CORE Group Spring Meeting 2010

In by Marc Pitre

More than 200 individuals from 80+ organizations exchanged ideas, shared state-of-the-art innovations and best practices, fueled the technical momentum of CORE Group’s eight Working Groups and mapped out the future of the CORE Group network.

View the meeting report, agenda and presentations from the various days with the following links:

Meeting Report
Agenda

Monday Pre-Sessions
Tuesday Sessions
Wednesday Sessions
Thursday Sessions
Friday Sessions

 


Monday Pre-Meeting Sessions

Maternal & Child Anemia: Science, Programs, and Overcoming Implementation Barriers

This session addressed scientific and programmatic issues for effective scale-up of maternal and child anemia interventions.

FacilitatorsShannon Downey, CORE Group; Rolf Klemm, A2Z Projecet; Malaria, Nutrition, and Safe Motherhood and Reproductive Health Working Groups

Presenters: Rolf Klemm, A2Z Project; Silvana Faillace, A2Z Project; Mary Hennigan, Catholic Relief Services; Jennifer Nielsen, Hellen Keller International

Maternal and Child Anemia- Why, What works, What Needs More Work?

Maternal Anemia within Child Survival Grants: Lessons Learned at Helen Keller International

Maternal Anemia within Child Survival Grants Program: Lessons Learned and a Way Forward?

 

Introduction to the Nutrition Program Design Assistant

This session introduced the Nutrtion Program Design Assistant Tool to potential users.  The tool is designed to help program planning teams select the most appropriate community-based nutrition approaches for specific target areas in collaboration with a range of partners.

Facilitators: Nutrtion Working Group (Paige Harrigan, Save the Children; Lynette Friedman, Consultant; Kristen Cashin, FANTA-2; Mary Hennigan, Catholic Relief Services)

Panelists: Judiann McNulty, Consultant; David Shanklin, ChildFund International, Judy Canahuati, USAID

Introduction to the Nutrition Program Design Assistant

Using the Nutrition Program Design Assistant

Nutrition Program Design Assistant (Workbook)

Nutrtion Program Design Assistant (Reference Guide)

 

Lives Saved Tool (LiST) for Child Survival Project: Using LiST to estimate the impact of maternal, newborn, and child health interventions

Child survival programs are already making important contributions through measurable population impacts on under-five mortality. The Lives Saved Tool (LiST) can assist with strategic planning and identifying the most effective interventions in project areas. LiST can also enhance project evaluations, providing a means to estimate the mortality impact of child survival projects.

Facilitators: Jim Ricca, Debra Prosnitz, Becca Levine, NGO/PVO Support Team, Maternal Child Health Integrated  Project (MCHIP)

Lives Saved Analyes for Child Survival Projects: Basic How-to Use LiST

Lives Saved Analyses for Child Survival Projects: Using LiST to Estimate Impact of Maternal, Newborn and Child Health Interventions

 


Tuesday

Plenary Welcome

Tom Davis, Chair, CORE Group Board of Directors, Director of Health Programs, Food for the Hungry

Official welcome and start of this year’s CORE Group Spring Membership Meeting from Board Chair Tom Davis.

CORE Group Spring Meeting 2010: Being Bold Together

State of CORE

Karen LeBan, Executive Director, CORE Group

Karen LeBan introduced the Spring Meeting theme on communities and health systems strengthening. The session updated members and colleagues on membership trends, the CORE Group secretariat, and Working Group accomplishments over the past year.

Getting to the Heart of the Matter: Communities and Health Systems Strengthening (The State of CORE)

CORE Community Update and Network Building Session

Ann Hendrix-Jenkins, Director of Partnership Development, CORE Group; Tom Davis, Chair, CORE Group Board of Directors, Director of Health Programs, Food for the Hungry
Community Health Network participants often cite the amazing value they find in CORE Group facilitated networking. To get the ball rolling, CORE Group staff and Tom Davis set the group to work making connections in a lively way (with a practical twist, as usual).

Connected: The Surprising Power of Our Social Networks

Keynote Address:  The Child Development Perspective

Jack Bryant, Senior Faculty Associate, Johns Hopkins School of Public Health, Department of International Health
The presentation focused on the care we arrange for under-5 Orphans and Vulnerable Children (OVC) in the urban slums of Nairobi, Kenya. The care is strongly community-based, and includes a mix of primary health care and actions prompted by recent advances in the science of early childhood development.

Supporting Early Childhood Development in the Slums of Africa – Emerging Concepts

Keynote Address:  The Community: Strengthening the health system from the bottom up

Adrian Hopkins, Task Force for Global Health
The donation of Mectizan (ivermectin, Merck) in 1987 for the control of onchocerciasis (as much as was needed for as long as was needed) has not only led to new regional programs covering 19 countries in Africa and 6 countries in Latin America but has also led to novel ways of health service delivery.  Mectizan must be distributed once or twice a year to all the eligible population for many years (18-? 25 years depending on various factors).

In order to sustain programs it was clear that the community had to be fully implicated in the process. CDTI (Community Directed Treatment with Ivermectin) was developed after research showed that empowered communities were able to organize their own mass treatment after suitable social mobilization and appropriate training. The results have been remarkable in terms of scaling up and in terms of community participation. Many other activities have been added on by partners in the CDTI process. The Tropical Diseases Research and Training Program (TDR) further researched these activities and developed the process called Community Directed Interventions (CDI).

The Mectizan Donation Program has been a catalyst for the other donation programmes and the current move to control Neglected Tropical Diseases (NTDs).  Those targeting children or maternal and child health are based on special maternal and child health days or school distribution systems but those that target the total population are mostly using the CDI approach. Nearly all these programs depend on donated drugs for mass distribution. At present 80 million people are on treatment for onchocerciasis and over 100 million in Africa for Lymphatic Filariasis.

CDI has become a major component of some public health programs but there is a risk of setting up a parallel system. CDI must be seen as a process of empowering communities to intervene for their own health priorities, in full cooperation with the primary health service team and as part of the health district strategy for delivering health care to the most peripheral of communities. This is instrumental in strengthening the health systems from the bottom up which is vital to counterbalance the current top down approach of some efforts to strengthen national health systems.

The Community: strengthening the health system from the bottom up

Lunch Roundtables

Roundtable: Polio Project Update

Frank Conlon, Project Director, Dora Ward, Sr. Technical Advisor, and Meg Lynch, Program Associate- CORE Group Polio Project
The latest directions in CORE’s work to eradicate polio.  Meet the new Project Director!

 

Roundtable: Newborn Health Indicator Questions

Allisyn Moran, Faculty Associate, Johns Hopkins School of Public Health, Department of International Health
The session organizers extend a welcome to all PVOs which have been collecting information on newborn health indicators, and those interested in this topic. The discussion will aim to understand PVO experiences with the use of the questions used to acquire these indicators.

