|
Innovation for Health
April 23-27, 2007
The Tidewater Inn
Easton, Maryland
Monday | Tuesday | Wednesday | Thursday | Friday
Monday April 23, 2007
Pre-Spring Meeting Events
HBLSS Workshop: Home-Based Life Saving Skills-Overview and Implementation
Betsy McCallon, Safe Motherhood Advisor, White Ribbon Alliance for Safe Motherhood
Diana Beck, American College of Nurse-Midwives
Jody Lori, HBLSS Consultant, American College of Nurse-Midwives
The Home Based Life Saving Skills (HBLSS) program works with women, families, and community members to come to a common understanding of the need and the means to prevent maternal and neonatal deaths starting at the family and community level. To implement this program, a systematic approach is used including initial planning, assessment, preparation for implementation and training, and monitoring and evaluation. Participants received an overview of HBLSS, discuss implementation steps, and have the opportunity for interchange with presenters who have implemented HBLSS.
At the end of the workshop, attendees were able to:
- Explain what Home Based Life Saving Skills is
- Describe the steps for implementing a HBLSS program
- Use the "HBLSS Guidelines for Decision Makers" and "Trainers Manual" to discuss implementation steps
- Understand how HBLSS can be adapted to meet the needs of different communities and donors
- Describe common issues/challenges that arise in the implementation of a HBLSS program and possible solutions
Country-Level Advocacy
Patrick Bertrand, Global Health Advocates
- Introduction
- Tools
- Examples
The resource landscape for maternal and child health is changing. PVOs are well positioned to raise issues and challenge decision makers to ensure that good policies are in place and that resources are available for maternal and child health programs. Influencing decision makers involves using the techniques of advocacy.
The Country Level Advocacy Skills Building Session helped participants understand how they can make advocacy part of their programs. The interactive session included information on the difference between advocacy, communication, and social mobilization, and tools for advocacy at the country level. By the end of the session participants could:
- Understand the importance of advocacy
- See themselves and their partners as change agents
- Understand the roles and perspectives of primary stakeholder groups e.g. media, private sector, and civil society organizations
- Know how to develop and deliver effective media messages and to use communications strategies (including the use of personal experience) to enhance their ability to reach target audiences
- Have explored how best to advocate for public policy to improve community level programs
Newcomers' Orientation: How You Can Get Involved, How You Can Benefit
Facilitator: Lynette Walker (CORE Group) and Working Group Chairs
PVO and partner staff new to CORE Group since last year's Spring Membership Meeting were invited to an introduction to CORE Group activities and services and a Q/A time. Working Group chairs were on hand to talk about WG activities and answer questions.
State of Maternal and Child Health
Peter Winch, Johns Hopkins University
This presentation reviewed selected recent developments in research and programs on maternal, newborn, and child health. The focus was on findings from recent newborn health studies, and integration of maternal, child, and birth spacing interventions during the first six months of life.
State of CORE Group
Karen LeBan, Executive Director, CORE Group
Tom Davis, Chair, CORE Group Board of Directors
Karen and Tom introduced new CORE Group member organizations and provided guidance on future directions for CORE Group.
Welcome Reception Hosted by Christian Children's Fund
Tuesday April 24, 2007
Opening Announcements
Day Facilitator: David Shanklin, Christian Children's Fund
Keynote Workshop: Innovation from the Inside Out-Rescripting Mindsets for Healthy Communities
Arvind Singhal, Ohio University
In this keynote, Dr. Singhal questioned the deficit-based thinking that has guided most social change interventions, urging practitioners to be innovative, playful, and creative in scoping out people-centered, people-generated solutions.
Dr. Singhal's presentation inculded examples of improved childhood nutrition in Vietnam (PD/Hearth), reduction of violence and traffic casualites in Bogata, Columbia, promotion of condom use in Thailand, and reduction of domestic violence in South Africa.
Poster Session: Innovations in Community-Based MCH Programming
Posters:
Lunch Roundtable: Integration of Family Planning Activities into Child Survival Health Grant Activities
Participants discussed the potential links between family planning and child survival interventions in the Child Survival Health Grant activities. The CSHGP wanted to hear recommendations for practical entry points where family planning messages and services can be easily incorporated into a child survival programs and your thoughts on the challenges of integrating these services.
