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April 18-22, 2005
Thayer Hotel
West Point, New York
Monday, April 18, 2005
Poster Preparation
Free time to make professional acquaintances and renew old ones. Groups presenting in Tuesday's Poster Session may want to complete posters and/or set up their posters and the surrounding table display area, tri-fold poster boards, tape, markers, etc. will be available.
Registration
Newcomers' Orientation
Facilitator: Lynette Walker (CORE)
PVO and partner staff new to CORE since last year's Spring Membership Meeting are invited to an introduction to CORE Group activities and services and a Q/A time.
Working Group Chairs Meeting
Working Group Chairs will share ideas/concerns about the Working Group planning process for FY05 and FY06, and discuss cross-cutting themes that might be promoted across Working Groups during the meeting. Chairs will also discuss any issues/recommendations to CORE for future support of Working Groups.
Welcome Reception
Dinner/New York Jeopardy Game
Tuesday April 19, 2005
Day facilitator: Linda Morales (Project Concern International)
Welcome Address
Siobhan Walsh, Executive Director, Concern Worldwide
Ms. Walsh addressed the challenges and trade-offs of working at scale while ensuring equity and sustainability among the poor, and how participation in CORE has benefited Concern's global health programs.
State of CORE
Karen LeBan (CORE)
Ms. LeBan presented a brief overview of new developments in global child health and survival, and provided guidance on future directions for CORE.
Announcement of CORE Board of Directors Candidates
Sanjay Sinho (CARE)
Marketplace/Poster Session
An opportunity for participants to talk to representatives of CORE Working Groups, CORE Diffusion of Innovation Projects, and CORE partner organizations. Posters will remain on display until Friday.
Lunch ¨ BOD Election ¨ SHOUT Roundtable
SHOUT Roundtable
The following session will be meeting at a designated table in the lunch area for informal presentation/discussion. Participants should bring their lunch to the Roundtable. Moderator: Jennifer Yourkavitch (CSTS+)
The SHOUT Group (SHOUT) is an informal theme group of PVO practitioners, CORE participants, CSTS+, USAID, researchers, and consultants interested in advancing the practice, the art and the science of designing and implementing health programs leading to more sustainable health outcomes in poor communities of the developing world. Its first and most concrete output so far has been in the development and continued adaptation of the Child Survival Sustainability Assessment (CSSA) framework and methodology.
Lunchtime roundtable discussions were held on Tuesday and Thursday to discuss project updates from last year's technical assistance provision, an indicator compendium project, an update on CSTS+ TA efforts this year (three new projects), developments with the SUSPRO database, a TB rapid sustainability assessment, challenges with integrating the CSSA with project design, the upcoming GHC and mini-university sessions, and next steps as a group. If you want to participate or learn more, please join us.
Opening Plenary: Scaling Up
What Do We Mean by "Scaling Up" and How Do We Know It When We See It?
Moderator: Janine Schooley (Project Concern International)
Panelists: David Oot (Save the Children), Sanjay Sinho (CARE), Jules Mihigo (USAID); Nadeem Mohammad (World Bank)
This moderated panel discussion examined definitions, taxonomies, and a conceptual framework for "scale" so that meeting participants can begin to use the same language and understand each other better when describing and discussing "going to scale" across various organizations and countries. Panelists will discussed processes, challenges, stakeholder participation, replicability and lessons learned from programs that have been scaled up successfully.
Working Group Planning Time
Working Groups used this time to review 2005 workplans and update the status of existing activities; develop FY06 workplans; address questions regarding materials dissemination and scale-up at country level for inclusion in FY05 and FY06 activities; review WG membership; and conduct WG elections, if needed.
USAID CSHGP Update
Facilitators: Susan Youll (USAID), Leo Ryan (CSTS+)
An evening session to celebrate the 20-year anniversary of the Child Survival and Health Grants Program (CSHGP). This session was an appreciation of where we've been and the latest thinking on where the CSHGP is going. Panelists provided an update on priority activities for USAID, particularly the CSHGP and the PVO/NGO Flexible Fund. The presentation included discussion about the CSHGP's new performance management plan, and an opportunity for participants to address how PVOs can contribute to the indicators in this plan for the purpose of raising the visibility of PVO accomplishments both within and outside of USAID. Also included was an update on planned CSTS+ activities in the coming months and how participants could benefit from and participate in those efforts.
