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Thursday May 12, 2011

Daily Facilitator: Areana Quinones


Taking a Human Rights-based Approach to Women’s and Children’s Health:  What would it mean and why should you care?

Alicia Ely Yamin, JD, MPH, Director, Program on the Health Rights of Women and Children, François-Xavier Bagnoud Center for Health and Human Rights, and Adjunct Lecturer on Health Policy and Management, Harvard University

At the same time as it is clear that sustained and equitable progress on women’s and child health requires more than adding funding to existing technocratic approaches, it is also clear that the concepts and principles of human rights law have not been adequately translated and operationalized to permit meaningful incorporation into development and health policy, programming and practice from the macro to the grassroots levels. This presentation explained the components of a rights-based approach to women’s and children’s health, including accountability, non-discrimination/equality, and meaningful participation, through concrete examples taken from the speaker’s years of experience with on-the-ground fieldwork.  It also exploree some tensions with mainstream health policies and programming in terms of implementation processes and indicators used for monitoring and evaluation.

Taking a Human Rights-based Approach to Women’s and Children’s Health:  What would it mean and why should you care?- Yamin

Concurrent Sessions:

1. Considerations for Incorporating Health Equity into Project Designs:  A Guide for Community-Oriented Maternal, Neonatal and Child Health Projects – Learn how to apply this guidance to projects

Jennifer Winestock Luna, Senior Monitoring and Evaluation Advisor, MCHIP
Debra Prosnitz, Malaria Communities Program Advisor, MCHIP
Andrew Gall, Senior Latin America Project Coordinator, URC -CHS
Khrist Roy, Technical Advisor, Child Health and Nutrition, CARE
Alan Talens, Health Advisor, CRWRC

Are you interested in practical guidance for improving health equity in your programs?  CSHGP and MCHIP developed a guidance document with practical advice for including equity considerations in project designs.This sessions discussed the document and how it can be applied to both new and on-going projects. The discussion also included guidance, small group work applying the guidance, and presentations from PVO representatives about their experiences.

Considerations for Incorporating Health Equity into Project Designs- Luna
Health Equity in Practice:  Cotopaxi, Ecuador- Gall
Prides itself in never having being colonised- Roy
Closing the Gap by Design: Setting up a maternal Newborn Health Program as if people mattered- Talens

2. Newborn Health

Joseph de-Graft Johnson, Team Leader for Newborn Health, MCHIP
Joan Haffey, Consultant for HBB Program, CORE Group
Rebecca Nerima, Community Health Program Associate, CORE Group/Atlas Corps Fellow

This session focused on essential newborn care (ENC) and began with an overview of the components of ENC. Itdescribed a simplified neonatal resuscitation training package that is currently being implemented through a global development alliance. Components of the Helping Babies Breathe® (HBB) program, as described in its new Implementation Guide, was presented, so that participants could discuss their own efforts and/or pursue relevant HBB links to their own programs. Presenters emphasized linking interested participants with global, regional, and country level HBB resources for further discussion. Presenters also discussed a package under development of essential newborn action messages geared to pregnant women, families, and communities.

Helping Babies Breath Implementation: Where are we?- Johnson
ENA Gaps: Survey Results- Haffey, Nerima

3. Ready to Use? Ready to Integrate! Lessons in the Integration of CMAM and IMCI Activities

Serigne Diène, Senior Nutrition and HIV Advisor, FANTA-2
Rose Luz, Team Leader, Kabeho Mwana Child Survival Program in Rwanda, Concern Worldwide
Marie-Sophie Whitney, Senior Nutrition Advisor, Action Against Hunger (ACF)
Eric Swedberg, Senior Director Child Health and Nutrition, Save the Children

Malnutrition contributes to about half of all child deaths and yet the treatment of moderate or severe malnutrition is not fully incorporated into traditional IMCI models, beyond the provision of vitamins and micronutrients.  This session presented experiences in incorporating the community management of acute malnutrition (CMAM) approach into existing IMCI activities, both at the program level as well as with national government policies. 