Working Group Presentation and Dialogue: Key Directions and Common Ground
This creative session was designed to familiarize CORE Group members and partners with the activities of the various working groups.
Working Group Planning Time
Working Groups used this time to review 2007 workplans; move key activities forward; develop FY08 workplans; and discuss technical issues.
CSHGP Update
Nazo Kureshy, USAID
CSTS Update Michele Pacque
SHOUT Meeting
The SHOUT Group (SHOUT) is an informal theme group of PVO practitioners, CORE Group members, 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. The group developed the Child Survival Sustainability Assessment (CSSA) framework and methodology.
Wednesday April 25, 2007
Opening Announcements
Day Facilitator: Barmak Kusha, IMC
Concurrent Technical Sessions:
1. Newborn Health
Sujata Ram, Maternal Child Health Advisor, American Red Cross
Gary Darmstadt, Associate Professor and Director of the International Center for Advancing Neonatal Health, Johns Hopkins University
Gary Darmstadt presented lessons learned from implementation of packages of maternal and neonatal health interventions in South Asia, ranging from preventive, essential, family and community-based newborn care to large-scale programmatic implementation of newborn preventive and curative care integrated with maternal-child-reproductive health and nutrition.
By the end of the session, participants were able to:
- Understand the elements of essential preventive and curative newborn care
- Understand some of the challenges to integration of newborn health care into broader health and nutrition programs
2. TB and HIV/AIDS: Co-Infection Issues
Emily Bell, Open Society Institute
Jamillah Mwanjisi, Open Society Institute
The co-facilitators and participants worked together during this interactive session to untangle the practical implications of the deadly synergy of these two diseases. What are the key issues an NGO must address when designing and implementing activities involving either or both diseases? How can the voices of patients, health workers, community volunteers, and other members of civil society be heard-and acted on-in order to improve the quality or scale of projects?
By the end of the session, participants were able to:
- Provide a short overview of the global situation of TB/HIV co-infection
- Describe the basic medical and treatment facts of TB/HIV co-infection
- View non-integrated community-based TB and HIV programs from the patient perspective
- Project potential improvement for integration of programming on the health and welfare of TB patients
- Describe common pitfalls of integration of services
- Cite real examples of how these issues play out on the ground
3. Pandemic Flu: Epidemiology, Prevention, Treatment, History, & Current Threat
Eric S. Starbuck, Child Survival Advisor, Save the Children
The 1918 influenza pandemic is the catastrophe against which all modern pandemics are measured. No other plague in recorded history killed as many people in such a short period of time. An estimated 20 to 40 percent of all persons on earth became ill, and at least 40 million people died as a result. As of April 2, 2007, H5N1 has resulted in the death of 59 percent of all confirmed cases in humans in a dozen countries since November 2003. Many of these deaths have occurred in spite of good medical care. This session is designed to provide international public health professionals with a comprehensive overview of the current threat.
By the end of the session, participants had a good understanding of the nature of the current threat of pandemic flu, including influenza epidemiology, prevention, and treatment.
Concurrent Technical Sessions:
1. Technology Fair: Innovations in Technology
Jim Ricca and David Cantor, CSTS+
Tom Davis, Food for the Hungry
Joel Selanikio, DataDyne
Emmanual d'Harcourt and Katie Haxall, IRC
Laban Tsuma, Plan
Pete McLain, T4 Global
During this session, Tom Davis demonstrated Pocket PC applications developed by PHCreations, including a sample child survival survey questionnaire, an IMCI job aide, a nutritional status calculator, and a Hearth meal nutrient calculator and follow-up database. These tools are suitable for use by supervisory- and technical-level staff in child survival programs.
David Cantor and Jim Ricca demonstrated two applications developed for collecting data on handheld PDAs: The LAYERS PL 480 Food Monitoring Data Management System developed by ORC Macro for monitoring PL 480 food stocks at food distribution points, schools, and health centers in Haiti; and the CSTS+ Project/USAID Flexible Fund Family Planning Baseline Survey conducted by the American Red Cross in Peshkopi, Albania.