Wednesday April 20, 2005
Day facilitator: Lisa Bowen (Plan USA)
Announcement of CORE BOD Elections Results
Board Chairman - Tom Davis
Secretary - Janine Schooley
At Large - Nduge Kiiti
At Large - Diana DuBois
Concurrent Technical Sessions:
1. Malaria During Pregnancy: Data-Driven Best Practices
Moderator: Michel Pacqué (CSTS+/ORC Macro)
Presenter: Monica Parise (CDC)
In sub-Saharan Africa, human immunodeficiency virus (HIV) and malaria are among the leading causes of morbidity during pregnancy. Results from recent studies show that HIV-infected women experience consistently more peripheral and placental malaria, higher parasite densities, and more febrile illnesses, severe anemia, and adverse birth outcomes than HIV-uninfected women. Evidence also suggests that there may be a relationship between placental malaria and mother to child transmission of HIV. The data show that there is a need to strengthen the deployment of existing malaria and HIV prevention and intervention measures for pregnant women and that further investigations of interactions between antiretroviral drugs and anti-malarial drugs in pregnant women are needed.
2. Case Examples of CORE Member Programs Working at Scale
Moderator: Bill Weiss (CORE/JHU)
Presenters: Sara Smith (CORE/World Vision), Peggy McLaughlin (World Vision), Kathryn Bolles (Save the Children), Kati Moseley (Mercy Corps), Lyndon Brown (USAID)
Panel members presented short case examples of CORE member programs that have achieved scale in various ways. Building on the scale-related sessions of the first day of the meeting, participants applied what they have learned by identifying key factors that have facilitated or hindered how the case examples have scaled up their programs. We hope that participants will be encouraged or have increased confidence in their future attempts to achieve greater scale in their own programs.
The three case examples include the following: (1) CORE Nepal IMCI; (2) World Vision India Child Survival Project; and (3) Scaling up PD Hearth in Indonesia. In Nepal, ADRA, CARE and Save the Children utilized an existing platform developed during the CORE Polio Project to scale up IMCI interventions simultaneously across six districts. In India, World Vision is applying the SEED-SCALE model of Dr. Carl Taylor to expand an earlier CSP: more interventions are being added to the original district and earlier interventions have been expanded to two additional districts utilizing the original project as a learning center. In Indonesia, six INGOs developed a PD Hearth network. The support and advocacy provided by this network--which has already graduated almost 3,000 children from Hearths--has led to the MOH adopting PD Hearth as a national strategy.
3. New Approaches in Environment Health - The Hygiene Improvement Project (HIP)
Presenters: Lynne Cogswell (USAID/HIP), Brandt Witte (USAID/HIP), Eric Mintz (CDC)
The Hygiene Improvement Project team took participants on an interactive, participatory exploration of hygiene improvement and sustainable hygiene behaviors at-scale. While this journey included a brief introduction to the HIP, the behavior change context of hygiene behaviors, and an engaging dialogue on CORE members' role in at-scale hygiene improvement efforts, the focus was on point-of-use water management alternatives and some of the behavioral implications of these alternatives as well as demonstrations of selected options. This session ended on "turbo-trip" to identify ways in which the HIP can facilitate and support CORE member hygiene efforts.
Concurrent Technical Sessions:
1. Maternal Health - Household to Hospital Strategies
Moderator: Virginia Lamprecht (USAID)
Presenters: Susan Otchere (Save the Children), Lynn Sibley (Emory University)
Participants learned about Save the Children's innovative and holistic approach to build the capacity of caregivers at all levels to provide care to mothers and newborns along a continuum from the household to the peripheral and district facilities. This approach is known as the Household to Hospital Continuum of Care (HHCC) and is complemented by the Gap Analysis Tool (GAT). Experiences of using this tool in Guinea and Afghanistan to improve maternal and newborn care will be shared.
