CORE Group Spring Meeting 2011

In by Marc Pitre

CORE Group’s Community Health Network hosted 217 participants from 94 organizations, making it our most extensive Spring Meeting ever. Plenary, concurrent and Working Group technical sessions took place from May 10-13, 2011, in Baltimore, Maryland.

A new program element added to the dynamic nature of this year’s meeting. As a partner on USAID’s TOPS project, CORE Group is overseeing the launch of the new Food Security and Nutrition (FSN) Network. By dovetailing an FSN Network event with our established Community Health Network
gathering, we were able to bring together a new set of stakeholders to explore the intersections of health, nutrition, agriculture, and more.

The FSN Network hosted its first Spring Technical Meeting on Monday, May 9. The next day, the Community Health Network scheduled topics of mutual interest to both the child survival and Title II communities. Participants and invited experts explored the roots of poverty, formative research in nutrition, and integration of gender, agriculture and nutrition in programs.

The meeting theme of equity reflects on the Community Health Network values of health for all. Several dialogue-based sessions explored the complementary equity themes of access and use, including how to: take successful approaches to scale, negotiate dense urban communities, strengthen as well as lengthen the reach of health systems through community health workers (CHWs) and technology, work with adolescents, use a rights-based framework, and engage the community.

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

Meeting Report
At-a-Glance Agenda

Program Agenda
Tuesday Sessions
Wednesday Sessions
Thursday Sessions
Friday Sessions


Tuesday May 10, 2011

Daily Facilitator: Diana DuBois

Plenary

Welcome & Overview

Karen LeBan, Executive Director, CORE Group
Judy Lewis, Haitian Health Foundation  Chair, CORE Group Board of Directors (BOD)
Mary Hennigan, Catholic Relief Services; Chair, BOD Nominations  Committee

A welcoming activity opened the meeting followed by an introduction to the meeting’s theme on equity in health and an update on CORE Group activities including membership trends, our new “associates”, the Food Security& Nutrition (FSN) Network and collaboration with TOPS, the Polio Project, the partnership with MCHIP, and Working Group accomplishments over the past year.  The CORE Group BOD presented CORE Group’s key directions and 2011 goals, followed by presentation of the 2011 BOD’s slate of candidates.

State of CORE Group- LeBan
BOD Directions- Lewis

BOD Candidates- M. Hennigan

Keynote Speaker

Anirudh Krishna, Professor of Public Policy and Political Science and Associate Dean for International Academic Program, Duke University, Author of “One Illness Away—Why People Become Poor and How They Escape Poverty”

Why does poverty persist? Anirudh Krishna’s presented his research which investigates how poor communities and individuals in developing countries cope with the structural and personal constraints that result in poverty and powerlessness. He has examined poverty dynamics at the household level, tracking movements into and out of poverty of over 35,000 households in 400 communities of India, Kenya, Uganda, Peru and North Carolina, USA.  Anirudh presented his Stages-of-Progress methodology and how his research can be used by NGOs and in addressing health equity issues.

One Illness Away—Why People Become Poor and How They Escape Poverty- Krishna

 

Lunchtime Roundtables

Nutrition Working Group (FSN & CHN)

Newcomer Lunch

Who are the Heroes Who Can Mobilize Americans Around Global Health

Mary Beth Powers, Campaign Chief, Newborn and Child Survival, Save the Children

Mary Beth Powers shared Save the Children’s efforts in partnership with the Ad Council to build an engaging campaign to get Americans to take an action on behalf of child survival through supporting frontline health workers. Powers also updated on the global efforts to influence the UN and policy makers around the world to close the gap in the health workforce.

What’s Happening on the Forefront of Care Group Implementation?   

Alyssa Davis, Health Advisor, Burundi, Concern Worldwide

Participants came together with Care Group practitioners to discuss new developments in the application of the Care Group Model. They shared recent experiences in Care Group implementation and learned about the innovative ways others are applying the Care Group Model. The discussion also focused on generating ideas for operations research across Care Group projects (e.g. measuring changes in social capital, health facility utilization gender based violence, respect for volunteers/women and MOH adoption of the model) as well as opportunities for collecting Bellagio or LiST data for projects using the Care Group Model.