Emmanuel d'Harcourt demonstrated and answered questions on the use of PDAs for routine supervision. He showed a sample supervision checklist and PDA form, as well as data collected through them, and had them available for try out.
Laban Tsuma explained Plan International's pilot electronic birth registry program in Bangladesh, which allows health officials to track individual children's immunization records and remind parents when their children are due for immunizations.
Pete McLain discussed lessons learned from the past four years of work with communication and training of over 5 million oral learners in various regions of the world. A feature of his presentation was demonstrating various simple, low cost audio and video technologies that facilitate a transfer of training to oral learners in poor and remote areas. He discussed how these technologies can augment other live workshop training efforts, providing greater reach and scale of consistent training material, as well as how they can help trainer-of-trainer (TOT) and peer education models.
By the end of the session, participants:
- Saw demonstrations of various information and communications technologies
- Heard how these technologies could be used in their own projects
- Were able to try many of the technologies for themselves
- Got answers to their questions about these information and communication technologies
2. Fostering Ownership of Innovation within an Organization
Ellen Vor der Bruegge, Freedom from Hunger
Michelle Kouletio, Concern
David Kurth, Counterpart
Pierre Marie Metangmo, Plan
Jan Disselkoen, CRWRC
As public health practitioners, CORE Group members are often early identifiers of innovations either from their own programs or from the broader public health community that should be replicated or moved forward within their organizations. However, infusing change within an organization can be challenging regardless if one works for a small or large organization. Championing change across technical units, country offices and projects, and across departments and up and down hierarchical executive levels requires strategic action.
Reviewing case studies from two very different NGOs, this session helped participants develop guiding principles to better promote innovation through broader organization commitment and advancement. While diversity abounds, there are several powerful principles that unite us.
By the end of the full session, participants:
- Analyzed two case studies of initiatives that have been mainstreamed into an organization
- Identified guiding principles for mainstreaming innovation
- Outlined actions for infusing an innovation within the participants' organizations
Working Group Planning Time
Working Groups used this time to review 2007 workplans, move key activities forward, develop FY08 workplans, and discuss technical issues.
Concurrent Technical Sessions:
1. Barriers to Reproductive Health
Judy Lewis, Haitian Health Foundation
Susan Otchere, Save the Children
Sandra K. Krause, Director, Reproductive Health Program, Women's Commission for Refugee Women and Children
The session began with an overview of the Minimum Initial Service Package (MISP). MISP is a set of priority reproductive health (RH) activities to be implemented during the onset of a complex emergency. The goal of the MISP is to reduce mortality, ill-health, and disability among populations affected by crises, particularly women and girls. The MISP is comprised of five key activities including: 1) Identifying an organization(s) and individual(s) to facilitate the coordination and implementation of the MISP; 2) Preventing sexual violence and providing appropriate assistance to survivors; 3) Reducing the transmission of HIV; 4) Preventing excess maternal and neonatal mortality and morbidity; and 5) Planning for the provision of comprehensive RH services, integrated into primary health care, as the situation permits. When implemented in the early days of an emergency, the MISP saves lives and prevents illness, especially among women and girls. Neglecting RH in emergencies has serious consequences: preventable maternal and infant deaths, sexual violence and subsequent unwanted pregnancies and unsafe abortions, and the spread of HIV.
Three examples were presented to illustrate lack of MISP implementation in relief settings, despite the fact that it is Sphere standard required at the beginning of every emergency. Assessments undertaken by the Women's Commission for Refugee Women and Children in Pakistan, Chad, and Indonesia demonstrated that many humanitarian actors working in emergencies did not know the priority RH services of the MISP that should be implemented in every emergency setting. Many humanitarian staff do not understand the importance or necessity of implementing priority RH services. Strategies for ensuring the implementation of MISP were discussed.