Home Based Life Saving Skills (HBLSS) was integrated over three years into a district-level child survival project with the MOH and Save the Children in Southern Ethiopia. In late 2002 and 2004, ACNM and the HBLSS field-test team conducted an internal descriptive review of the programs. Both reviews assessed performance, case management, method of learning transfer and coverage. Participantss heard about the positive findings of the review, demonstrating that significant transfer and uptake of skills is taking place.
2. Motivational Interviewing
Facilitator: Tom Davis (Food for the Hungry)
Studies in behavior change have shown that people usually move through stages when making a change. People move through changes with differing levels of readiness to change. Employing particular strategies for people who are in a particular stage of change can be very effective in changing behaviors. Conversely, using strategies like giving advice or suggestions for taking action when people are not prepared to make a change can be premature, inappropriate or ineffective. The problem is that many child survival programs often start by suggesting that a person make a change, long before they have been prepared to make the change.
Motivational Interviewing (MI) is a method for helping people to make decisions that improve their health (or that of their children). It is grounded in decision-making theory and motivational psychology. It has been shown to be most effective for those who are less ready to change: those who are in the Contemplation and Preparation stages of change, people who often have high levels of ambivalence about making a change or adopting a behavior. MI helps to bring out a person's own arguments for change and helps the person to use their own resources to make a change. MI has been effective in helping people change a wide range of health behaviors including more difficult behaviors where ambivalence can be quite high such as smoking cessation, alcohol and other drug abuse, cardiovascular health, and diabetes. Since 2000, Motivational Interviewing has also been used effectively in health promotion in developing country settings such as Zambia when applied by non-professionals. During this session, participants learned some of the basics of Motivational Interviewing and how they may be applied to projects.
3. Debate: Are the Poor Entitled to Free Insecticide-Treated Mosquito Nets?
Moderator: Ellen Vor de Bruegge (Freedom from Hunger)
Panelists: Mark Grabowsky (American Red Cross), Stewart Parkinson (PSI), Malick Diara (AED/NetMark)
Insecticide-treated nets (ITNs) have become an important tool in the prevention of malaria in highly endemic areas. At present, large-scale ITN programs are being implemented in sub-Saharan Africa, Asia and Latin America using a number of operational approaches. Malaria experts agree that if the targets of the Abuja Declaration and MDGs are to be reached, the scale of operations needs to be increased substantially. What experts cannot agree upon, however, is which operational method for ITN distribution will have the greatest impact toward reaching and sustaining those targets. This session offered an overview of the channels of distribution and provided an opportunity to openly discuss and debate the challenges and opportunities of the different distribution methods.
Lunch ¨ Dory Storms Award Vote ¨ Roundtable: Input to CORE
Dory Storms Award Vote
Each year at the Annual Spring Meeting, CORE presents the Dory Storms Child Survival Recognition Award to "a person(s) recognized for exceptional efforts resulting in more effective child survival program implementation and increased impact in improving the health of the poorest of the poor including mothers, children and infants in underserved communities throughout the world." Each PVO has one vote per organization to select the 2004 recipient of the Dory Storms Award from among this year's nominees.
The Recipient of the
2005 Dory Storms Child Survival Recognition Award is
Robb Davis
Roundtable: Input to CORE
The following session will be met at a designated table in the lunch area for informal presentation/discussion on future directions for CORE and how CORE can better serve its members. Facilitator: Karen LeBan (CORE)
Working Group Planning Time
Working Groups used this time to review 2005 workplans and update the status of existing activities; develop FY06 workplans; address questions regarding materials dissemination and scale-up at country level for inclusion in FY05 and FY06 activities; review WG membership; and conduct WG elections, if needed.
Concurrent Technical Sessions:
1. Practical Applications of Lessons Learned in Scale
Facilitator: Melanie Morrow (World Relief)
This session was designed to give participants practice in thinking through how to "scale up" without crippling the quality of programs. Participants engaged in small group work to examine issues of scale related to two CORE technologies: the application of PD/Hearth (Nepal) and Care Groups (Mozambique).