 

Plenary

U.S. Government Health Initiatives Panel

Moderator:  Karen LeBan, CORE Group
Richard Greene and Laura Birx presented via videoconference.

Global Health Initiative

Richard Greene, Director, Office of Health, Infectious Diseases and Nutrition, Bureau for Global Health, USAID
President Obama announced a comprehensive whole-of-government approach to global health, the Global Health Initiative, in May 2009, as a $63 billion, six-year (FY2009 – FY2014) effort.  This initiative would build on current disease-specific initiatives for HIV, TB and malaria while expanding these efforts to include maternal health, child health, nutrition, family planning / reproductive health, neglected tropical diseases and health systems strengthening.  After extensive consultation with partners, the State Department released its consultation document “Implementation of the Global Health Initiative” in March 2010.  The consultation document outlines seven core principles (women-centered approach, strategic coordination and integration, strengthening of multilaterals and partners, country-ownership, health systems strengthening, improved metric, and research and innovation) while expanding on four main implementation components: do more of what works, build on existing platforms, innovate for results, and collaborate for impact / promote country ownership.   Richard Greene provided an update on the Global Health Initiative, highlighting milestones in progress and planning to date.

The U.S. Government’s Global Health Initiative

Global Hunger and Food Security Initiative (GHFSI)

Laura Birx, Research and Technical Advisor, Nutrition Division, Bureau for Global Health, USAID
Achieving food security for developing countries is an essential component of eradicating poverty. Over a billion people still go to sleep hungry every night, but momentum is building for global action to fight the problem. In July 2009 at the L’Aquila G8 Summit world leaders committed new resources for agricultural development and a new approach to global food security. The Obama Administration has prioritized the food security issue in the U.S. global development agenda and has committed to collaborate with stakeholders in this new global initiative.  Specifically, the Administration has committed to advance action that addresses the needs of small scale farmers and agri-businesses, and harnesses the power of women to drive economic growth. The U.S. government intends to achieve these by increasing investment in agriculture development while maintaining the support for humanitarian food assistance. In a consultation document in September 2009, the U.S. government outlined its five principles (comprehensively address underlying causes of hunger and malnutrition, country-ownership, strategic coordination, leveraging of multi-laterals, and sustainable and accountable commitments) towards pursuing a comprehensive approach to food security.  Laura Birx will highlight current developments of this initiative and next steps, and update the audience on USAID Bureau for Global Health priorities in nutrition.

Feed the Future Update April 2010

Maternal and Child Health Integrated Program (MCHIP)

Koki Agarwal, MCHIP Project Director
The Maternal and Child Health Integrated program (MCHIP) is USAID’s flagship maternal, neonatal and child health (MNCH) program, which focuses on reducing maternal, neonatal and child mortality. MCHIP is designed to accelerate progress toward achieving the Millennium Development Goals (MDGs) in USAID’s 30 maternal and child health (MCH) priority countries over five years. Building on strong  program experience, MCHIP will address the major causes of mortality in the 30 priority countries, where more than 70% of the world’s maternal, newborn and child deaths occur. The MCHIP partnership works together with countries to help implement effective strategies for reducing maternal, neonatal and child deaths at scale.  Currently MCHIP works in over 25 countries along the MNCH continuum of care (including family planning and HIV/AIDS) from pre−pregnancy to age five, and by linking communities, first−level facilities, and hospitals.  MCHIP  is a five-year (October 2008 – September 2013) $600 million Leader with Associates award managed by Jhpiego in partnership with Save the Children, ICF/Macro, JSI, PATH, PSI, BBA and IIP.   Koki Agarwal, Project Director,  highlighted MCHIP’s structure (country, global, NGOs) and how the project supports partnerships to achieve country health strategies and USAID’s Bureau for Global Health priorities.  She provided an overview of key project highlights from the first two years of project implementation.

Maternal and Child Health Integrated Program – MCHIP

Foreign Aid Reform – A Civil Society Perspective

Monica Mills, Director of Government Relations, Bread for the World
There has been a continuing call for reform of the Foreign Assistance Act of 1961 which created the basis for U.S. foreign assistance.  The last time this act was amended was in 1985.  Both Congress and the Administration have initiated discussions on new foreign aid reform legislation;  there is a Presidential Study Directive on Global Development that calls for a review of global development policy; and the State Department is finalizing a first of its kind Quadrennial Diplomacy and Development Review.   While these efforts are not specifically health-focused , it is likely that they will have implications for the U.S. global health efforts.  Monica Mills presented foreign aid reform efforts from a civil society perspective informed by Bread for the World, and discussed how the GHI and GHFSI serve as a model for broader reform efforts, and how the reform efforts may affect the health efforts.  She offered suggestions on how the global health civil society community can take advantage of opportunities to advocate for coordination and civil society input into the dialogue.

 

Concurrent Sessions

Working Group Planning Time

Working Groups used this time to review accomplishments, discuss tasks to be completed during the second half of the year, and to discuss “CORE Group MCH Initiatives” planning.

 


Wednesday

Plenary

Hearing the Unheard Cry: Three pillars to improve newborn survival.

Newborn deaths are a steadily increasing proportion of under-five deaths, currently representing more than 40%. Addressing newborn mortality is essential to achieving MDG 4, is closely linked to achieving MDG 5, and requires scaling up of evidence-based interventions through various delivery platforms by governments and NGO partners. Recent attention to stillbirths has increased awareness that interventions focused at the time of birth have triple benefit to reduce maternal mortality/morbidity, reduce neonatal deaths due to intra-partum-related events, and reduce intra-partum stillbirths. Coverage of key life-saving maternal and newborn interventions, however, remains unacceptably low, especially for the poorest families.

This session emphasized three evidence-based pillars of successful strategies to improve newborn survival: (1) increasing availability/access of evidence-based interventions, (2) improving ‘demand’ and use of key interventions, and (3) improving quality of care.

Pillar 1: Increasing availability/access of evidence-based interventions. Where access and use of facility-based care is low, there is clear evidence that using community health workers to make well-timed home visits can save newborn lives.  Based on this evidence, the UN agencies recently released a WHO/UNICEF Joint Statement, Home Visits for the Newborn Child: a strategy to improve survival.  The Joint Statement calls for governments and partners to analyze the country situation, and to implement early postnatal home visits for mothers and newborns, especially where families’ postnatal contact with health facility providers may not be feasible.

Pillar 2: Improving demand and use of key interventions.  Creating demand and changing household practices for newborn care is especially challenging due to strong cultural traditions and norms around childbirth. Therefore, programs should include evidence-based strategies to mobilize communities around maternal and newborn care to improve key household practices and to increase timely and appropriate care seeking for maternal and newborn complications.  There is expanding global evidence of impact of demand creation strategies, and increasing need for effective implementation at scale of these approaches.