The Care Group Model- Operations Research in Burundi_Davis

Concurrent Sessions

Revisiting Trials of Improved Practices Methodology

Joan Jennings, TOPS Nutrition & Food Technology Senior Specialist
Joy Miller Del Rosso, Senior Nutrition Advisor, The Manoff Group
Lilly Schofield, Evaluation and Research Advisor, Concern Worldwide Kenya
Elena McEwan, Senior Health Technical Advisor, Catholic Relief Services

Several recent examples were presented of the use of the TIPS methodology for pretest and development of the actual practices that a program will promote during implementation. TIPS is a formative research technique developed by The Manoff Group that was first used in the late 1970’s and early 1980’s in nutrition programming.  Over the past decade, it has been applied to many other public health issues.

Revisiting Trials of Improved Practices Methodology- J. Jennings
Introduction to the Methodology and its essential Elements- Rosso
Trials for improved practices for an urban IYCF program- Schofield

“Gender responsive programming” Changing men’s support to women during pregnancy, deliveries, and post partum- E. McEwan

 

CHWs on the Move

Fe Garcia, Senior MCH Advisor, World Vision International
Donna Bjerregaard, Senior Technical Advisor, Initiatives Inc
Laban Tsuma, Senior PVO/NGO Advisor, MCHIP
Karen LeBan, Executive Director, CORE Group

Participants selected one of three small groups to share their experiences, ideas, and concerns — CHW typologies, Components of a Community Health System, and an introduction to the CHW Functionality Tool (AIM) – and then reported back to the larger group with a moderated discussion on each of these themes accompanied by a synopsis of new developments.

CHWs on the Move- F. Garcia
Assessing and Improving CHW Programs- Bjerregaard
CHW AIM Toolkit Chances and Applications- Bjerregaard

CHWs on the Move- Tsuma
CHWs on the Move- LeBan

 

LQAS – Pitfalls, controversy & addressing concerns

Jennifer Winestock Luna, Senior Monitoring and Evaluation Advisor, MCHIP
Todd Nitkin, Senior Advisor in Monitoring and Evaluation and Representative for Washington DC, Medical Teams International
William Yaggy, Director of Institutional Giving, AMREF

The Lot Quality Assurance Sampling (LQAS) methodology is commonly used by community-oriented projects, especially among CORE members. Presenters discussed the pitfalls that can prevent you from using the information, the controversies surrounding the types of decisions made from LQAS information, and solutions for these issues.

LQAS – Pitfalls, controversy & addressing concerns- Luna, Nitkin, Yaggy

Urban Health

Paul Freeman, Clinical Assistant Professor, Department of Global Health, University of Washington
Marilyn Patton, Child Survival Advisor, HOPE worldwide
Concern Worldwide Video http://www.concernusa.org/Public/Program.aspx?pid=119

Urban Health is an increasingly important area of concern in meeting the MDG goals. This session shared resources and copies of presentations from multiple organizations. Paul Freeman provided an overview and conclusions from a day-long meeting on Urban Health at the 2009 American Public Health conference. Concern Worldwide shared a short video on their Bangladesh child survival project and share their Urban Health Model Toolkit.

Urban Health in Developing Countries- Freeman
The BRAC Manoshi Urban Maternal, Neonatal and Child Health Project in Dhaka, Bangladesh- Freeman
“Chotton Ki Asha” Hope for the little ones- Patton

 

Plenary

Equity and Nutrition through Agriculture

Judiann McNulty, Independent Consultant
Cheryl Jackson Lewis, Senior Nutrition and Health Advisor, Bureau for Food Security, USAID
Neha Kumar, Postdoctoral Fellow, IFPRI
Agnes Quisumbing, Senior Research Fellow, International Food Policy Research Institute (IFPRI).

Cheryl Jackson-Lewis described USAID’s Gender Informed Nutrition and Agriculture Alliance (GINA), an integrated agriculture and health program designed to improve nutritional outcomes of children under 5 that was tested successfully in Mozambique, Nigeria and Uganda. The program integrates the Essential Nutrition Actions framework into activities to promote improved farm management technologies and also builds market linkages for women’s groups and aims to influence national policies. The new Nutrition Collaborative Research Support Program will build further on these findings to identify agricultural development strategies that can also improve dietary quality and diversity and nutritional status.