2. Operational Issues in Newborn Care
Moderator: Lisa Bowen (Plan USA)
Presenters: Gary Darmstadt (Saving Newborn Lives), Renata Seidel (JHU/CCP), Alfonso Rosales (Catholic Relief Services)
Presenters discussed:
- Experiences with introduction of skin-to-skin care in a rural community in Uttar Pradesh, India, and implications of the findings for strategies to implement KMC in the community;
- Classic behavior guidelines and their application in newborn health interventions;
- Lessons from an initiative to integrate neonatal health into maternal programs in Honduras.
3. Messaging and Advocacy for Child Survival
Moderator: Carmen Coles (AED/US Coalition for Child Survival)
Presenters: Kaia Lenhart (GMMB), Paula Fleming (WGBH/Boston)
Beginning with the Lancet series on newborn health and the World Health Day theme of "Make Every Mother and Child Count" there will be several opportunities this year to mobilize the US Government and its partners to increase support for the "unfinished agenda" in child health. However, to fully take advantage of these opportunities and successfully advocate for increased resources, the child survival community must be united in voice and message.
The US Coalition for Child Survival is collaborating with both GMMB and WGBH to raise awareness of child health and survival in 2005. GMMB, a public relations firm hired by the Gates Foundation, is providing guidance on messaging and advocacy campaigns for the US Coalition and its partners. WGBH is launching a nationwide social impact campaign to educate and inform Americans across the country about child health and survival. These advocacy efforts, however, cannot be successful without participation from the PVO/NGO community.
CORE Board of Directors Meeting/Dinner
The newly elected (and continuing) members of the CORE Board of Directors Meeting.
Thursday April 21, 2005
Day facilitator: Peggy McLaughlin (World Vision)
Concurrent Technical Sessions
1. Mainstreaming HIV/AIDS
Presenters: Breda Gahan (Concern Worldwide), Darshana Vyas (Counterpart International), Milton Amayun (World Vision)
Breda Gahan gave a presentation on Concern's rationale for mainstreaming, its definition of mainstreaming, minimum requirements for internal and external mainstreaming, critical elements of mainstreaming and lessons learned, and on Concern's progress and challenges. Darshana Vyas presented on Counterpart's mainstreaming of HIV/AIDS with food security, TB, child survival and microenterprise programs. Milton Amayun presented on World Vision's experience mainstreaming HIV/AIDS with Asian tsunami efforts. A discussion followed.
By the end of the session, participants:
- Learned of three organizational HIV/AIDS mainstreaming approaches
- Shared other organizational mainstreaming responses
- Discussed process, progress, lessons and challenges in mainstreaming an HIV/AIDS response within an organization
2. Comprehensive Approaches to Achieving Quantitative Scale
Moderator: Jim Ricca
Presenters: Alfonso Rosales (Catholic Relief Services), Kendra Blackett-Dibinga (Africare), Peggy Koniz-Booher (URC)
Quantitative scale (i.e. coverage) is often achieved through "stripped-down" or vertical interventions like National Immunization Campaigns, EPI, ORS promotion, or ITN distribution. There has been little successful experience and even less rigorous study of how one might achieve high coverage levels of key child health interventions through comprehensive approaches. This session looked at the experience of three countries trying to achieve nationwide scale of child health interventions through such comprehensive approaches (the Philippines, Uganda, and Guatemala). After a brief presentation of the background situation, the presenters analyzed the policy, managerial, technical, and economic factors that facilitated or hindered this process. It is too early in the process to definitively analyze the impact of these experiences in terms of sustainability or equity, but preliminary thoughts on issues were also discussed by the panelists.
3. Writing Right: Tips for More Forceful Writing
Facilitator: David Marsh (Save the Children)
Participants in this two-part workshop learned how to strengthen the
mechanics and content of their technical writing. Specifically, they will
learn to avoid the 12 common pitfalls of casual writing and to state
quantitative findings correctly and "with a human face."