Pillar 3: Improving quality of health care interventions.  Whereas 1 million annual newborn deaths are due to intra-partum-related events (termed “birth asphyxia”), basic newborn resuscitation is a life-saving intervention that must be available to all newborns who do not breathe at birth. Health providers must be able to quickly assess and recognize the condition, take immediate simple steps, and have the essential basic equipment. Unfortunately, there are many ‘missed opportunities’ to provide quality resuscitation at lower levels of the health system, such as health clinics and district hospitals. Recent developments, however, hold new promise. New, simple tools now exist to train health care providers/workers. With USAID leadership, partners are now collaborating through a newly created Global Development Alliance to scale up quality newborn resuscitation in weak health systems using these new training tools.

Introduction and Session Overview

Increasing Access through Postnatal Home Visits:  Implementing the WHO/UNICEF Joint Statement
Stephen Wall, Senior Advisor, Technical Leadership & Support, Saving Newborn Lives, Save the Children (Washington, DC); Moderator and Presenter.

Hearing the Unheard Cry: Pillars To Improve Newborn Survival

Increasing Demand for Maternal & Newborn Care Practices and Care Seeking:  Implementing evidence-based approaches
Joseph de Graft-Johnson, Maternal and Newborn Health Advisor, Save the Children, Saving Newborn Lives (Washington, DC, USA and Addis Ababa, Ethiopia); Team Leader, Newborn and Community Health, MCHIP Program

Increasing demand for maternal & newborn care practices and care seeking: Implementing evidence-based approaches

Preventing Intrapartum-related Neonatal Deaths (deaths due to “birth asphyxia”):  New tools (Helping Babies Breathe) to improve quality of care in low-resource settings including global burden
Susan Niermeyer, Professor of Pediatrics, Section of Neonatology, University of Colorado Denver School of Medicine

Helping Babies Breathe

New, Affordable Technologies to Improve Quality of Care at Childbirth– Presentation and hands-on demonstration
Tore Laerdal, Executive Director, Laerdal Foundation for Acute Medicine

Laerdal: Helping Save Lives

Scaling up Newborn Resuscitation – New strategies and global implementation plans through partnerships
Lily Kak, Senior Maternal and Newborn Health Advisor, Bureau for Global Health, USAID

 

Concurrent Sessions

Early Childhood Development: The perfect Venn diagram

Shannon Senefeld, Senior Technical Advisor for HIV, CRS, Moderator
Janine Schooley, Senior Vice President for Program, PCI; Moderator
Session presenters shared information on different approaches to responding to early childhood development (ECD) needs within the context of MCHN, HIV and other programming, including recent successes, lessons learned, promising practices and tools. Participants had the opportunity to ask questions of the presenters about their programs and approaches. Full group discussions focused on how ECD can be better utilized by CORE members as an integrator, able to link education, OVC, IYCF, pediatrics, and other elements.

Overview of Early Childhood Development
Jack Bryant, Senior Faculty Associate, Johns Hopkins School of Public Health, Department of International Health
The presentation added any context, issues for discussion, challenges, and priorities that were not already covered in Tuesday’s plenary presentation.  Jack  focused on raising issues that might be useful to discuss in small groups, challenging the group to think strategically and outside of the box.

Early Childhood Development: Emerging Concepts II – The Place of the World Bank in Support of ECD

Establishing an Essential Package for Young Orphans and Vulnerable Children (OVC)
Nicole Richardson, Program Coordinator for the Hilton Initiative, Quality Improvement Specialist for OVC, Save the Children
Nicole presented an overview of a two-year initiative being funded by the Conrad N. Hilton Foundation. The initiative’s main objective is to develop an Essential Package for young orphans and vulnerable children which will include age-appropriate program quality standards.

Developing an Essential Package for Young Children Affected by HIV/AIDS

Say and Play: A tool to help adults support the psychosocial needs of young children
Janine Schooley, Senior Vice President for Program, PCI
While older OVC are more likely to be reached with psycho-social support through primary school and trained home-based caregivers, OVC under-5-6 are often underserved and unable to benefit from psychosocial support until primary school, by which time the psychosocial damage may be extensive. The recently launched Say and Play tool developed by PCI/Zambia was presented, and included a brief orientation to the tool, how to access it, and ideas for utilization.

Say and Play

 

Improving Your Community Health Worker Program: An interactive introduction to the CHW-AIM tool and approach

Leo Ryan (ICY Macro International), Moderator
Rebecca Furth, Senior Technical Advisor, Initiatives Inc.
Alison Wittcoff, Quality Improvement Specialist, URC- HCI Project
The global public health community has recognized the importance of community health workers to achieving the Millennium Development Goals and providing critical health services to underserved populations. Despite the recognition of the important contributions that CHWs can make and the rapid expansion of health service delivery, no tools exist for helping program managers and key stakeholders assess and strengthen CHW programs. This interactive session introduced participants to the CHW Program Assessment and Improvement Matrix (CHW-AIM) tool and process. CHW-AIM offers a framework for a participatory assessment of CHW programs – based on defined standards in fifteen key CHW program elements – and action planning for program strengthening.  In this session, participants will engage in an interactive exercise to apply the CHW-AIM tool. The exercise was followed by a discussion of the approach and of experiences in applying CHW-AIM.

CHW Program Assessment and Improvement Matrix

 

Operations Research in Maternal and Child Health Programs: Measurement challenges

Peter Winch, Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Maternal and Child Health Integrated Program (MCHIP), Washington DC
Jennifer Luna, Maternal and Child Health Integrated Program (MCHIP), Washington DC
The session started with an overview of opportunities for NGOs to be engaged in operational research. It then turned to a presentation on measurement of the mechanisms through which community-based programs achieve their impact.  Much emphasis in recent years has been on how to measure key coverage and health outcome indicators in a standard way. Much less effort has been invested in measurement of the mechanisms through which community-based programs achieve their impact. One reason for this is that it is challenging to measure abstract concepts such as empowerment and social capital. A second reason is that community-based programs frequently seek to affect the entire health system, from the household to the referral facility, to strengthen connections and establish a solid continuum of care. Such a broad undertaking again poses a number of measurement challenges. The session also summarized how MCHIP is working to support NGOs to examine these mechanisms.

Improving measurement through Operations Research

Operations Research In MCH Programs: Measurement Challenges – How MCHIP is working to Support PVOs

 

Dory Storms Award

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 NGO has one vote to select the recipient of the Dory Storms Award from among this year’s nominees.

This year’s winners are Dr. Abhay and Dr. Rani Bang.

 

Roundtables

Roundtable: Operations Research Discussion

Peter Winch, Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Maternal and Child Health Integrated Program (MCHIP), Washington DC
Jennifer Luna, Maternal and Child Health Integrated Program (MCHIP), Washington DC
This session provided  an opportunity for people with questions concerning specific operations research studies in which they are engaged to ask questions or share experiences. A range of topics were discussed, including: study design and data collection to analysis and paper writing.