Neha Kumar described IFPRI’s research findings from the Reaching End Users with Orange Fleshed Sweet Potato (OFSP) in East and Southern Africa project implemented by Harvest Plus in partnership with CORE members World Vision and Helen Keller International (and others) in Mozambique and Uganda. The project successfully expanded adoption of OFSP production and demonstrated significant increases in vitamin A intakes among children and women, making it a highly cost effective intervention by WHO metrics. A key factor in the success of OFSP dissemination was the critical role played by women both as caretakers and as producers and retailers of OFSP.

Agnes Quisumbing presented research from Bangladesh that explored the long-term impacts of improved vegetable and fish technologies on the nutritional status of vulnerable individual and household members among those adopting these technologies; and that revealed nutritional improvements and women’s long-term accumulation of assets were greater when these technologies were disseminated through women’s groups. She also described IFPRI’s Gender, Agriculture and Assets Project (GAAP), which is examining projects underway in multiple settings to identify optimal approaches for reducing gender gaps in asset access and ownership.

 Gender Informed Nutrition and Agriculture (GINA) Alliance & Nutrition Collaboration Research Support Program_ Lewis
Learning From Evaluation: The HarvestPlus Orange-Fleshed Sweet Potato Project in Mozambique and Uganda- Kumar

Evaluating the Long-term Impact of Agricultural Technologies in Bangladesh- Kumar, Quisumbing

Evening Session

USAID: New Directions and Opportunities 
Nazo Kureshy, Team Leader Child Survival and Health Grants Program
Ari Alexander, Director, USAID Center for Faith Based and Community Initiatives

The United States Agency for International Development (USAID) has embarked on an ambitious reform effort, USAID FORWARD, to change the way the Agency does business—with new partnerships, an emphasis on innovation and a relentless focus on results. It gives USAID the opportunity to transform its agency and unleash its full potential to achieve high-impact development. USAID FORWARD is a comprehensive package of reforms in seven key areas, and the evening reception provided an overview of USAID FORWARD as well as insights for key areas relevant to partnerships with NGOs. Several USAID staff  contributed to the discussion moderated by Nazo Kureshy.


Wednesday May 11, 2011

Daily Facilitator: Mary Hennigan

Plenary

Innovations-Investment Processes and Outcomes

Peter Winch, Professor and Director of the Social and Behavioral Interventions Program in the Department of International Health, Johns Hopkins Bloomberg School of Public Health
Donna Espeut, Maternal, Newborn and Child Health Specialist,  Concern Worldwide US
Nazo Kureshy, Team Leader, USAID Child Survival and Health Grants Program, Office of Health, Infectious Diseases and Nutrition, Bureau for Global Health, USAID
William Yaggy, Director of Programs  and Cudjoe Bennett, Former Program Technical Advisor, AMREF

The panelists presented the new focus on “innovations” from their different perspectives. Concern Worldwide US described its approaches and learning to date in generating innovative health solutions in three focus countries. They also describedn the different types of innovations currently being tested at a district level in each of the countries. Concern Worldwide US is executing a multi-country, multi-million dollar initiative to support the development and field testing of bold and inventive ways to overcome barriers to delivering proven maternal, newborn, and child health (MNCH) interventions. The initiative, known as Innovations for MNCH, engages both traditional and non-traditional players in health to find innovative MNCH solutions. They have just completed Phase One of the Project in Malawi, Sierra Leone and Orissa state in India, and shared their experiences and learning to date. They described their exciting new strategy to inspire and develop additional innovations that can be pilot tested at a district level.

USAID CSHGP described the process they have used since 2008 to fund innovations and how the types of innovations they have funded have evolved over the past three years.

AMREF will presented innovations, from their perspective, from their USAID-funded Busia, Kenya project.  They also provided a PVO perspective on innovation processes, and how they, as an organization, have been able to adapt to the innovations challenge and link with donors and field staff.