Concurrent Technical Sessions
1. Operationalizing Zinc
Moderator: Erin Dusch (Helen Keller International)
Presenters: Emmanuel d'Harcourt (International Rescue Committee), Maureen Phelan (International Rescue Committee), Donna Staton (International Rescue Committee), Eric Swedberg (Save the Children)
Diarrhea continues to be a major cause of infant and child mortality throughout the world. Recent recommendations from WHO/UNICEF for the use of ORS and zinc are not yet widely implemented in the management of diarrheal disease. This session will describe how programs in DR Congo, Mali and in a refugee camp in Bathai, Chad, were able to integrate zinc into child health and survival projects. Participants will discuss lessons learned, issues of supply and logistics, policy, and scaling up. Results from the First International Conference on Scaling Up Zinc Treatment for Young Children (SUZY) with Diarrhea will be presented as well.
2. HIV/AIDS and FBOs: Experiences with ABC and Home-Based Care
Moderator: Milton Amayun (World Vision)
Presenters: Saifuddin Ahmed (JHU), Melanie Morrow (World Relief), Bram Bailey (SAWSO)
ABC and home-based care are just two interventions faith-based organizations (FBOs) are engaged in as part of the fight against HIV/AIDS. Come and ask the panelists about the controversies, methodologies and challenges faced by FBOs on the ground.
By the end of the session, participants learned to:
- describe what ABC is as an AIDS prevention strategy
- discuss the difference between risk prevention and risk reduction
- identify three effective AIDS interventions that FBOs are pursuing
- discuss two challenges in measuring results of HIV/AIDS prevention programs
3. Using Data for Decisionmaking: Case Studies
Moderator: Juan Carlos Alegre (Project Hope)
Presenter: Bill Weiss (JHU)
Participants were presented with some new ideas from the M&E Working Group on how to improve decisionmaking (primarily from existing data). More specifically, participants received guidance on how M&E plans for proposals and DIPs can more directly define the decisions that will be made from the M&E system the project will implement. Following this, participants had an opportunity to apply the ideas presented using case examples of PVO Child Survival projects. Participants practiced defining the decisions to be made from M&E data, the analysis needed to make such decisions, and the charts/visuals needed in support of the analysis.
Lunch ¨ Roundtables: SHOUT, Tuberculosis ¨ DVD Screening: The Last Child
SHOUT Roundtable
The following session met at a designated table in the lunch area for informal presentation/discussion over lunch. Moderator: Michelle Kouletio (Concern Worldwide)
The SHOUT Group (SHOUT) is an informal theme group of PVO practitioners, CORE participants, CSTS+, USAID, researchers, and consultants interested in advancing the practice, the art and the science of designing and implementing health programs leading to more sustainable health outcomes in poor communities of the developing world. Its first and most concrete output so far has been in the development and continued adaptation of the Child Survival Sustainability Assessment (CSSA) framework and methodology.
Lunchtime roundtable discussions were held on Tuesday and Thursday to discuss project updates from last year's technical assistance provision, an indicator compendium project, an update on CSTS+ TA efforts this year (three new projects), developments with the SUSPRO database, a TB rapid sustainability assessment, challenges with integrating the CSSA with project design, the upcoming GHC and mini-university sessions, and next steps as a group.
DVD Screening: The Last Child
The Last Child, a one-hour documentary produced and directed by CARE's Scott Thigpen, tells the behind-the-scenes story of the global campaign to eradicate polio. From the frontlines in Nigeria, India, Haiti and elsewhere, you'll witness the victories and challenges of trying to eradicate a disease worldwide for only the second time in history. The award-winning documentary began airing on PBS stations last fall. CORE's Polio Partners Project is featured in the film; members of the polio team were available to answer questions. For more information, see: www.lastchild.org.
Working Group Planning Time
Working Groups used this time to review 2005 workplans and update the status of existing activities; develop FY06 workplans; address questions regarding materials dissemination and scale-up at country level for inclusion in FY05 and FY06 activities; review WG membership; and conduct WG elections, if needed.
