Showing posts from category PHE.
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Healthy People, Healthy Ecosystems: Results From a Public-Private Partnership
›“A lot of people probably don’t think that an organization with a name like ‘World Wildlife Fund’ would have a program on population, health, and the environment,” said WWF’s Tom Dillon at the Wilson Center, but actually it is very natural. “Most of the people we work with are in rural areas, and they depend on their natural resources for their own livelihoods and for their own well-being. Of course, if you are in that situation, in order to be a steward of the environment, you’ve got to have the basics. You have got to have your own health.”
Dillon was joined by staff from WWF, as well as Scott Radloff, director of USAID’s Office of Population and Reproductive Health, and Conrad Person, director of corporate contributions at Johnson & Johnson, to talk about the results of a three-year partnership between USAID, WWF, and Johnson & Johnson. The joint effort, a formal Global Development Alliance, provided health and family planning services, clean water, and sanitation to communities in three of WWF’s priority conservation landscapes: The Salonga National Park in the Democratic Republic of Congo (DRC), the Lamu Archipelago in Kenya, and the Terai Arch Landscape in Nepal.
By creating an innovative public-private partnership that linked health objectives, particularly related to family planning and maternal and child health, to environmental and conservation activities, “this alliance was ahead of its time,” said Radloff.
Human Health Linked to Environmental Health
The project had four objectives, said Terri Lukas, WWF’s population, health, and environment (PHE) program manager: improve family health; reduce barriers to family planning and reproductive health services; improve community management of natural resources and habitat conservation; and document and promote successful approaches.
“Human health cannot be separated from environmental health anywhere,” Lukas said, “but most especially when we are working with very poor people who live very close to nature.”
Projects Provide Integrated Services
The Salonga National Park in the DRC is home to many endangered species, including the bonobo, one of the four great apes. Local communities are very isolated, and lack access to safe drinking water and sustainable livelihoods, as well as basic health and family planning services, according to Lukas. The PHE project was able to train 135 voluntary community health workers in family planning and maternal and child health care, including 55 women. One year after the training, health workers were distributing contraception to more than 300 new users per month, Lukas said.
The alliance has also integrated health and family planning services into conservation programs in Kenya’s Kiunga Marine National Reserve, in part, “to demonstrate to the people that we care about them as well as the environment, and also to show them the synergies that exist between the health issue and the environment issue,” said WWF Program Coordinator Bahati Mburah. The region has been suffering through a year-and-a-half-long drought, and has one of the highest population growth rates in east Africa, placing considerable pressure on natural resources.
“We talk to [the fisher folk] about health and family planning, and how they are related to the management of fisheries,” said Mburah. With improved transportation and mobile outreach services provided by the project, 97 percent of women are now able to access family planning services within two hours of their home, she said.
The third site is in the Terai region along the southern border of Nepal. In this lowland region, the alliance is attempting to safeguard and restore forest areas in order to allow wildlife to move and breed more freely, while at the same time improving the health and economic prospects of the people. By linking these goals, support for conservation efforts increased from 59 percent to 94 percent of households, with 85 percent attributing positive attitude changes to increased access to health services and safe drinking water, according to Bhaskar Bhattarai, project coordinator for WWF-Nepal.
Documenting and Promoting Successful Approaches
Cara Honzak, WWF’s senior technical advisor on population, health, and environment, said the global objective of the alliance was to document and promote successful PHE approaches. Comprehensive baseline and endline surveys provided critical evidence that integrated PHE programming increases family planning use in remote areas, improves conservation buy-in within communities, and leads to increased participation of women in community leadership and decision-making.
“We have played a key role in producing some of the evidence that has been used throughout Washington [D.C.], especially to provide information to government bodies that are making decisions about bringing more money into family planning, health, and particularly in the environmental sector,” said Honzak.
“After two decades in the field, and working in this area, I wasn’t expecting many surprises. I couldn’t have been more wrong,” Lukas said. “These three years have changed almost everything about the way I now view health development…I have long called myself a conservationist, but now I say to my international health colleagues: we are all conservationists, and if we aren’t, we should be.”
Event Resources- Bhaskar Bhattarai presentation
- Cara Honzak presentation
- Terri Lukas presentation
- Bahati Mburah presentation
- Photo gallery
- Video
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Pascal Gakwaya Kalisa, PHE Champion
Coffee Farmer and Extension Manager Promotes Improved Health and Livelihoods in Rwandan Coffee Communities
›This PHE Champion profile was produced by the BALANCED Project.