By the end of the session, participants could:
- Understand the immediate reproductive health needs in emergency situations
- Explain the components of the Minimum Initial Service Package (MISP)
- Describe each activity in the MISP
- Address some of the challenges associated with implementing the MISP Identify the gaps in implementing the Minimum Initial Service Package (MISP) in three settings (Chad, Indonesia and Pakistan)
- Identify some best practices in implementing the MISP in displaced person settings
- Collaboratively discuss and complete a quiz on the MISP
2. Exploring Determinants of Behavior Change: A Closer Look at Doer/Non-Doer Analysis and Barrier Analysis
Will Story, Child Survival and Health Technical Advisor, Christian Reformed World Relief Committee (CRWRC)
Laban Tsuma, Health Associate, Plan International
Tom Davis, Director of Health Programs, Food for the Hungry
Mary Hennigan, Catholic Relief Services
The Designing for Behavior Change Matrix (the BEHAVE Framework), developed by the Academy for Educational Development, is a tool that enables managers, planners, local staff, and the community to strategically plan for behavior change in a variety of settings. A key component of planning behavior change activities is identifying the factors that are most important to behavior change. Doer/Non-Doer Analysis and Barrier Analysis are two rapid assessment tools that have been developed to identify determinants associated with a particular behavior in order to design more effective behavior change activities.
During the first half of this session, participants examined three distinct case studies on the use of Doer/Non-Doer Analysis and Barrier Analysis. These case studies explored a range of health interventions including HIV/AIDS prevention, breastfeeding promotion, and immunization coverage. During the second half of the session, participants took a closer look at some of the practical questions that arise when conducting a Doer/Non-Doer Analysis or a Barrier Analysis.
By the end of the session, participants:
- Examined three case studies of Doer/Non-Doer (DND) Analysis and Barrier Analysis (BA)
- Determined how to analyze DND and BA results
- Examined how to use DND or BA with behaviors that are not commonly practiced currently
- Assessed the pros and cons of using focus group discussions and individual interviews for DND and BA
- Compared and contrasted different views on how sampling should be done for DND and BA
- Identified and addressed other burning issues regarding DND and BA
3. Addressing Stigma: TB and HIV/AIDS
Emily Bell, Open Society Institute
Jamillah Mwanjisi, Open Society Institute
Since 2004, the Open Society Institute's Public Health Watch project has promoted informed public participation in the fight against TB and HIV/AIDS. Public Health Watch's Jamillah Mwanjisi and Emily Bell have looked at stigma from many angles as they've traveled the world, engaging in dialogue with key players at all levels - from patients to policymakers.
In this session, Jamillah and Emily worked with participants to consider:
- On a practical level, how do stigma and discrimination interfere with effective TB control?
- What are some examples of how NGOs have effectively helped to stop the perpetuation of these fatal ideas?
- What are the programming implications of the double stigma dynamic of TB and HIV/AIDS?
- How can NGOs act as a bridge between communities and local and national policymakers to weaken stigma's interference in TB control?
By the end of the session, participants were able to:
- Explain why stigma related to TB and HIV/AIDS is so pervasive in endemic countries
- Describe how stigma and discrimination interfere with effective TB control
- Illustrate approaches that NGOs have used/might use to learn about stigma where they are working
- Depict the complex synergy of dual stigmas of TB/HIV
- Describe strategies NGOs have used/might use to lessen stigma
Thursday April 26, 2007
Opening Announcements
Day Facilitator: Lali Chania, IRD
Concurrent Technical Sessions:
1. Measuring Dimensions in the Process of Social Change
Kim Ashburn, International Center for Research on Women
Michelle Kouletio, Health Advisor, Concern Worldwide
Anna West, Maternal & Child Health, World Relief
Over the past several years, the International Center for Research on Women (ICRW) has applied the participatory, learning, and action (PLA) approach as an intervention strategy in programs focusing on aspects of HIV/AIDS and reproductive health, among others. For example, the PLA approach is being applied in an HIV-related stigma reduction project in Vietnam, "Reducing Stigma and Discrimination in Vietnam." Through the PLA approach, communities are able to build their awareness of HIV-related stigma, understand how stigma relates to the spread of HIV, and create strategies to change HIV-related stigma. Participatory methods are used in monitoring the level of engagement of participants in the PLA strategy and qualitative and quantitative methods are used in operationalizing the stigma construct and evaluating change in HIV-related stigma. This project will serve as a case study to demonstrate the tools adapted specifically for this project, and to describe the process of implementation and evaluation of change in HIV-related stigma.