Concurrent Technical Sessions
1. HIV and Infant Feeding
Moderator: Kathryn Bolles (Save the Children)
Presenters: Peggy Koniz-Booher (URC), Ted Greiner (PATH)
This session investigated what we know-and still don't know- surrounding infant feeding within the context of PMTCT. The first presenter summarized findings from a compilation of program evidence on HIV and infant feeding, discussed major results from a review of infant feeding presented at a recent Bangkok meeting, and reported on key recommendations from a scientific meeting on the "Balance of Risks." The second presenter took a closer look at the evidence base regarding the infant feeding component of PMTCT programs and suggested the existing research is of doubtful relevance to most settings in Africa, where most of the world's maternal-to-child transmission is taking place. While much attention has focused on the need for risk assessment regarding infant feeding choices before birth, almost none has gone to issues related to decisionmaking on when breastfeeding should end. Both presenters discussed the implications for NGO PMTCT programs.
2. Strengthening Health Systems To Save Lives
Moderator: Leo Ryan (CSTS+)
Presenters: Jack Galloway (Abt Associates/PHR Plus), Melinda Ojermark (Abt Associates/PHR Plus)
The USAID Health Systems Mainstreaming Initiative is an effort to build the capacity of USAID Missions and service delivery program implementers to recognize and respond effectively to health system strengthening challenges within their manageable interests. One component of the Mainstreaming Initiative concerns incorporating HSS approaches into the practices of the Child Survival Grants program. This will entail integration of HSS perspectives and content into: CSHGP Technical Reference Materials (TRMs), proposal guidance, and proposal submissions. On behalf of USAID, PHRplus is collaborating with CSTS in preparing a TRM module on Health Systems Strengthening.
This session presented an overview of the draft Health Systems Strengthening TRM, and challenge participants with questions concerning the opportunities and constraints inherent in HSS at the PVO project level. Participants considered the following key issues:
- The relationship between improving Child Survival Services and overall health system strengthening.
- How child survival projects can implement health system strengthening interventions to enhance project results and sustainability
The facilitators shared HSS tools with the participants, and elicit examples, case studies and references drawn from the discussion for incorporation into the TRM.
3. Community Case Management
Moderator: Eric Starbuck (Save the Children)
Presenters: Diana Silimperi (BASICS), Jules Mihigo (USAID/Rwanda)
In Africa, pneumonia, malaria and diarrhea are the leading causes of death for children under five. Pneumonia and malaria overlap in terms of clinical presentation, the requirements for their effective management, and the feasibility of providing care in the community. Technically sound and manageable community interventions that tackle both conditions would reduce child mortality. This session will explore issues, opportunities and next steps in community case management of Malaria and ARI by presenting experiences from Rwanda and Senegal.
Social Event
Dinner and Band: Brooklyn Corn Dodgers
Hot fiddle tunes, back-porch torch songs, sweet waltzes, snappy cakewalks and weepy ballads - this is the stuff of the Brooklyn Corn
Dodgers. Their unique approach to traditional American music brings the intimate musical sounds of the parlor and the raucous energy of the barn dance to the stage.
Driven by the twin harmonicas and vocals of Trip Henderson and Randy Weinstein, the ensemble of Val Mindel (harmony vocals and guitar), Henry "Hank" Sapoznik (5-string banjo, tenor guitar and lead vocals) and Gerry Yoselevich (tuba) animates the nearly lost moment when old time Appalachian music collided with Tin Pan Alley songs of a mythic South of plantations and levees.
Friday April 22, 2005
Day facilitator: Leo Ryan, CSTS+
Optional Session: De-Stress with Linda Morales (PCI)
Speaker: Dr. E. Anne Peterson (Alliance for Mother, Newborn & Child Health)
Dr. Peterson addressed roles for PVOs within the new Global MNCH Partnership and in reaching the MDGs, and the importance of community-based approaches in public health.
Plenary: Working Group Report-Out/CORE Strategic Directions
This session provided an opportunity for each Working Group to report the week's accomplishments and share next steps with the larger CORE membership.
Meeting Adjourned
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