Integration CMAM into National Health Systems- Diene
Rwanda Expanded Impact Child Survival Program: Integrating CMAM with C-IMCI_Luz

Supporting CMAM Scaling Up- Whitney

Community Case Management of Severe Acute Malnutrition in Southern Bangladesh: An Operational Effectiveness Study- Swedberg

4. Non Communicable Diseases – The Unheralded Global Epidemic

Jeff Meer, Special Advisor, Global Health Policy and Development, Public Health Institute
Inoussa Kabore, Director of Strategic Information, FHI
Vivien Tsu, Director, HPV Vaccines Project; Associate Director, Reproductive Health, PATH
Charlotte Block, Program Officer, Global Health, Chronic Disease & Nutrition, Project Hope

Non-communicable diseases (NCDs), account for 60% of the world’s deaths with approximately 35 million people dying from them, of which 18 million are women. The four main diseases are cancer, cardiovascular disease, chronic respiratory disease and diabetes. Low and middle income countries are hit especially hard and are particularly vulnerable due to a variety of factors including rapid urbanization, dual disease burden with infectious disease, poverty and underdeveloped health systems.
Click here to read more about each presentation

Non Communicable Diseases – The Unheralded Global Epidemic- Meer
FHI”s Experience in Integrating Cardic Vascular Diseases (CVD) and Underlying Risk Factors Screening and Services into Existing HIV/AIDS Program- Kabore
Women-Specific cancers: Challenges and opportunities- Tsu
Project HOPE: Addressing Diabetes around the World- Block

Lunchtime Roundtables:

1. Community-Based Social and Behavior Change for Family Planning

Adrienne Allison, Project Director, Birth Spacing Integration, International Programs Group, World Vision

New FP messages about Healthy Timing and Spacing of Pregnancy foster new alliances and partnerships within communities. The sessions covered the following questions: What is your experience in building support for FP using these messages among groups that previously did not support FP?  What are best practices?  What are the best approaches to introducing these new concepts to previously resistant people and groups? 

2. MCHIP Update

Leo Ryan, PVO/NGO Support Team Leader, MCHIP

MCHIP is USAID’s Flagship Program for Maternal and Child Health, and CORE Group is an important MCHIP collaborating partner.  This roundtable covered MCHIP’s priority initiatives, country presence, new tools and resources, and opportunities for collaboration through the CORE Group. 

Maternal and Child Health Integrated Program- MCHIP- Ryan

3. New ENA Training and BCC Tools Available through CORE Website

Agnes Guyon, Senior Child Health & Nutrition Advisor, JSI Research & Training Institute

The Essential Nutrition Actions (ENA) framework is an operational framework for managing the advocacy, planning and delivery of an integrated package of preventive nutrition actions encompassing infant and young child feeding (IYCF), micronutrients and women's nutrition. The actions were all highlighted in the Lancet Series on Maternal and Child Undernutrition as having demonstrated impact.  Using multiple contact points, ENA targets health services and behavior change communication support (BCC) to women and young children during the first 1,000 days of life - from conception through the first two years of life - when nutrient requirements are increased, the risks of undernutrition are great, and the consequences of deficiencies most likely to be irreversible. The tools now available include the booklet of key messages, a training guide for health workers, and a training guide for community volunteers. French versions of these tools will also soon be available. Agnes Guyon has been one of the key champions of the ENA framework over the past 15 years.


Concurrent Sessions:

1. Operational Research:  Methods, challenges, emerging lessons and opportunities

Florence Nyangara, PVO/NGO Support Team Research & Evaluation Advisor, MCHIP
Dennis Cherian, Deputy Director, Health and HIV, International Program Group, WVUS
Alyssa Davis, Health Advisor, Burundi, Concern Worldwide

This interactive session provided an opportunity for participants to share ideas, challenges, and lessons learned from implementing operations research to test innovations. The sessions included an overview of the OR studies conducted by Child Survival and Health Grants Program (CSHGP) innovation grantees followed by practical examples from two representatives  grantees. Common tips and traps for conducting operations research, based on the experiences of CSHGP Innovation grantees over the past 3 years. Two innovation grantees, World Vision and Concern Worldwide, presented their experiences in identifying and developing innovative solutions to overcome their program challenges, implementing OR studies to test the innovations, and the lessons they learned.  

Operations Research: Methods, Challenges, Emerging Lessons, and Opportunities- Nyangara
Operations Research: Methods, Challenges, emerging Lessons and opportunities- Cherian
The Care Group Model: Operations Research in Burundi?- Davis

2. Community Case Management Updates & Improvements

Dr. Serge Raharison, Child Health Technical Officer, MCHIP
Sarah Andersson, Country Technical Manager, SC4CCM Project, JSI Research & Training Institute, Inc.
Shannon Downey, Community Health Program Manager, CORE Group

Community case management (CCM) is one promising approach to reducing childhood mortality; however, evidence shows that CCM is hampered by inconsistent availability of appropriate, quality and affordable medicines. The Improving Supply Chains for Community Case Management (SC4CCM) Project is a learning project focused on finding affordable, simple, and sustainable supply chain solutions that address the unique challenges of community health workers. The project works in three sub-Saharan countries: Malawi, Ethiopia and Rwanda. The first activity of the SC4CCM project was to conduct baseline assessments, in collaboration with the MOH, to gather information on the current status of the CCM supply chain, and identify opportunities for testing innovative supply chain strategies that may significantly impact product availability. Please join us for a presentation of key findings from the baseline assessments and the proposed intervention strategies for these countries to address the findings.