By the end of the session, participants:
- Identified the importance of considering social change in behavior change interventions
- Developed an understanding of a range of tools that can be used in participatory learning and action as an intervention and for measuring change in social constructs
- Reviewed a field example of applying participatory learning and action as a strategy to build awareness and action in an HIV-related stigma reduction strategy
- Discussed the selection and application of some participatory tools useful for action planning in child survival programming
2. Progress on Community Case Management
Kathryn Haxall, International Rescue Committee
Peter Winch, Johns Hopkins University
Emmanuel Wansi, BASICS
This panel provided an update on current CCM programming and offer a commentary on challenges from several perspectives. In particular, the panelists discussed how to secure Ministry of Health collaboration for quality programming through innovative ways to counter MOH resistance at the policy and operational levels. They also suggested ways to elicit MOH presence and supportive supervision of CCM projects. The panelists shared field experiences that reduce the likelihood of error on the part of community volunteers and improve reporting of CCM activities.
By the end of the session, participants were able to answer the following questions:
- How has resistance from the Ministry of Health to antibiotic prescription at the community level been addressed at both policy and operational levels?
- How can programs reduce the likelihood of errors in treating multiple symptoms?
- How can reporting by community health workers, and particularly illiterate volunteers, be improved?
- How can programs elicit greater presence and supervisory support from the Ministry of Health?
3. Community Nutrition Programs at Scale
Rae Galloway, Technical Director, The Infant and Young Child Nutrition Project, PATH
Kathryn Bolles, Child Health and Nutrition Advisor, Save the Children
Thomas Schaetzel, Nutrition Technical Officer, BASICS, The Manoff Group
While there has been some progress in the last decade in reducing malnutrition in children in developing countries, national programs to address the problem are insufficient to meet the Millennium Development Goal target of reducing underweight in nutrition children by one-half by the year 2015. However, there have been large-scale nutrition programs in the last several decades that offer lessons about essential program components that will effectively reduce malnutrition if applied more widely. These components include using the appropriate approach to addressing the problem of malnutrition, reaching adequate coverage, focusing on the most vulnerable groups, getting the behavior change messages correct, and knowing what program inputs will maximize impact. New programmatic impact data from at least one national program (in Honduras) provided new information about essential components for impact on nutrition.
By the end of this session, participants:
- Knew the evidence for essential programmatic components for national nutrition programs and could discuss their own experience in implementing large-scale nutrition programs
Concurrent Technical Sessions:
1. Brainstorming the Brain Drain: How NGOs Can Promote Health Systems Strengthening and Minimize Impact on the Human Resource Crisis
Wendy Johnson, MD, MPH, Director of New Initiatives, Health Alliance International
Janine Schooley, Project Concern International
The session began with an overview of forces that have conspired to create the human resources (HR) crisis in the developing world including external and internal brain drain; constraints on building and supporting public health systems and training programs; changing patterns of immigration; and global and domestic economic forces.
Given these constraints, participants examined how different international NGO policies might exacerbate the human resources crisis and tangible ways that NGOs can help to promote health system strengthening and adopt policies that "do no harm" to the public health workforce in countries where they work. Participants discussed and contributed to the development of a code of conduct to guide NGO practices and explore ways NGOs can continue to operate effectively in the face of HR constraints.
By the end of the session, participants could:
- Understand the major factors contributing to and perpetuating the health care worker crisis in the developing world, especially Africa
- List ways that NGO actions might exacerbate the human resource (HR) crisis
- Understand and list specific ways that NGOs can manage their operations to both "do no harm" and help to mitigate the HR crisis
- Explore ways that NGOs can continue to operate effectively in the face of HR constraints
2. AIDS: There is Another Way
Laban Tsuma, Health Associate, Plan International
Jean-Louis Lamboray, Constellation for AIDS Competence
The battle against HIV/AIDS can be won by the local people themselves. The Constellation for AIDS Competence believes in people's capacity to respond to a threat like HIV/AIDS. The Constellation stimulates the development of facilitation teams, supporting communities on their way to AIDS competence. The AIDS Competence Process consists of
1) A way-of-thinking: Believing in people's capacity to respond
2) A way-of-working: SALT which stands for S: Stimulate; A: Appreciate; L: Learn, Listen; T: Transfer
3) A set of tools stimulating local ownership of the problem, dialogue, change within communities, sharing of experiences between local actors
During the first half of this session, participants were exposed to the AIDS Competence Process and its components. During the second half of the session, participants took a closer look at some of the practical questions that arise when applying the AIDS Competence Process, including an example from a similar process Plan International used in Cameroon.
