complex challenges such as inequities, urbanisation and climate change. However, the factors influencing coordination among government entities in low-income and middle-income countries are not well known. Although theory building is well suited to explain complex social phenomena, theory-based health policy and systems studies are…
Crying baby gets the milk? The governmentality of grievance redressal for patient rights violations in Karnataka, India
BACKGROUND: Patient rights aim to protect the dignity of healthcare-seeking individuals. Realisation of these rights is predicated on effective grievance redressal for the victims of patient rights violations. METHODS: We used a critical case (that yields the most information) of patient rights violations reported in Karnataka state (South India) to explore the power dynamics involved in resolving grievances raised by healthcare-seeking individua…
A perspective on urban health systems and research for equitable healthcare in Africa
Key messages Urbanisation in Africa poses complex challenges for health due to ill-informed planning and governance, worsening gaps in the built environment and the quadruple burden of disease. Achieving equitable urban (health) benefits requires a framework for understanding how urban health systems are conceptualised, planned and governed. Five approaches and frameworks for analysing or implementing urban health strategies in sub-Saharan Africa…
Using social network analysis to understand multisectoral governance in district-level tobacco control programme implementation in India
INTRODUCTION: Interest in multisectoral policies has increased, particularly in the context of low-income and middle-income countries and efforts towards Sustainable Development Goals, with greater attention to understand effective strategies for implementation and governance. The study aimed to explore and map the composition and structure of a multisectoral initiative in tobacco control, identifying key factors engaged in policy implementation …
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