Mr. Pascal Gakwaya Kalisa has produced coffee in the densely populated country of Rwanda for the past nine years. A proud member of the 1,200 member Maraba Coffee Cooperative in Huye District in the Southern Province of Rwanda, Kalisa knows that a larger income alone does not ensure a better quality of life for his fellow coffee farmers and their families. He also knows that a successful coffee growing/exporting enterprise depends on preserving the fragile Rwandan soils, as well as on the health and well-being of farming families and communities. Therefore, Kalisa and other cooperative members treat the land and trees with a level of personal care that is necessary for optimum organic production and soil preservation.
Kalisa and the community have set up small, garden-sized coffee farms that are more productive than usual. Cooperative washing stations have enabled the small-scale farmers to improve product quality, and the cooperatives themselves are learning to negotiate better coffee prices with international buyers. Through such efforts and the support of many international donors and industry partners, Rwanda has become a producer of high quality specialty coffee since 2005, and its coffees are being marketed through renowned coffee roasters and importers in the United States, Europe, and Japan. In just six short years, Rwandan farmers have doubled their incomes and created 2,000 jobs, and the first renowned specialty coffee competition Cup of Excellence in Africa was held in Rwanda in 2008.
SPREAD: A Community Partnership
Recognizing the broad-based health, social, and economic needs of coffee farmers and their families in this part of East Africa, the U.S Agency for International Development initiated the Sustaining Partnerships to Enhance Rural Enterprise and Agribusiness Development project (SPREAD) to provide rural cooperatives and enterprises involved in high-value commodity chains with both appropriate technical assistance and access to health-related services and information. It is this combination of technical assistance and health-related outreach and services that has resulted in increased and sustained incomes and improved livelihoods.
Kalisa and other members of various cooperatives that SPREAD supports recognize that not only should farmers and their families preserve the land, but they must also preserve their own health in order to perform the labor needed to farm the crop that will produce the steady stream of high quality coffee upon which their livelihoods depend. Initiating community dialogues around issues such as protected sex, gender roles, and how coffee revenue is spent within households has also been crucial to project success among both youth and adults.
In his role as coffee zone coordinator for the SPREAD project, Kalisa works with coffee cooperatives to implement improved agricultural practices that improve the quality of their crop. This includes using cleaner environmental practices during coffee processing, such as introducing composting of coffee cherry pulp. Kalisa also helps disseminate integrated health and coffee messages through a weekly coffee talk-show produced by the National University of Rwanda’s Radio Salus, called Imbere Heza (“Bright Future”). In one show, for example, a man explained to a fellow farmer that to get good coffee cherries, he should thin his trees to renew his plantation.
Integrating Healthy Lives
Kalisa has also helped the SPREAD project’s health team deliver integrated messages on family planning, maternal and child health, alcohol, nutrition, gender issues, and the linkages between these. He uses examples such as the one about tree thinning to explain that families that space their children tend to be healthier, as they can plan the number of children to better fit with the financial and natural resources at hand.
Kalisa sees the benefits of using community agents to deliver integrated health, environment, and livelihood messages. This includes training extension agents to discuss environmental and human health issues in the context of coffee growing. Also, having coordinators from the coffee program and the health program go hand-in-hand to the field saves time, fuel, and other project costs. Kalisa believes that this campaign to educate coffee farmers and their families on the linkages between human health, a healthy environment, and strong livelihoods will lead to long-term change in their behavior, attitudes, and knowledge – change that will help them live better lives today and into the future.
This PHE Champion profile was produced by the BALANCED Project. A PDF version can be downloaded from the PHE Toolkit. PHE Champion profiles highlight people working on the ground to improve health and conservation in areas where biodiversity is critically endangered.
Photo Credit: “Rwanda photos 060,” courtesy of David Dewitt/counterculturecoffee. -
Health and Harmony: Population, Health, and Environment in Indonesia
›Borneo’s Gunung Palung National Park is a microcosm of both the island’s ecological wealth and vulnerability. More than half of the park is undisturbed forest; the remainder, however, “is being torn down day after day” at an alarming rate, said Health in Harmony’s Nichol Simpson at an event on integrated approaches to population, health, and environment (PHE) programs in Indonesia. Alene Gelbard of the Public Health Institute’s Company-Community Partnerships for Health Indonesia (CCPHI) program joined Simpson on September 29 at the Wilson Center. Both speakers emphasized that no matter what issue a group works on, engaging local communities is essential for success.