By the end of this session, participants:
- Understood the underlying concepts of the AIDS Competence Process
- Examined case studies of communities striving for AIDS Competence
- Identified and addressed burning issues regarding AIDS Competence
3. Nets for Life: Malaria Advocacy Campaign
Enid Wamani, MACIS
Susan Lassen, Episcopal Relief and Development
The control of malaria has to be delivered to "the end of the road" and is particularly to vulnerable communities. The Anglican Church plays a unique role in community surveillance for sustained preventative health care, and has developed strong programs for HIV/AIDS. Episcopal Relief and Development's long-term commitment to integrated community health programs builds on partnership with the Anglican church and serves all in need regardless of faith. This session focused on how a faith-based organization has been successful in rapidly scaling up end-of-the-road services by focusing on training, monitoring, evaluation, and community health surveillance. Presenters shared lessons learned and early results in year one countries: Zambia, DR Congo, Angola, Burundi, Namibia, Ghana, Kenya, and Mozambique.
By the end of the session, participants learned about and discussed the challenges of grass roots volunteer-based malaria prevention programming and identified gaps and lessons learned when working with churches and faith-oriented groups.
4. Pandemic Flu Preparedness and Response: Resources for NGOs
Ron Waldman, Team Leader for Pandemic Planning and Humanitarian Response, USAID Avian and Pandemic Influenza Response Group
Whitney Pyles, Avian Influenza Coordinator, CARE USA
Kathryn Bolles, Child Health and Nutrition Advisor, Save the Children
WHO states in recent guidance that "the present threat to international public health is sufficiently serious to call for emergency actions calculated to provide the greatest level of protection and preparedness as quickly as possible" (WHO Strategic Action Plan for Pandemic Influenza 2006-2007, page 4). There is no doubt that pandemics occur-on average every 28 years-and approximately 20-40 percent of everyone on earth will become ill with flu in the next pandemic. The current threat of highly pathogenic H5N1 in birds causing human illness has raised the risk and the need to prepare ourselves, our organizations, and the populations we serve. Presenters will review current resources for pandemic preparedness, examples of organizational and staff preparedness from Save the Children and CARE, and the latest in strategy, guidance, and resources from USAID's newly-formed Avian and Pandemic Influenza Response Unit.
By the end of the session, participants had:
- Become familiar with the latest resources for pandemic influenza preparedness and response
- Heard two examples of NGO preparedness to-date
- Learned about USAID's strategic directions and activities in pandemic planning and humanitarian response, and the potential roles for NGOs
Working Group Planning Time
Working Groups used this time to review 2007 workplans, move key activities forward, develop FY08 workplans, and discuss technical issues.
Concurrent Technical Sessions:
1. Nutrition Approaches: What, When, and How to Choose the Right One for Your Project
Judiann McNulty, MCHN consultant
Agnes Guyon, Senior Public Health Advisor, AED
Kathryn Bolles, Child Health and Nutrition Advisor, Save the Children
Jim Ricca, Capacity Development Advisor, CSTS+/ORC Macro
Judy Canahuati, MCHN and HIV Advisor, Food For Peace/USAID
Alfonso Rosales, Senior Regional Health Advisor, Christian Children's Fund, Honduras
This session started with an example of an application of the Essential Nutrition Actions framework and then examined and compared the following nutrition approaches: the nutrition elements of C-IMCI, community-based growth promotion (e.g. AIN-C), PD/Hearth, and breastfeeding promotion (mother-to-mother support and baby-friendly communities). Panelists presented brief descriptions of each approach, examples of applications within child survival projects, and the associated successes and challenges. Following this overview, participants worked in groups on case studies that include a project context with situational description, baseline survey data related to current nutrition practices, information on other project interventions, and allocated resources. Groups discussed which nutrition approach/es would be most effective and appropriate and the key messages to receive focus within the chosen approaches. Following group work, the moderator led participants and panelists in facilitated discussion.