Roundtable: Improving Your Community Health Worker Program: The discussion continues

Leo Ryan (ICF/ Macro International), Moderator
Rebecca Furth, Senior Technical Advisor, Initiatives Inc.
Alison Wittcoff, Quality Improvement Specialist, URC- HCI Project
The roundtable continues the discussion begun during the morning Concurrent Session “Improving Your Community Health Worker Program.”  New participants were welcomed to join in the discussion around the CHW Program Assessment and Improvement Matrix (CHW-AIM) tool and process.

Roundtable: Dot-mocracy Results: Burning Issues/Gaps

Natalie Campbell, MSH, Ann Hendrix-Jenkins, CORE Group, Burning Issue Champions, TBD earlier that day…
Champions of the burning issues that emerged during the morning session will meet over lunch to pitch their issue and link up with other interested parties. By the end of the session, participants were able to: describe in some detail what the burning issues and gaps were, and how CORE Group’s Community Health Network should move them forward.

Top TopicsInterested People# of Votes

Urban Health (including adapting technologies from rural to urban)

Anna Summer, SAWSO28
Community Capacity Building—Measurement of CapacityMychelle Farmer, CRS26
Measurement of Empowerment and its effects on health outcomes (specifically women’s empowerment)Bethann Cottrell, CARE23
Social Networking and MappingNatalie Campbell, MSH22
HIV Integration with Sanitation, Nutrition and TBSonya Kibler, Save the Children22
Community Governance Structures for HealthChung Lai, IRD20
Participatory Approaches to development beyond PD/Hearth, Care Groups, etc.Kirk Dearden, BU/CARE7
Expanding Access to Community Led SanitationSonya Kibler, Save the Children 5

Concurrent Sessions

Gender Equity: A dialog about focusing on gender inequity in order to improve health programming

Facilitators: Jennifer Luna, Jennifer Yourkavitch, Debra Prosnitz,
NGO/PVO Support Team, Maternal Child Health Integrated Project, ICF/Macro International
Panelists: Sunita Kishor, Senior Gender Advisor for the Demographic and Health Surveys, ICF/Macro; Kavita Sethuraman, Senior MCHN Advisor, AED; Elena McEwan, Senior Technical Advisor in Health, CRS

Are you concerned about reducing gender inequalities in order to improve health outcomes? This session provided an opportunity to discuss concerns with gender experts and other participants and to hear ideas on how to address gender in health programs.  This session was part of a process of developing a guidance document for incorporating equity into community focused programs. Participants’ suggestions will be used for this guidance. This session involved a panel presentation from gender experts, small group discussions and dialog between participants and panelists.

Gender Equity: A dialog about using this focus to improve health programming

Sex and Gender: What is the difference?

Gender responsive programming: An approach to planning and implementation

 

We must hang together, gentle colleagues…else, we shall most assuredly hang separately: Visioning future CORE collaborations

Dora Ward, Sr. Technical Advisor, CORE Group Polio Project
Meg Lynch, Program Associate, CORE Group Polio Project

Using the Secretariat Model of the CORE Group Polio Project, this session will be a facilitated discussion of the factors that contribute to NGO collaboration success and the ways such collaborations can enhance our impact. Presenters described the CORE polio secretariat model and invited descriptions of other collaborative experiences from participants. Participants then identified some of the key features various models have in common and any striking differences.  Finally, presenters led the group in idea generation about future collaborative projects for CORE members and the best structures to use for those potential projects.

By the end of the session, participants were able to:

  • describe the CORE secretariat model and its similarities and dissimilarities to other collaborative projects;
  • list features that it and other successful collaborative projects have in common, as well as common challenges to collaboration;
  • discuss how the technical content and political context of an initiative can influence the optimal structure for collaborative work;
  • generate specific, detailed descriptions of potential future collaborative projects in areas of child health among CORE Group members, including suggestions for how a collaborative mechanism should be structured.  (Ideally these projects will lead to further discussion and eventually to seeking resources jointly.)

 

Lessons Learned Providing Life Saving Interventions through Community Case Management

Yolanda Barbera, Community Case Management Technical Advisor and Senior Coordinator, International Rescue Committee
Amina Issa Mohamud, Regional Community Case Management Coordinator, International Rescue Committee
Jeanne Koepsell, Community Case Management Advisor, Save the Children
Megan Wilson, Child Survival Program Manager, Population Services International

With Canadian International Development Agency (CIDA) funding, IRC, PSI and Save the Children are working to establish an evidence base for the impact on child mortality rates attributable to the community case management (CCM) approach. These programs are large-scale, multi-country initiatives to increase access to life-saving interventions for children under five by providing diagnosis and treatment free-of-charge in communities where no health facility is present. It is estimated that these programs can reduce under-five mortality by between 30 to 40% in the catchment areas and generate high quality data to support potential significant, future investments in CCM to achieve the Millennium Development Goals. Representatives from International Rescue Committee, Save the Children, and Population Services International discuss progress and lessons learned so far; small group work addresd barriers to CCM scale-up.

Community case management: IRC’s experience and considerations for scale up

PSI’s experience in Community Case Management programs

Save the Children’s Community Case Management Initiative

Plenary

How Do Disasters Affect our Work? Health systems, community health & emergencies – Reflections from Haiti, the Influenza Pandemic and more

Janine Schooley, Senior Vice President for Programs, Project Concern International, Moderator
Cate Oswald, Program Manager for Mental Health and Psychosocial Support Services, Partners In Health
Marci Van Dyke, Technical Advisor, Pandemic Preparedness and Response Group, Avian and Pandemic Influenza Unit, Office of Health, Infectious Diseases and Nutrition Global Health Bureau, USAID

CORE Group Members:
Judy Lewis, Haitian Health Foundation; Director, Global Health Education, Professor, Departments of Community Medicine and Pediatrics, University of Connecticut School of Medicine
Sharon Tobing, Technical Advisor, ADRA China/Independent Consultant
Monica Trigg, Sr. Program Officer Influenza, CARE USA
Ann Varghese, Program Officer, IMA World Health
Kathryn Bolles, Project Director, H2P Initiative

An exciting panel representing diverse programs discussed lessons learned and ongoing challenges to effective preparedness and response posed by the earthquake in Haiti, pandemic flu and other emergencies. Panelists looked at how collective preparedness for and response to disasters, programming and collaboration can be improved. Drawing on their experiences, speakers also discussed the “relief to development continuum” and the “two-prong approach of emergency response and development” as they looked at how best to move forward and be better prepared in the future. A collective participation and discussion period helped to further extrapolate additional perspectives and promising practices.


Thursday

Concurrent Sessions

Pro-poor Health Financing Strategies

Jaime Carrillo, Executive Director, Curamericas Global, Inc.
Ira Stollak, Senior Program Specialist, Curamericas Global, Inc.