The Destructive Cycle: Poor Health, Poor Environment
For Simpson, “the intersection between human and environmental health” is at the heart of Health in Harmony’s work. Health in Harmony opened Clinic ASRI in 2007, aiming to provide improved healthcare to villagers throughout Gunung Palung National Park while ending their dependence on illegal logging as a means of financial survival.
The area’s inhabitants were all too easily trapped in what Simpson called “the destructive cycle.” When faced by an unexpected medical emergency, families would go into debt to pay their medical bills. Health in Harmony found that of 232 local households surveyed, 13 percent had recently experienced a major medical emergency, at an average cost of $360. Most households in the area only hold around $260 in emergency savings, so to make up the difference, about a third turned to illegal logging to pay down their debt.
By deforesting the park, illegal logging worsens the health of nearby communities. For example, Simpson said that Clinic ASRI has seen a rise in cases of malaria and tuberculosis in the surrounding communities, in part because deforestation has increased the level of mosquito activity. The link between human and environmental health is clear, said Simpson: the people ASRI serves are “living it every day. They know the cause of this. And…they want it to stop.”
Protecting Natural Resources By Improving Health
The Health in Harmony clinic located in Sukadana, a small village sandwiched between Borneo’s coast and Gunung Palung Park, helps break the destructive cycle by treating patients regardless of their ability to pay. If patients do not have cash, they can barter for their care. In one case, a girl named Yani came to ASRI after her family incurred $500 over two months of visiting hospitals and traditional healers, none of whom could treat her condition. ASRI diagnosed and treated Yani for scabies. In exchange, her mother signed a pledge to protect Gunung Palung from logging and made the clinic a floor mat to cover the $1.50 bill.
By providing affordable, high-quality healthcare that is contingent upon pledging to protect the environment, Clinic ASRI improves human and environmental health in one fell swoop, said Simpson. “Because the infant mortality rate has decreased and you’re not overcompensating,” said Simpson, families can choose to have fewer children, using free birth control provided by ASRI.
“When you have fewer and healthier children, you’re investing in your education,” said Simpson. “When you’re investing in your education, you’re investing in your country and your community. This is the virtuous cycle. I didn’t invent it, but we are proving it in Sukadana.”
The communities around the clinic have embraced ASRI’s work, partnering with them to expand their services to address additional community needs, like training farmers in more productive organic methods and providing mated pairs of goats for widows, who pay ASRI back with kid goats and manure for fertilizer.
All but one of the 23 villages that ASRI services have been consistently free of illegal logging, according to monitors who visit them on a regular basis. “We’re proving the theory that we can protect natural resources by improving health,” Simpson said.
“Health Is Key to Sustainable Development”
Gelbard took a step back to talk about CCPHI’s experience establishing multi-sector partnerships among NGOs and corporations by building trust and enabling dialogue between the communities.
With corporate responsibility becoming more popular, “everyone’s talking about partnerships these days, and everybody’s partnering with everyone,” said Gelbard. “I don’t care what they call it – I care what they’re doing” and what results they achieve, she said. A successful partnership involves “all partners doing something more than just giving money.”
Gelbard said the 2004 tsunami reinforced the notion of corporate responsibility for a lot of companies operating in Indonesia. They saw that unless they branched out beyond their own walls and “did things to help strengthen communities,” efforts at corporate responsibility simply “would not benefit them in the long-run,” she said.
Through CCPHI, companies and NGOs have partnered on a wide range of efforts, including improving access to and funding for reproductive health services, improving sanitation by increasing access to water, and combating human trafficking by empowering girls and women.
Achieving the Millennium Development Goals will require increasing access to health care in a manner that reflects the needs of communities, she said. At its core, CCPHI’s work and the partnerships it facilitates are “based on the knowledge that health is key to sustainable development,” said Gelbard.