The objectives of this session are to:
- Present an overview of key approaches for promoting recommended maternal and child nutrition practices to sustainably improve nutritional status
- Provide an opportunity and guidance for participants to discern which approaches are most appropriate in different project contexts
2. Lessons Learned in Household Water Treatment and Safe Storage
Merri Weinger, MPH, Program Manager, Hygiene Improvement, USAID Bureau for Global Health
Chuck Szymanski, Senior Manager-MCH, PSI
Daniele Lantagne, Environmental Engineer, CDC
The health consequences of inadequate clean water supply, sanitation, and hygiene include an estimated 4 billion cases of diarrhea and 1.8 million deaths each year, mostly among children under five in developing countries. Household-level point-of-use water treatment has been shown to significantly reduce diarrheal disease in vulnerable populations and should become an essential intervention within child survival, HIV/AIDS, and water supply programs. Population Services International (PSI) was involved with the CDC in the design and testing of the first household safe water programs and has since implemented social marketing and behavior change programs to introduce household water treatment products in 24 countries.
Recently USAID and the POUZN Project released a paper titled "Best Practices in Social Marketing Safe Water Solution for Household Water Treatment," which highlights best practices and lessons learned from PSI household water treatment programs. This session was led by two of the authors of the best practices paper and included a brief background on the issue, a presentation of the key lessons, and a participatory portion focused on providing practical guidance to participants interested in incorporating household water and hygiene components into their ongoing programs.
By the end of the session, participants were able to:
- Describe the three components of the Safe Water System (SWS) and the rationale for promoting the SWS
- List at least three of the "lessons learned" that are critical to the success of a SWS project
- Identify at least one action NGOs can take immediately to begin incorporating safe water quality into their programming
3. Malaria and HIV Programming
William Oscar Fleming, HIV/AIDS Program Specialist, Christian Children's Fund
Paula Brentlinger, International Training and Education Center on HIV
The session began with an overview of the interactions of HIV infection and malaria, including its effects on health outcomes. They examined the public health consequences and explore interventions at the facility and community levels that have been effective in addressing both. Participants explored additional programming opportunities with the presenter.
By the end of the session, participants could:
- Understand the health outcomes for individuals living with HIV and malaria
- Be able to identify opportunities and program interventions that can be developed to address these epidemics jointly
- Explore ways that NGOs can further expand programming to address malaria and HIV in their own settings
Dinner and Social Event
Friday April 27, 2006
Opening Announcements
Day Facilitator: Tom Davis, FFH
Concurrent Technical Sessions:
1. Improving Healthy Timing and Spacing of Pregnancies through Family Planning Service Integration
Joseph deGraft-Johnson, Save the Children
Betty L. Farrell, CNM, MPH, Sr. Medical Associate/Integration, Engenderhealth/ACQUIRE project
Theresa Norton, MBA, Associate Editor, INFO Project, Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs
Catherine McKaig, JHPIEGO
Despite empirical evidence that family planning (FP) saves the lives and improves the health of women, children, and newborns, FP services are often not systematically included in many health programs. Much attention and resources have been placed on increasing people's access to HIV counseling and testing as a strategy for prevention and increasing access to Anti-Retroviral Therapy (ART) services for disease management and improved quality of life. An obvious gap in most HIV/AIDS programs is the absence of a strong family planning service component. FP is also not a major component of most maternal and newborn health programs. Given the impact that FP has on maternal, neonatal, and child health and survival, there is need for program designers to understand how to integrate FP into their existing programs or incorporate FP elements into new health programs.
This session discussed lessons learned from programs that have successfully integrated FP into HIV/AIDS, maternal, neonatal, and child health interventions. Participants were taken through the process used by the ACQUIRE project to integrated FP into an ART program implemented by The AIDS Support Organization (TASO) Mbale Center in Uganda. Using a participatory approach, participants explored opportunities and challenges associated with the integration of postpartum FP messages and/or services into existing or new maternal, newborn, and child health services. Lastly, participants were introduced to a comprehensive database on FP integration services that would no doubt enhance their accessibility to the evidence-base, approaches, and best practices information.