The facilitators presented a summary of findings concerning pro-poor strategies implemented in diverse countries at the local and national levels.  While many strategies have failed to increase healthcare access and/or to reduce out-of-pocket health expenses for the poor, they may be considered for adaptation to local/regional approaches that  actively incorporate beneficiaries in the delivery of services.  In general, national health initiatives have focused on availability, and to lesser extent on accessibility and affordability. But if services are to be reached by the poorest, special attention should be given to the adequacy and the acceptability of health care to the users.

The focus of the exchange during this session was on potential approaches to minimize barriers and enhance successes of presented strategies with the intent to incorporate suggestions into an ongoing effort to implement community-based health system strengthening.

Getting Beyond the Physical: Integrating mental health response into local health systems

Session presenters provided concrete examples of how mental health has been integrated into primary healthcare systems. Participants had the opportunity to ask questions of the presenters about their programs and approaches and were encouraged to take part in interactive activities during the session in order to apply the information provided during the session.

The Current Condition of Mental Health in Afghanistan: Integrating mental health into primary healthcare
Nahid Aziz, Associate Professor, Argosy University

The Current Condition of Mental Health in Afghanistan: Integrating Mental Health into Primary Healthcare

Responding to mental health needs of HIV positive pediatric patients in resource-poor communities
Vicki Tepper, Associate Professor of Pediatrics and the Director of the Pediatric AIDS Program at the University of Maryland School of Medicine

Responding to Mental Health Needs of HIV-Positive Pediatric Patients in Resource-Poor Communities

Family Planning and Child Survival Integration:  What are the possibilities?
Victoria Graham, Senior Technical Advisor, Bureau of Global Health, USAID
Mia Foreman, Program Associate, ICF Macro

With the creation of the Global Health Initiative, USAID is committed to strengthening and integrating public health programming –including the integration of family planning (FP)– into maternal and child health programs. Family Planning programs have been shown to lowers rates of newborn, infant, and child mortality; delay next pregnancy and allow more time for mothers to breastfeed and improve overall infant health; and allow more time for women to recover physically from delivery and nutritionally between births (Family Planning Saves Lives, 4th edition, PRB).

During this session, participants learned about the historical perspective of integrating FP into the CSHGP, learned how some MCH programs are integrating birth spacing/family planning into their programs, and identified FP program strategies and activities that may improve FP indicators. Participants had an opportunity to ask questions, and share their experiences and ideas for future collaboration and technical support.

Integrating Family Planning Into CSHGP and MCH Programs

Global Health Action – Haiti: To contribute to the reduction of maternal and infant mortality in the Petit Goave Region of Haiti

 

Care Groups: The Essential Ingredients
Carolyn Wetzel, Senior Coordinator for Health Programs, Food for the Hungry USA
Thomas Davis, Senior Director of Health Programs and International Program Quality Improvement, Food for the Hungry USA
Melanie Morrow, Director of MCH Programs, World Relief USA

Care Groups have been proven to reduce malnutrition, decrease child mortality, and save lives. Since 1995, World Relief, Food for the Hungry, and more than 12 others PVOs in more than 14 countries have “adopted the Care Group model,” but the degree to which organizations adhere to the original components of the model varies greatly.  There is a danger that the wide variations in what is called a “Care Group” by various agencies will lead to misunderstandings about the model and the use of less effective strategies that do not fit within the model. These variations, in turn, could lead to fewer opportunities to advocate for the Care Group model and its role in child survival since the term “Care Groups” may come to mean many different things to different people and may not be as effective in lowering malnutrition and mortality.

In this session, participants discussed what elements must be found within a program design for it to be considered a “Care Group.” After the impact and basic elements of the Care Group Model were presented, participants divided into small groups and discussed the rational for  the requirements and suggested elements of the Care Group method, giving input and experiences related to each criterion.

Care Groups: The Essential Ingredients

 

Working Group Showcase (and Planning) for IMCI, Malaria, Nutrition and TB Working Groups

IMCI and Malaria Working Groups (joint session)
Philip Wegner, Health Advisor, Concern Worldwide
Yolanda Barbera, Senior Technical Health Coordinator, International Rescue Committee
Melanie Morrow, Director of Maternal & Child Health Programs, World Relief

The IMCI and Malaria Working Groups jointly hosted a Showcase featuring representatives from the three NGOs–Concern Worldwide, IRC, and World Relief–that make up the consortium for the Expanded Impact Project in Rwanda. Together they discussed the latest challenges and lessons learned in their attempt to reduce child mortality by addressing the three leading direct causes of death in children under five—malaria, diarrhea, and pneumonia—through community-based approaches and improved linkages with health facilities. Participants discussed progress towards integrating home-based management of fever and community case management with Community Integrated Management of Childhood Illness (C-IMCI) and into the overall Community Health System of the Ministry of Health, including looking at how the C-IMCI framework could be changed to better address some of the challenges identified.

Expanded Impact Child Survival Program in six underserved districts in Rwanda

Nutrition Working Group
The Nutrition Working Group continued to highlight useful nutrition assessment tools. The presentation showcased Food for the Hungry’s Local Determinants of Malnutrition tool and was followed by a discussion of experiences and the implications of using new food products to address undernutrition.

Local Determinants of Malnutrition: An Expanded Positive Deviance Study

TB Working Group
Khrist Roy, Technical Advisor, CARE
Janet Hwang, Program Associate, CARE
Jennie Quick, Governmental Affairs ManagCommunity Mobilization: Indonesia MITRA TB Projecter, PSI
The session provided a snapshot of diverse activities led by CORE members, with specific activity descriptions/results for these organizations and open discussion time for other  members/organizations that briefly brought the group up to date on current TB activities. CARE colleagues presented results from the MITRA project in Indonesia, focusing on two key aspects of this activity. First, they described the project’s success with the pagyuban (TB support groups) as the social mobilization and advocacy platform for DOTS TB in Indonesia. This model has been recognized and showcased nationally by the MoH. The MITRA training curriculum and modules for treatment observers and treatment observer supervisors were also be presented during this session. These modules (adapted version) were accepted by the MoH for national replication.

Community Mobilization: Indonesia MITRA TB Project

Jennie Quick provided an overview of PSI’s tuberculosis activities, with a significant focus on how PSI uses private-public partnerships to provide DOTS in Myanmar and Pakistan. She will also discuss HIV/TB integration activities in southern Africa, focusing on Zimbabwe. The group  also discussed the draft CORE Group initiative focusing integration of disease specific services at the community level.