Event Resources
Sources: Alam Sehat Lestari, American Journal of Tropical Medicine and Hygiene, Company-Community Partnerships for Health Indonesia, ExxonMobil, The Guardian, Health in Harmony, National Geographic, PBS News Hour, Public Health Institute, Republic of Indonesia Ministry of Forestry, United Nations, World Wildlife Fund
Photo Credit: Used with permission courtesy of ASRI and Nikki See, Under-told Stories. -
PHE Is One Great Idea That Won’t Be On the Rio Agenda, Says Roger-Mark De Souza
›October 17, 2011 // By Sean Peoples“I am now serving as an example to other women in the community because I am not having any more children. I have received training in sustainable agricultural practices, I’m generating income, and I’m educating others,” said Berhane Ferkade, an Ethiopian farmer, to Population Action International’s Roger-Mark De Souza earlier this year. The 39-year-old mother of 11 become one of the community’s model farmers after working with LEM Ethiopia – a local population, health, and environment (PHE) development organization.
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Lisa Hymas on Envisioning a Different Future With Family Planning in Ethiopia
›ECSP caught up with Lisa Hymas, senior editor at Grist, last week during the first South by Southwest (SXSW) Eco conference and she spoke about her recent visit to Ethiopia to see the country’s community health extension program in action. “Ethiopia has a big challenge around population,” Hymas said, “but the government is committed to bringing that down.”
The government extension program places health-workers – young women, for the most part, who have received basic training – directly into each community, where they are able to give out immunizations, provide advice on nutrition, teach families how to properly hang bed nets to prevent mosquito-borne illnesses, and provide family planning services and advice.
Thanks to the program, these health workers and those in the communities they service can “envision very different lives for themselves than their mothers had,” Hymas explained. For instance, one woman recounted that her mother gave birth to 10 children, “and almost died giving birth to the last one, because there was no access to birth control, and there was no good access to health care.” In contrast, she is now able to have a career and to use family planning to delay and space her own childbearing.
For more on Ethiopia’s health extension program, see Schuyler Null’s report on visiting a village health clinic near the town of Fiche last spring. -
Strengthening the Voices of Women Champions for Family Planning and Reproductive Health
›“The health, security, and well-being of families depend importantly on the health of women,” said Carol Peasley, president and CEO of the Centre for Development and Population Activities (CEDPA). “When women have the ability to voluntarily space and limit the number of children they have, maternal and newborn child deaths decrease, as do abortions and abortion-related injuries,” she continued.
Peasley was joined by three panelists on September 28 at the Wilson Center: Dr. Nafis Sadik, special advisor to the UN Secretary General; Tigist Kassa Milko, health communications program coordinator for Panos Ethiopia; and Rosemary Ardayfio, a reporter for the Ghanaian paper, The Daily Graphic.
Ardayfio and Milko both recently participated in a CEDPA-led workshop, which is designed to create effective women champions for family planning and reproductive health.
“The voices of women champions may in fact be the best way to influence policymakers and just average citizens around the world,” said Peasley.
Women’s Rights Essential for Development of All
According to Sadik, women have gained some autonomy over their reproductive health:- Maternal mortality around the world is down by 40 percent compared to 1990 levels;
- Family planning reaches over 65 percent of women who need and want it;
- Many developing countries will achieve parity in girls’ and boys’ education by 2015; and
- Women are increasingly prominent in national and international leadership.
- Women’s literacy rates are still much lower than men’s;
- Pregnancy and childbirth still pose major health risks for women;
- Maternal mortality is the single biggest differential between developed and developing countries;
- We are far from reaching the Millennium Development Goal of reducing maternal mortality by 75 percent; and
- The current unmet demand for family planning (215 million women) is projected to rise by 40 percent by 2050 as the reproductive age population grows.
Local Champions for Local Needs
Although Tigist Kassa Milko and Rosemary Ardayfio come from two African countries hundreds of miles apart, their struggles are eerily similar.
In Ethiopia, the more than 1.5 million women who live in pastoral or nomadic areas shoulder many responsibilities, including walking long distances to fetch food and water for their families. The well-being of these women and their families is further strained by the challenges of climate change and limited health service provision.
To help overcome these obstacles, a number of micro-credit associations now offer female pastoralists alternative livelihood options. Panos Ethiopia also provides “reproductive health, family planning, gender-based violence forums” and “trainings on life skills and saving” to those who come for loans, said Milko.