At the end of the session, participants were able to:
- List key opportunities for family planning service integration
- Explain effective strategies for integrating family planning services in to existing health programs
- Describe the distinction between postpartum family planning and traditional family planning
- Address some of the challenges associated with family planning service integration
2. Community-based Therapeutic Care (CTC) in HIV Affected Populations: Lessons on Improving Access to Testing, Treatment, and Treatment Compliance
Janine Schooley, Project Concern International
Saul Guerrero, Community & Social Development Advisor, Valid International
Community-based Therapeutic Care (CTC) was developed in 2000 by Valid International to increase the effectiveness and coverage of treatment for acute malnutrition. It aims to treat the majority of malnourished at home using a ready-to-use therapeutic food (RUTF); an energy dense supplement that is safe to use for outpatient care. It soon became apparent that CTC could also be applied to the nutritional care and support of people living with HIV/AIDS (PLWHA) in Africa. There is great similarity between the CTC approach and HBC programs used to support PLWHA in the developing world. Both approaches aim to provide nutritional support, to reduce the opportunity costs of care by minimizing hospital stays and to use existing capacity in communities for the referral and follow up of sick individuals. Using CTC as a service delivery mechanism for the provision of care to PLWHA has been the focus of recent operational research. The findings suggest that CTC has the potential to improve access to testing, treatment, and treatment compliance. The presentation explored some of these initial results, their implications for existing models of nutritional care as well as the social impact of an integrated (ARV/Nutritional) response using the CTC model.
By the end of the session, participants were able to:
- Provide an overview of Community-based Therapeutic Care (CTC) for the treatment of severe malnutrition
- Discuss the results of operational research on the use of CTC for the delivery of care to HIV positive adults and children
- Discuss the potential of the CTC model to improve community involvement in programme activities, as well as increased uptake in testing and treatment, and improved treatment compliance.
3. Avian Influenza: Programming at the Community Level
Whitney Pyles, Avian Influenza Coordinator, CARE USA
CARE continues to accumulate new lessons learned in working with communities for both avian and pandemic flu prevention. In this session participants covered several models of interventions CARE has used, lessons learned after implementation and the challenges that they have seen in the field, including:
- Models for community mobilization to prevent and respond to the current H5N1 threat
- Strengthening community based surveillance for avian and pandemic flu
- Improving local capacity to deal with and prepare for AI and pandemic issues
- Models of NGOs as advocates and champions in improving national government preparedness
They paid particular attention to resources and tools that participants can take back and share with field offices.
By the end of the session, participants could:
- Know several models of intervention that they can apply to their programs in the field
- Have a number of AI lessons learned documents and program tools that they can share with their field staff
- Be familiar with innovative ways to mainstream AI messages and communicate with field staff
Community-Based Primary Health Care: Past, Present, and Future
Henry Perry, Future Generations
Carl Taylor, Professor Emeritus, Johns Hopkins University
Rudolf Knippenberg, Senior Health Advisor, UNICEF
In this session presenters reviewed community-based primary health care (CBPHC) in a historical perspective, shared findings regarding the effectiveness of CBPHC in improving child health, and prognosticated about the future evolution of CBPHC from the perspective of UNICEF and other major international organizations. The presentation arose from a current ongoing systematic review of the literature regarding the effectiveness of CBPH, which is being led by a Task Force of the Working Group on CBPHC of the International Health Section of the American Public Health Association. This review is also being supported by WHO, UNICEF, and the World Bank.
The presenters were Dr. Carl Taylor, Professor Emeritus of International Health at Johns Hopkins, one of the founders of the CBPHC movement, and Chair of the Expert Review Panel for the systematic review; Dr. Henry Perry, Carl Taylor Professor for Equity and Empowerment at Future Generations and Co-Chair of the Task Force leading the systematic review; and Dr. Rudolph Knippenberg, Senior Health Advisor at UNICEF and a member of the Expert Review Panel.
New Directions for Maternal Child Health: Innovation in Action and Meeting Wrap-Up
Tom Davis, Director of Health Programs, Food for the Hungry
|