Tuberculosis and PSI

Working Group Showcase and Planning for HIV, M&E, SMRH, and SBC Working Groups

HIV Working Group
Addressing Adherence in Resource-constrained Settings: Models of community success
Shannon Senefeld (CRS) and Janine Schooley (PCI), Moderators
Martine Etienne, University of Maryland School of Medicine, Institute of Human Virology

Community Adherence within a Multi-country HIV Treatment Program
Martine Etienne, University of Maryland School of Medicine, Institute of Human Virology
The presentation focused on the recently developed adherence curriculum entitled “A Guide to Providing Highly Supportive Antiretroviral Treatment and Maximizing Adherence in Resource-Limited Settings” which is being used in all of the AIDSRelief/PEPFAR programs. The development process included conducting focus group discussions to help target some of the factors associated with adherence of patients on antiretroviral treatment. Through this process, a Patient Adherence Survey, which is currently being used as part of the evaluation of patient adherence in the AIDSRelief/PEPFAR countries, was designed and piloted.

Community Based Treatment Support Services: The Treatment Support Arm of the AIDSRelief Program

The HIV Working Group also discussed its role and ideas for CORE Group’s Integrating Infectious Disease Programming Initiative.

Monitoring and Evaluation Working Group
James Ricca, Senior Sustainability & Tuberculosis Control Advisor, NGO/PVO Support Team, Maternal Child Health Integrated Project, ICF/Macro International

The vision of the M&E Working Group is to develop new and improved tools and trainings to increase child survival and health program performance and quality through the standardization of use of data, analysis and reporting. M&E is a cross-cutting discipline that touches all aspects of child survival and health programming including IMCI, SMH/RH, TB, HIV/AIDS, SBC, and malaria. This year the M&E WG has been focusing on improving the methods of measurement of equity for NGOs, an effort being led by Jennifer Luna, a Senior Advisor of M&E for MCHIP, through ICF Macro which has been working on methods of incorporating equity into program design.The M&E WG has also been working on improving methods of measuring mortality and community capacity.

The WG Showcase featured Jim Ricca from ICF Macro. Through the MCHIP project he has been developing a new “Contact Intensity” population survey that may be included with KPC or other surveys. The purpose of this survey is to show the effects of CARE Groups and other similar methodologies on the frequency of contact with health personnel and/or the frequency of attendance at community meetings in which discussing child health with mothers is the focus. These results may also be correlated with other health outcomes measured in the KPC survey in order to determine the effect that increased contact has on these intervention methodologies. The discussion contained results from a pilot study that was performed in Liberia by Todd Nitkin and Medical Teams International.

In addition, Jim Ricca has been developing a new “toolkit” through the MCHIP project with five tools for health facility assessment for MNC programs. It was originally developed for national MoHs but is very appropriate for CSHGP projects. It has just been field tested it in Kenya and Ethiopia. Presently the paper forms are finalized and a PDA application is now being developed, along with all the supporting materials: a manual, tabulation plan, and a sample report.

Contact Intensity Index

Safe Motherhood and Reproductive Health Working Group
Judy Lewis, Haitian Health Foundation; Director, Global Health Education, Professor,  Departments of Community Medicine and Pediatrics, University of Connecticut School of Medicine
William Brieger, Professor, Johns Hopkins Bloomberg School of Public Health, Senior Malaria Specialist, JHPIEGO; Certified Health Education Specialist
Lindsey Grenier, Midwifery Advisor, American College of Nurse Midwives

The Safe Motherhood Reproductive Health Working Group showcased programs to save the lives of mothers and newborns. These presentations provided critical information for reaching MDGs 4 and 5.

Saving Haiti’s Mothers,” a documentary produced by NOW on PBS which aired on January 29 2010, discusses the issue of maternal mortality pre-earthquake. It presents several innovative approaches to improving access to skilled care. The documentary provides an overview of global maternal mortality as well as several programs in Haiti, including CORE’s own Haitian Health Foundation.

Nigeria has very high maternal and neonatal mortality rates. William Brieger presented the outcomes of a final project evaluation in Nigeria which was directed at improving antenatal care access and utilization.

This program incorporates volunteer community outreach workers to increase antenatal care utilization. Training and monitoring of focused antenatal care improved all aspects of service quality.

Community Directed Interventions to Improve Malaria in Pregnancy Control Services in Nigeria

Lindsey Grenier presented materials from the new edition of Home Based Life Saving Skills (HBLSS) which has been developed in collaboration with CORE SMRH Working Group.  She also Showcased the ACNM-CORE Maternal/Newborn Health Initiative.

HBLSS: Improving on Innovation

Social and Behavior Change Working Group
The SBC working group shared new information on the following:

1)  new results on the power of Partnership Defined Quality in three countries including a case control comparison;
2)  an update from the Powerful to Change group on the factors that make successful exclusive breastfeeding programs;
3)  the unveiling of the AED Kit for integrating WASH into HIV Programs. The kit includes capacity building materials, job AIDS, monitoring and evaluation indicators and other treats;
4)  plus breaking news on the top four reasons to volunteer for a Working Group!

Barrier Analysis Survey: Working Group Participation

Meeting the Water, Sanitation and Hygiene Needs of People Living with HIV/AIDS and their Families

Concurrent Sessions

We’ve Collected the Data. Now What? A tool for health systems strengthening through entering, cleaning, analyzing and using Infant and Young Child Feeding (IYCF) data
Kirk Dearden, Consultant and Associate Professor, Boston University
Bethann Witcher Cottrell, Director, Child Health and Nutrition, CARE USA
Carlos Rojas, Senior Advisor, Monitoring, Evaluation and Advocacy, CARE (invited)

Worldwide, more than 9 million children under five years of age die each year. Malnutrition underlies a majority of these U5 deaths. Extensive research has contributed to global feeding recommendations to maximize health for infants and young children. Recent WHO work identifies appropriate indicators of optimal infant and young child feeding (IYCF) behaviors but until now, there has been little specific guidance about how to collect and use these data, especially at the field level where implementing agency staff are best situated to make changes to programs.
The Step-by-Step Guide presented in this session provides instruction to help CARE staff and personnel from other agencies adapt WHO operational guidance for use with smaller-scale surveys among children 0-23 months of age. The Guide provides assistance with the selection of indicators, choice of sampling strategy, entering and cleaning IYCF data, and analyzing the data and reporting the results.

The Guide and accompanying tools are designed for staff from implementing agencies who collect data on IYCF behaviors as well as people who collect data on other topics. While the examples used in this Guide focus on IYCF practices, the Guide can be used by staff working in other content areas as well.

We’ve collected the data. Now what? Step-by-step instructions to enter, clean, analyze and use IYCF data

 

Partnership Defined Quality – Act it out!
Bonnie Kittle, Independent Consultant
Beth Outterson, Director, Adolescent Health, Save the Children

Have you heard about Partnership Defined Quality (PDQ) but you’re still confused about how it works?  Have you thought about using it to improve the quality of care in your health facilities but you weren’t exactly sure what it entails?  Come to the Acting It Out – Partnership Defined Quality session facilitated by Beth Outterson and Bonnie Kittle where we’ll be acting out the steps of PDQ.  This entirely participatory session had participants experiencing the PDQ steps for themselves.

Partnership Defined Quality: Acting it Out!