But “when it’s a choice between walking to get water and walking to get contraceptives, water will win,” said Milko, so it is essential to focus on integrating ways to improve livelihoods, health, and ecosystems – also known as population, health, and environment (PHE) programs.
In Ghana, women also grapple with competing issues of development, poverty, healthcare, and cultural barriers. According to Ardayfio, 35 out of every 100 Ghanaian women want to space or limit births but are not using modern family planning methods. As a journalist, she acknowledged that there are many myths about reproductive health that need to be dispelled. The newspaper she writes for, The Daily Graphic, publishes three articles on women’s health each week.
“The stories of women dying from pregnancy-related causes should continue to be told in a compelling manner until our government makes good on the many international commitments it has signed to,” said Ardayfio. “Our decision-makers should be told again and again that it’s time to scale up family planning.”
Event Resources:
Sources: CEDPA, Guttmacher Institute, Population Reference Bureau, UNESCO, UNICEF, USAID.
Photo Credit: Dave Hawxhurst/Wilson Center. -
SXSW Eco Panel: Three Great Ideas That Won’t Be On the Rio+20 Agenda
›September 30, 2011 // By Schuyler NullSouth by Southwest (SXSW) – the popular music, film, and alternative showcase – is moving into the green space with its first ever “eco” conference, kicking off next week, October 4, with more than 50 panels on “solutions for a sustainable world.” There’s one in particular though you should tune into: “Three Great Ideas that Won’t Be On the Rio Agenda,” featuring Geoff Dabelko, director of the Wilson Center’s Environmental Change and Security Program; Roger-Mark De Souza, vice president of research and director of the climate program at Population Action International; and Aimee Christensen, CEO of Christensen Global Strategies.
The panel will feature discussion on three issues that will likely not be on the table at the Rio+20 UN Conference on Sustainable Development next year: integrated population, health, and environment development programs, climate adaptation as a path to peacebuilding, and how to get the private sector better involved in helping cope with climate change.
If you’re traveling down to Austin, “Three Great Ideas” is scheduled for Thursday, October 6 at 10am CST; if not, stay tuned for webcast information! -
Babatunde Osotimehin Answers Seven Questions on Population
›PSI’s Impact magazine has an interview up with UNFPA Executive Director Babatunde Osotimehin asking him seven questions about population. It’s not likely this will be the last seven-something-themed story as we approach October and the expected seven billion mark for global population, but Karl Hofmann, president and CEO of PSI, asks some good questions, including on the prospect of harnessing the “demographic dividend” and about the barriers facing more integrated development efforts – a critical topic in population, health, and environment (PHE) circles.
On the demographic dividend:Karl Hofmann: Demography can be a key to progress with the right policy environment in place, but it can also be a burden when we don’t have the right framework in place to take advantage of growing populations. Some have described this as the demographic dividend – growing populations as a potent driver of economic growth and development. Give us your perspective on that.
And on integrated development:
Babatunde Osotimehin: I spoke at the 17th African Union Summit this year and one of my messages was that we have the opportunity right now to take advantage of the demographic dividend of young people. It’s important for African governments to understand that they have a youthful population. Most of Africa is under the age of 35. If 85 percent of the African population is under 35, the implication is that you have to have education, social services, housing, all of that, tailored to meet the needs of this population.
Beyond that, given what we’ve seen with the Arab spring uprising and others in many parts of the developing world, young people who are out of work want education and economic opportunities. We want to appeal to member states to provide skills appropriate to development and also ensure that we have continuing conversations with young people about their reproductive health and rights so they can make the choices that will ensure they plan for their families.KH: There are lots of conversations going on in global health circles these days around the synergy of integration. From your perspective, what are the barriers to this integration?
Read the full interview on Impact.
BO: I think it’s bipolar. Some countries are satisfied with vertical programs. Others are resistant to changing their system at the request of a donor. One argument for integration is that you can have the one-stop shop situation where one, two, three trained providers can deliver services at the same time. These include integration of HIV counseling, testing and treatment with family planning, with health education for non-communicable diseases, with immunization for children or with maternity services.
When you look at the components of an integrated system, it is very easy to sell. In terms of investment, it makes sense for the governments to build and put this together. The supervision becomes a lot easier, and the training of health workers would then capture all of the skill sets that would be required. Some countries, like India, Ethiopia and Nigeria have started this kind of integration.
Sources: PSI.
Image Credit: Adapted from UNFPA.