Innovations-Investment Processes and Outcomes- Winch
Listening to Unheard Voices, Exploring New Possibilities- Espeut

Child Survival and Health Grants Program: INGO led Innovation and Operations Research (2008-2011)- Kureshy

Concurrent Sessions

MCH Curricula: Strategies for Developing Effective Materials

Nicole Racine, long-term consultant, Infant and Young Child Nutrition (IYCN) Project-Haiti
Stephanie Martin, BCC Specialist, IYCN
Mitzi Hanold, Training and Curriculum Specialist, Food for the Hungry
Susana Mendoza Birdsong, Program Officer, Institute for  Reproductive Health

Speakers shared from their experiences in developing materials. (1) PATH will shared information, lessons learned and tools on pretesting, with specific examples form IYCN’s recent experience developing infant and young child feeding counseling cards in Haiti.  (2) FH shared the ASPIRE method used to increase participatory learning and the effective use of visual aids. (3) IRH demonstrated how images are used across training, provider and client materials to address lower literate population needs. IRH materials have gone through an evolution as they continue to be simplified. Through focus group testing and adaptation they have developed well-accepted and understood materials- but there are limitations.

Pretesting infant and young child feeding counseling cards in Haiti- Racine
Facilitation Cues for Effective BCC- Hanold
Developing and Testing Materials for Lower Lit and Direct-to-Consumer audiences- Birdsong

 

mHealth at the Community Level:  Recommendations for roll-out

Jeanne Koepsell, Community Case Management (CCM) Advisor, Save the Children
Adele Clark, HIV Program Specialist, Catholic Relief Services
David Isaak, Mobile Technology Consultant, SixBlue Data
Jonathan Jackson, Chief Executive Officer, Dimagi

Jonathan Dimagi has been rolling out its Commcare program with ASHAs in India, in partnership with a variety of organizations, including many CORE Group members. Jon provided some of the on-the-ground details, insights and practical advice for those interested in how one software program has been tailored to meet the needs of clients, health workers, implementers and the larger health system.

Focus on Acceptance. How do community workers feel about mhealth? David Isaak
As a community, we are often more comfortable dealing with human behavior than technology. But what happens when you mix the two? David focused on the technical and non-technical challenges that are often not considered during field-level planning and implementations, including the human factor.

Focus on Programming.  How can mhealth affect the lives of orphans and vulnerable children?
Catholic Relief Services and D-Tree International have created a specially designed tool to serve as a key component of a program that serves 40,000 orphans and vulnerable children in Tanzania. Implementation progress based on the tool was analyzed over a 3-week period using empirical data collection instruments, field observations, and focus groups. The findings are compelling, including recommendations which may hint at the next generation of mhealth dynamics.

Improving OVC programs with Mobile M&E: Operations Research Results- Clark
How do community workers feel about mHealth?- Isaak

Integrated Program Approaches to Support the Continuum of Transition from Adolescence to Youth to Young Adults

Sadia Parveen, Reproductive Health Specialist, ChildFund International
Judy Diers, Associate, Population Council
Gwyn Hainsworth, Senior Adolescent SRH Advisor, Pathfinder International
Beth Outterson, Director of Adolescent Health Programs, Save the Children

Adolescents and youth constitute over one-fourth of the world’s population. This is a vulnerable time in life; a stage when emerging young adults are exposed to often confusing and challenging new life experiences. Programs addressing the needs of adolescents and youth must address the transition between the life stages, from the child to the adolescent, from the adolescent to the youth, from the youth to the adult. Young people need the skills to communicate with and establish inter- and cross-generational relationships; adopt healthy behaviors; differentiate between the acceptable and unacceptable and the right versus wrong.  They also need to have the ability to adapt and adopt, deal with rejection and failure, and make adjustments in their lives that are driven by reality.

Building Assets for a safe, Healthy, and productive Transition to Adulthood- Diers
Women’s and Girl’s Empowerment program in Ethiopia- Hainsworth
Integrated Approaches for Save the Children’s experience- Outterson

 

Compensating and Retaining Community Workers

Ram Shrestha, Senior Quality Improvement Advisor, Community Health and Nutrition, URC
Molly Christiansen, Manager, Health Practices and Business, Living Goods
Adugna Kebede, CRS Malawi

How to best compensate and retain community workers continues to be a subject of intense interest. The panel members all have significant experience in implementing programs in the field using different financial incentive models. This session reviewed the good, bad, and ugly of each approach, and then turned it over to the audience to identify ways to qualify where each type of incentive may work best.