CCM Benchmarks, framework and indicators as a tool for documenting country programs- Raharison
Supply Chains for CCM: Preliminary Baseline Results and SC Intervention Areas- Andersson

3. Practical Family Planning Integration – What does it really mean?

Jennifer Bergeson-Lockwood, Technical Advisor, Community-based Family Planning; Global Health Fellow, USAID
Linda Bruce, Director, Building Actors and Leaders for Advancing Community Excellence in Development (BALANCED) Project
Victoria Graham, Senior Technical Advisor, Bureau of Global Health, USAID;  Rebecca Levine, MCHIP
Sadia Parveen, Reproductive Health Specialist, Child-Fund
Winnie Mwebesa, MCHIP

What are potential entry points to integrate family planning into existing health and development programs?  How do family planning integrated programs work in the field?The focus of this dynamic panel is practical FP integration – discussing how programs integrate FP in the field. The session features a panel of integration experts who will offer three different examples of approaches to FP integration. This session will include time for questions and contributions of other examples from the audience, as well as a brief review of the CBFP materials and resources available.

Practical Family Planning Integration: What does it really mean?- Lockwood
Reaching the hardly Reached with Integrated Approaches- Bruce
Zambia Family Planning Integration Project: Integrating MNCH into Programs- Praveen
Integrated approach to deliver MNCH-FP-Nutrition services- Mwebesa

4. Influencing the Influencers

Catherine Taylor, Global Program Leader, Maternal and Child Health and Nutrition, PATH
Leah Sawalha Freij, Senior Advisor on Gender, Extending Service Delivery Project/IntraHealth
Kiersten Israel-Ballard, Technical Officer, Maternal and Child Health and Nutrition, PATH
Lisa Mueller, Program Officer, PATH
Altrena Mukuria, Senior Country Program Specialist, Infant & Young Child Nutrition Project

 This session exploreed the power of involving community influencers to change health behaviors. Panelists from different organizations discussed effective strategies for identifying and engaging influential community members in global health programs. They presented research, lessons, and results from activities that have successfully influenced key influencers such as grandmothers, men, and community group leaders to improve infant and young child feeding practices, increase access to family planning services, and address gender inequities. 

Mobilising Muslim Religious Leaders as RH/FP “Champions”- Sawalha
Infant Feeding Buddies: Strategies for supporting mothers for Optimal Inafnt and Young Child Feeding- Israel-Ballard
Engaging grandmothers and men: a family-focused approach- Mukuria

Working Group Time:

1. Community Child Health and Malaria - Joint

Roll-out of RDTs to CHWs in Ngoma District, Rwanda
Anne Langston, Health Coordinator, International Rescue Committee Rwanda

RDTS were first introduced in Ngoma district in November 2010. Early data shows good uptake and a positivity rate in the expected range.  CHWs appear to be using the RDTs appropriately.  How their use will change community behavior remains to be seen.

Piloting CCM in Nimba County Liberia: Preliminary Results from EQUIP Liberia
Debra Prosnitz, Malaria Communities Program Advisor, MCHIP

Malaria Communities Program (MCP) EQUIP Liberia is one of three partners implementing a NMCP supported pilot of integrated community case management in Liberia. In April 2011 NMCP conducted an evaluation of the three CCM pilots. This sessions will share preliminary results, best practices and lessons learned from EQUIP’s pilot.


Going Beyond the Buzz Word:  Building Sustainability in OVC Programming in Kenya
Facilitated by HIV/AIDS WG Co-Chairs Janine Schooley, Project Concern International and Shannon Senefeld, Catholic Relief Services
Roger Mutie, World Concern

This session included a highlighted presentation “Laying the Foundations for Sustainability: the ‘how’ and ‘why’ behind sustainable outcomes from an OVC care and support project in Kenya” by Rogers Mutie, World Concern. Rogers summarized the findings from an evaluative case study World Concern Development Organization (WCDO) undertook in Kenya in March 2011 to understand the factors that contributed to sustainability of its USAID/PEPFAR funded OVC Care and Support Project, which recently concluded following a 6 year project. 

Laying Foundation for sustainability. The “how” and “why” behind sustainable outcomes resulting from an OVC Care and support in Kenya- Mutie

3. TB

How the community can be involved in treatment of TB and MDR-TB patients_Golubkov

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