Community Water Supply and Sanitation Solutions

Elynn Walter, Program Director of Global Water, Health and Schools for Water Advocates introduced the session, which included presentations from the Hygiene Improvement Project (HIP) and CORE Group members PSI and PATH.

 

HIP Community Sanitation and Hygiene Approaches
Sarah Fry, Senior Hygiene Programming Advisor, Hygiene Improvement Project, AED

Traditional responses to the rural sanitation crisis which treat communities as beneficiaries rather than consumers have clearly not worked; providing subsidized, “one-size-fits-all” latrines through development programs has proved unsustainable and ineffective.

Recognition of past failures and growing recognition of the impact of poor sanitation on all sectors has fostered new and innovative approaches to rural hygiene and sanitation improvement such as Community Led Total Sanitation (CLTS) and customer-centered sanitation marketing.

The USAID-funded Hygiene Improvement Project works at scale in Ethiopia and Madagascar and on a smaller scale in Uganda and Peru, where sanitation innovations are being put into practice and are yielding lessons. CLTS builds on participatory approaches implemented by many CORE members and is a process by which communities confront their own defecation practices and launch collective sanitation actions motivated by disgust and shame. In Ethiopia, HIP has found that CLTS is most effective coupled with more intensive behavior change support through outreach workers ‘negotiating’ small doable improvements over time. In Madagascar, Uganda and Peru, HIP creates demand for sanitation through CLTS, community mobilization, household-level BCC and mass media channels, but also stimulates local supply of a range of hygiene and sanitation products through commercial channels such as hardware stores, small cement factories, and local trained masons, for consumers to purchase and enjoy.  Creative public private partnerships (PPP) are also extending the availability and affordability of community sanitation facilities. Another aspect of HIPs rural sanitation improvement includes a focus on “WASH friendly” schools and health centers that combine CLTS and WASH improvements. In all program activities, handwashing with soap is integrally linked to sanitation promotion and ensures maximum health impact from improved household and community activities.

Sanitation Innovations – Hygiene Improvement Project

 

PSI Diarrhea Prevention and Safe Water Approaches 
Megan Wilson, Child Survival Program Manager, Population Services International

PSI’s diarrheal disease programs promote healthy behaviors by educating individuals about purifying drinking water in the home, practicing improved hygiene, and offering treatment for  diarrheal disease if a child falls ill. PSI and its many partners are working together to promote the Safe Water System, a water quality intervention that employs proven, easy-to-use and  inexpensive solutions appropriate for the developing world. The Safe Water System (SWS) was developed by the U.S. Centers for Disease Control and Prevention (CDC) in 1996. The objective of the Safe Water System is to make water safe to drink at the household through chlorine-based household water treatment and safe storage at the point of use.

Household water treatment and safe storage (HWTS) ensures that each sip of water is safe to drink. HWTS can be adopted quickly, inexpensively, at national scale in both development and emergency situations, making an immediate difference on the lives of those who rely on  transporting  to and storing water in their homes. HWTS works to address water quality issues while complementing water supply, hygiene, and sanitation interventions. This approach was highlighted in the 2003 UN World Water Development Report as the most cost effective water purification solution.

Preventing recontamination of drinking water through the residual protection of chlorine, HWT keeps properly stored water safe for 24 hours after treatment. Through numerous field-based studies, chlorine-based HWT prevents new episodes of diarrhea on average of 50%.

PSI Diarrhea Prevention and Safe Water Approaches

 

PATH’s Household and Community Water Treatment Approaches

Lorelei Goodyear, Senior Program Officer, Safe Water Project Evaluation and Research, PATH

In resource-poor settings, water often comes from unsafe sources and carries deadly pathogens. The World Health Organization estimates that 1.8 million people die each year from diarrheal diseases, many of which are attributed to unsafe water. Safe drinking water is one of the United Nations Millennium Development Goals—by 2015, the United Nations hopes to decrease the proportion of people without sustainable access to safe drinking water by 50 percent. Household water treatment and safe storage (HWTS) systems are among the most simple, acceptable, affordable, and effective methods of getting safe drinking water to people who need it. If they can be provided at a reasonable cost and with education and service to low-income populations, more people will have access to safe water. They will also be more likely to use HWTS systems correctly and consistently, thereby reducing disability, illness, and death related to unsafe water.

Through the Safe Water Project, PATH is exploring the potential for commercial enterprises to sustainably produce, distribute, sell, and maintain HWTS consumer products to low-income populations. During the five-year lifespan of the project, PATH and its collaborators in India, Cambodia, and Vietnam are testing the effectiveness of several commercial strategies for providing HWTS. PATH is also working with companies to develop new, more affordable  technologies for low-income households based on its understanding of user needs in developing countries.

As an alternative to household water treatment, PATH is field testing a smart electrochlorinator for small batch production of highly active chlorine. This fosters micro-entrepreneurship within low income communities, and provides a safe water source for the community at  large. The organization believes more households will drink safe water if there are  more alternatives for treating water.

PATH’s Approach to HWTs and Community Water Solutions

Retention, Attrition and Motivation of Voluntary Workers in Community-based Programs
Peter Winch and Anne Palaia, Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health

Implementation of community-based programs frequently depends on unpaid or minimally compensated workers.  Data on factors affecting the motivation and attrition of these volunteers were presented from three studies.  In an evaluation conducted during the start-up phase of a study on community-based voluntary counseling and testing services in rural Tanzania, the degree of pro-social motivation, programmatic support and expectations of remuneration were found to be important influences on motivation and attrition.  The second study was a systematic review of experience with volunteer motivation and attrition in HIV/AIDS programs. The evidence base was found to be thin. Of 2,659 potentially-relevant abstracts identified, only eight provided primary data on HIV/AIDS volunteer attrition in a low- or middle- income country. None of these interventions offered a clear definition for attrition. The third study is an analysis of factors affecting attrition of community health workers in a newborn care intervention study in Sylhet District, Bangladesh. This latter study highlights the interplay between individual, household and community-level factors.

Retention, attrition and motivation of voluntary workers in community-based programs


Friday

Concurrent Sessions

mHealth and Manifestos (as in, Checklist Manifestos): Mobile technology for community health

CORE Group mHealth Interest Group and Adam Slote, Senior Health Advisor, USAID

Professionally, many of us are intimidated by and/or dubious about the prospect of incorporating mobile phone technology into our community health programming. Yet we all have cell phones in our pockets. Why the disconnect? This interactive session will meld feedback from the Working Groups with the wisdom of the participants while tapping into the ìchecklist manifestoî craze. Sound zany? A crack team of mhealth advocates and experts will make sure no one gets hurt, and even distribute prizes.