An Entrepreneurial Solution for Improving Community Health- Christiansen

Lunch Sessions

Pathways to Sustainability

Karen LeBan, Executive Director, CORE Group
Eric Sarriot, ICF Center for Design and Research in Sustainability

CORE Group is developing a mixed-method study of sustainability with ICF Macro’s CEDARS Center entitled “Pathways to Sustainability” for which we plan to seek funding. This study will measure post-project sustainability, and aim for enough power to demonstrate the value of key project and local determinants of sustainability. We will also strive to qualitatively analyze the complex processes which are at play in post-project/post-investment periods.  We think this study can be a key element in informing the future of health system strengthening, by providing evidence for and intelligence about the value of community-based approaches, in a context of increasing global initiatives.

FP Integration via Social and Behavior Change 

Leah Elliot, Flex Fund
Carol Hooks, CORE Group

Presenters discussed the creation of a new training module to build NGO capacity to employ social and behavior change (SBC) methods to support family planning (FP) integration. The session covered questions such as: What is the best training format for such a tool? What aspects of SBC and FP Integration should serve as the foundation or framework? Instructional design consultant Carol Hooks will be there to learn from you.

Concurrent Sessions

Scaling-up GBV Interventions using Organizational Barrier Analysis

Jayme Cloninger, Public Policy Consultant (Food for the Hungry), Campaign Organizer (Raising Hope for Congo) (The Enough Project);
Tom Davis, Senior Specialist for Program Quality Improvement (Food for the Hungry), Senior Specialist for Social & Behavior Change (TOPS Project)

During this session, participants heard the results of an “Organizational Barrier Analysis” study conducted with CORE Group member organizations to explore why some organizations measure and intervene in gender-based violence (GBV) and others do not. This methodology can be used to explore other organizational-level behaviors. Also discussed were the next steps for CORE Group member organizations and Working Groups to scale-up GBV interventions within child survival, food security, MCH, and other programs.

Scaling up GBV Interventions Using Organisation Barriers Analysis- Cloninger

Recent Findings from an Evaluation of the CORE Group Polio Project

Meg Lynch, Senior Program Officer, CORE Group Polio Project
Henry Perry, Senior Associate, Health Systems Program, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University
Dora Ward, Senior Technical Advisor, CORE Group Polio Project.

The CORE Group Polio Project (CGPP) is the second phase (2008 – 2012) of a global initiative to support polio eradication through cooperation with host governments and international and local organizations in Angola, Ethiopia, and India. In 2010, the CGPP conducted a household survey and key stakeholder interviews as a follow up to the baseline evaluation conducted at the start of the second phase in 2008. The session examined contributions of NGO-implemented community-based mobilization and capacity building support to the global polio eradication effort in high risk areas in the three project countries.  The session also focused on the comparison of outcome data between baseline and midline as well as perceptions arising from key stakeholder interviews of the project’s contributions to national and local polio eradication efforts. The session concluded with a discussion of findings, recommendations, and next steps.

CORE Polio: Integration in Practice_Lynch
Global Polio Eradication Initiative: Current Status- Perry

Mid-Term Evaluation of the Core Group Polio Project: Conclusions and Recommendations- Perry
CORE Group Polio Project Midterm Evaluation Results- Ward

 

Adapting HBLSS to Fit Your Program Needs: a moderated panel of NGOs with HBLSS implementation experience

Diana Dubois, WellShare International
Carolyn Kruger, World Vision
Judy Lewis, HHF
Suzanne Stalls, ACNM

HBLSS is a community mobilization tool that has been used in more than 15 countries to reduce maternal and neonatal morbidity and mortality during pregnancy and delivery in settings where facility utilization is low.  This panel was composed of representatives of several NGOs with experience implementing Home Based Life Saving Skills (HBLSS) in a variety of settings. The session included a brief overview including handouts of panelist program descriptions followed by a moderated discussion of successes and challenges focused on integration with existing or planned services, costs, implementation, and sustainability.

