“Population-health-environment [PHE] connections have really been a focus of ours here at the Wilson Center for the last 15 years,” said outgoing ECSP Director Geoff Dabelko in an interview at the Wilson Center. The goal of ECSP’s project – HELPS (health, environment, livelihoods, population, and security) – is “really trying to understand these issues together.”

“If I reflect on the 15 years of those discussions, at least three things come to mind as to where we are now,” he said.

The first is the emergence of more peer-reviewed evaluations from the field. “We’re finally achieving some of the long-term looks at how integration works in the field – how these projects when combined and taking into account population, health, and environmental interventions, what kind of results we’re getting,” he said.

An evaluation published in Environmental Conservation last year, for example, compared the results from two municipalities in the Philippines – one that employed separate marine management and reproductive health programs, and one that integrated the two into one. The authors found that the integrated project achieved better conservation and food security results (measured by coral reef and mangrove health, and a decline in dynamite and cyanide fishing), better health results (more young people willing to use family planning delay early sex), and a decline in the number of people below the poverty threshold.

And a case study published in the Mount Sinai Journal of Medicine last year on integrated health and forest conservation interventions in Nepal found that in areas of high biodiversity and high population density, they were highly efficient at making progress towards multiple Millennium Development Goals.

“We’re seeing now peer-reviewed work from long-term assessments of projects in the field and we’re seeing results that suggest that there are real merits to taking this approach,” said Dabelko.

Bringing Voices From the Field to the Policy Realm

But what we’re also seeing is that academic studies, regardless how rigorous, are not sufficient, said Dabelko. “It’s a necessary avenue for understanding these links and responding to them, but it’s not sufficient. To be able to tell the story and really understand what’s going on in the field with the lives of these folks who are facing multiple challenges, we have to find a way to get those voices from the field into policy discussions, into academic discussions.”

“For us here at the Wilson Center, that’s meant going to those people, those communities, and finding avenues for them to share their insights…respecting the ways that they share those insights and can tell those stories and facilitating that for them.”

ECSP’s FOCUS series has highlighted the experiences of PHE practitioners from Ethiopia, Rwanda, Uganda, and Madagascar, to Nepal and the Philippines. Issue 21 was a video tour of several projects in Ethiopia’s Tigray region and Wichi watershed, and a similar look at sites in Tanzania is forthcoming in partnership with the BALANCED Project. We also blogged from the PHE consortium of Ethiopia’s annual general assembly last year, reporting on how the diverse set of practitioners (more than 48 organizations attended) approach integration differently and the challenges they face.

Because integrated development is so context-dependent, and any population-related discussion can be sensitive, bringing these local voices to the fore is critical. “Those are the kinds of ways that we have to stretch beyond our formal documentation of analysis to really understand what’s going on,” Dabelko said.

Following along those lines, Dabelko said it’s also important to keep in mind the big picture: “It’s really critical that these endeavors in population, in health, in environment, be framed within the larger imperative of development and livelihood concerns for these people.”

“These are remote populations from urban centers and economic centers – they are by definition living on the margins. For them, literally, survival and their livelihoods concerns are day-to-day. And so for us, working in what we have called ‘PHE,’ we need to really respect and integrate that priority and understanding.”

That’s part of how ECSP arrived at the name HELPS for our project with USAID, Dabelko said. Health, the environment, livelihoods, population, and security are linked challenges for so many around the world. Explicitly putting all those things together was done to “fundamentally respect the fact that those sources of threat and challenge, but also opportunity, in each of those realms, have to be taken together, and understood together, and acted upon together.”