Community Health and Mhealth

 

Boosting Nutrition through Integrated Programming

Judiann McNulty (Independent), Moderator ; Bethann Witcher Cottrell, Director, Child Health and Nutrition, CARE US ; Heather Danton, Senior Director, Livelihoods Program Integration, Save the Children ; Paige Harrigan, Advisor, Health and Nutrition, Save the Children

The session provided examples of proven program models and practices from a range of program settings that have demonstrated success in improving nutrition. By the end of the session, participants were able to: learn how  integrated approaches led to documented reduction of malnutrition in a variety of contexts.

 

SHOUHARDO: Making a Difference with Integrated Programming 

Bethann Witcher Cottrell, Director, Child Health and Nutrition, CARE USA

CARE Bangladeshís SHOUHARDO (Strengthening Household Abilities for Responding to Development Opportunities) Program aimed to “Sustainably reduce chronic and transitory food insecurity of 400,000 households in 18 districts of Bangladesh by 2009”. The SHOUHARDO Program, a Title II Development Assistance Program (DAP), funded through Food for Peace (FFP) and the Government of Bangladesh will close in May 2010. SHOUHARDO addressed not only the availability, access and utilization issues that lead to food insecurity, but also the underlying issues that contributed to vulnerabilities such as a lack of participation, social injustice, and discrimination that prevent people from realizing their full potential in leading healthy and productive lives.

Results from the final evaluation that examined the relationships between participation in SHOUHARDO interventions and achievement of the project outcome indicators were presented. With respect to children’s nutritional status, one of the most significant outcomes is the clear evidence that project interventions have contributed toward the strong reductions in stunting and underweight that have taken place over the life of the SHOUHARDO project.

SHOUHARDO CARE Bangladesh Evaluation FY2009

 

Reducing Malnutrition through Multi-sectoral Programming 

Heather Danton, Senior Director, Livelihoods Program Integration, Save the Children ; Paige Harrigan, Advisor, Health and Nutrition, Save the Children

Save the Children presenters drew from several program experiences and shared common lessons learned and outstanding gaps.

Boosting Nutrition Impact via Integrated Program Strategies

 

In Sync with Zinc 

Vicki MacDonald, Zinc Technical Advisor, POUZN Project, Abt Associates ; Cecilia Kwak, Child Health Program Manager, POUZN Project, Population Services International

POUZN Project Staff discussed the role of zinc in the treatment of childhood diarrheas, experience to date in implementing zinc treatment programs in a variety of country settings, introduced and discussed a number of tools created to collect both quantitative and qualitative data on zinc use and provider/caregiver/community agent behaviors, and presented results and lessons learned from both research data and program monitoring.

In Sync with Zinc

 

Community Health Systems: What are they really? Emily deRiel, Communications and Policy Manager, Health Alliance International ; Henry Perry, Johns Hopkins University, Bloomberg School of Public Health ; Andrea Wilson, Program Officer, Aga Khan Foundation

First came “health system strengthening.” Now comes “community health systems strengthening.” Is it simply an extrapolation of the “health system strengthening” ideas and methodologies? That was a trick question. It’s not. But what is it? Interested parties are trying to work that out, and this session offered participants a chance to find out what they are thinking and contribute to the process.

Working with the “institutional” health system: HAI’s model of health systems strengthening

 

Plenary

Hype or Help? Is community health ready for mHealth? (mHealth = mobile technology for health) 

Kerry McNamara, Independent Consultant, Scholar in Residence at the School of Communication at American University, Moderator

This session brought together key mhealth practitioners and other interested stakeholders to exchange implementation experiences in Community Health-related work.  The session worked to identify essential factors that contribute to successful implementation of community-based mhealth initiatives.  To strengthen the recommendations of ìbest practices, failures and troubleshooting techniques were also be discussed. After an introduction from Kerry that included a summary from the morningís concurrent session on mhealth, there were three presentations followed by interactive dialogue.

From Outreach Clinics to Households: How mHealth is helping to advance community health 

Patricia N. Mechael, Director of Strategic Application of Mobile Technology for Public Health and Development Center for Global Health and Economic Development. Earth Institute, Columbia University

As a world leader in the field of mHealth, Dr. Mecheal addressed issues of mobile adoption, design from the user perspective, women and mobiles, how Millennium Villages have harnessed mobiles to improve health outcomes, and what she sees as the future of mobile health.

YouTube Video: Millennium Promise (link pending)

Text Message Networks 

Josh Nesbit, Executive Director, FrontlineSMS:Medic

Josh showed participants how mhealth needn’t be overly complicated, expensive or daunting, through examples of how his organization has applied its products and ideas to improve health in Malawi, sub-Saharan Africa and Haiti.

mhealth – hype or help?

Initiating mHealth into a CSHGP in Afghanistan 

Carolyn C. Kruger, Senior Technical Specialist, International Programs Group, World Vision US ; Dennis Cherian, Director of Operations, Health and Hope, Resource Development and Management, International Programs Group, World Vision US ; Neal Lesh, Chief Technology Officer, D-Tree International

CommCare is a mobile-phone based application that enables community health workers to provide better, more efficient care while also enabling better supervision and coordination of community health programs. Neal Lesh will introduce CommCare and its adaptations. The World Vision team presented a new module of CommCare being introduced into World Visionís Afghanistan CSHGP as part of an Innovations Information Technology Operations Research study.

CommCare for WV BHAMC Child Survival Project

Golden Nuggets of the week (CORE Group’s version of  Pearls of Wisdom) and Closing Remarks 

Tom Davis, Chair, CORE Group Board of Directors, Director of Health Programs, Food for the Hungry

Golden Nuggets – Closing Remarks

Roundtable: SHOUT (Sustained Health Outcomes) 

James Ricca, Senior Sustainability & Tuberculosis Control Advisor, NGO/PVO Support Team, Maternal Child Health Integrated Project, ICF/Macro International

For participants who’ve been involved in using the Sustainability Framework (SF) in projects and want to share experiences. The presenters looked to have both old hands and new faces at the SHOUT (Sustained Health Outcomes) Sustainability Roundtable and talked about the Sustainability Page on the new MCHIP website, the more general ICF Macro CEDARS (Center for Sustainable Health and Development) website, some developments on sustainability outside of CSHGP, and the Sustainability Framework manual (Taking the Long View) and granteesí experience with it.

Roundtable:  Metrics and Evaluation of mHealth Activities: Teasing out the attribution of mobile technologies to the achievement of health outcomes 

Patricia Mechael, Director of Strategic Application of Mobile Technology for Public Health and Development, Center for Global Health and Economic Development, Earth Institute, Columbia University

In this session, key mhealth practitioners and other public health practitioners, specifically evaluation experts, came together to identify the contributions that mhealth has made towards improving health outcomes. Participants evaluated and expanded upon the metrics and evaluation practices and indicators from an mhealth M&E survey conducted in mid-April by the WHO and the Earth Institute, Columbia University. The outputs of this session will help shape a standardized framework for analysis and evaluation of mhealth initiatives and promote ìbest practices for mhealth programs.

Preliminary results from a survey on the use of metrics and evaluation strategies among mHealth projects