HBLSS-Karatu District Tanzania- DuBois
HBLSS Integration- Kruger
HBLSS Training is Fun- Lewis
HBLSS: An Overview of Methodology and Applications- Stalls

 

Addressing Anemia Full Spectrum

Luis Benavente, Director, Improving Malaria Diagnostics, Medical Care Development International (MCDI)
Rolf Klemm, Technical Director, USAID A2Z Micronutrient Project and Ass. Scientist, Johns Hopkins Bloomberg School of Public Health
Kim Koporc, Director, Children Without Worms
Beth Outterson, Director, Adolescent Health, Save the Children

 

Luis Benavente presented on the Bioko Island Malaria Control project implemented malaria prevention and improved diagnosis and case management, decreasing anemia prevalence among children and pregnant women.
Impact of Malaria Control activities on Anemia on Bioko Island, Equatorial Guinea- Benavente

Rolf Klemm provided an overview of maternal and child anemia, highlight recent scientific findings on the benefits of maternal iron supplementation, summarize key program implementation issues and examine opportunities for integrating approaches to reduce anemia in women and children.
Recent scientific findings, implementation issues and opportunities for integration- Klemm

Kim Koporc presented the results and next steps of an NGO Deworming Inventory.  Several CORE member organizations participated in the Inventory. The information they provided contributed to an increase in the number of treatments recorded by WHO’s preventive chemotherapy database for STH.
Results of the First Global NGO Deworming Inventory- Koporc

Beth Outterson gave brief overview of the background, purpose and activities planned for the adolescent girls’ anemia prevention project that Save the Children is currently developing in Bangladesh.
Addressing the Factors Affecting Education of Adolescents Girls in Bangladesh- Outterson

Working Group Time

M&E

Applying the Child Status Index to Measure OVC Program Effectiveness- Mutie

SBC

Nudge: Improving Decisions about Health, Wealth, and Happiness- Hanold


Thursday May 12, 2011

Daily Facilitator: Areana Quinones

Plenary

Taking a Human Rights-based Approach to Women’s and Children’s Health:  What would it mean and why should you care?

Alicia Ely Yamin, JD, MPH, Director, Program on the Health Rights of Women and Children, François-Xavier Bagnoud Center for Health and Human Rights, and Adjunct Lecturer on Health Policy and Management, Harvard University

At the same time as it is clear that sustained and equitable progress on women’s and child health requires more than adding funding to existing technocratic approaches, it is also clear that the concepts and principles of human rights law have not been adequately translated and operationalized to permit meaningful incorporation into development and health policy, programming and practice from the macro to the grassroots levels. This presentation explained the components of a rights-based approach to women’s and children’s health, including accountability, non-discrimination/equality, and meaningful participation, through concrete examples taken from the speaker’s years of experience with on-the-ground fieldwork.  It also exploree some tensions with mainstream health policies and programming in terms of implementation processes and indicators used for monitoring and evaluation.

Taking a Human Rights-based Approach to Women’s and Children’s Health:  What would it mean and why should you care?- Yamin

Concurrent Sessions

Considerations for Incorporating Health Equity into Project Designs:  A Guide for Community-Oriented Maternal, Neonatal and Child Health Projects – Learn how to apply this guidance to projects

Jennifer Winestock Luna, Senior Monitoring and Evaluation Advisor, MCHIP
Debra Prosnitz, Malaria Communities Program Advisor, MCHIP
Andrew Gall, Senior Latin America Project Coordinator, URC -CHS
Khrist Roy, Technical Advisor, Child Health and Nutrition, CARE
Alan Talens, Health Advisor, CRWRC

Are you interested in practical guidance for improving health equity in your programs?  CSHGP and MCHIP developed a guidance document with practical advice for including equity considerations in project designs.This sessions discussed the document and how it can be applied to both new and on-going projects. The discussion also included guidance, small group work applying the guidance, and presentations from PVO representatives about their experiences.

Considerations for Incorporating Health Equity into Project Designs- Luna
Health Equity in Practice:  Cotopaxi, Ecuador- Gall
Prides itself in never having being colonised- Roy
Closing the Gap by Design: Setting up a maternal Newborn Health Program as if people mattered- Talens

Newborn Health

Joseph de-Graft Johnson, Team Leader for Newborn Health, MCHIP
Joan Haffey, Consultant for HBB Program, CORE Group
Rebecca Nerima, Community Health Program Associate, CORE Group/Atlas Corps Fellow

This session focused on essential newborn care (ENC) and began with an overview of the components of ENC. Itdescribed a simplified neonatal resuscitation training package that is currently being implemented through a global development alliance. Components of the Helping Babies Breathe® (HBB) program, as described in its new Implementation Guide, was presented, so that participants could discuss their own efforts and/or pursue relevant HBB links to their own programs. Presenters emphasized linking interested participants with global, regional, and country level HBB resources for further discussion. Presenters also discussed a package under development of essential newborn action messages geared to pregnant women, families, and communities.

Helping Babies Breath Implementation: Where are we?- Johnson
ENA Gaps: Survey Results- Haffey, Nerima

Ready to Use? Ready to Integrate! Lessons in the Integration of CMAM and IMCI Activities

Serigne Diène, Senior Nutrition and HIV Advisor, FANTA-2
Rose Luz, Team Leader, Kabeho Mwana Child Survival Program in Rwanda, Concern Worldwide
Marie-Sophie Whitney, Senior Nutrition Advisor, Action Against Hunger (ACF)
Eric Swedberg, Senior Director Child Health and Nutrition, Save the Children

Malnutrition contributes to about half of all child deaths and yet the treatment of moderate or severe malnutrition is not fully incorporated into traditional IMCI models, beyond the provision of vitamins and micronutrients.  This session presented experiences in incorporating the community management of acute malnutrition (CMAM) approach into existing IMCI activities, both at the program level as well as with national government policies.

Integration CMAM into National Health Systems- Diene
Rwanda Expanded Impact Child Survival Program: Integrating CMAM with C-IMCI_Luz

Supporting CMAM Scaling Up- Whitney

Community Case Management of Severe Acute Malnutrition in Southern Bangladesh: An Operational Effectiveness Study- Swedberg

 

Non Communicable Diseases – The Unheralded Global Epidemic

Jeff Meer, Special Advisor, Global Health Policy and Development, Public Health Institute
Inoussa Kabore, Director of Strategic Information, FHI
Vivien Tsu, Director, HPV Vaccines Project; Associate Director, Reproductive Health, PATH
Charlotte Block, Program Officer, Global Health, Chronic Disease & Nutrition, Project Hope

Non-communicable diseases (NCDs), account for 60% of the world’s deaths with approximately 35 million people dying from them, of which 18 million are women. The four main diseases are cancer, cardiovascular disease, chronic respiratory disease and diabetes. Low and middle income countries are hit especially hard and are particularly vulnerable due to a variety of factors including rapid urbanization, dual disease burden with infectious disease, poverty and underdeveloped health systems.

Jeff Meer will gave an overview on preparations for the first-ever UN High Level Session on NCDs. Government delegations are meeting the world over offering a preview of their positions on this critical global health issue.  This presentation gave an overview of the global NCD environment, how the global health community is organizing to bring these issues to the forefront of the international health debate and how NGOs can become engaged.

PATH – Women-specific Cancers: Challenges and Opportunities
Vivien Tsu addressed cancer in the development context including PATH’s country programs. She covered the global disease burden, challenges for low-income countries, new opportunities to address these issues, next steps in programming and particularly what can be done in the context of MCHN.

FHI – Cardiovascular Disease (CVD): Integration with HIV/AIDS Health Care Services
Inoussa Kabore presented on FHI’s pilot programs to integrate CVD and cervical Cancer services with HIV/AIDS programs in Kenya, Nigeria with the goal to demonstrate the feasibility and effectiveness of CVD/HIV and cervix cancer/HIV service integration and assess CVD risks associated with HIV and ART in developing countries. He covered the current situation; lessons learned and how the intervention contributes to health systems strengthen.

Project HOPE – Diabetes: A Threat to Health and Human Development
Charlotte Block gave an overview of the global diabetes epidemic.  She reported on the prevalence of diabetes and its impact in low and middle-income countries, the challenges faced by lack of awareness, medications, and funding and how Project HOPE is addressing these issues through diverse country-specific approaches ranging from community awareness to training of medical professionals.

 Non Communicable Diseases – The Unheralded Global Epidemic- Meer
FHI”s Experience in Integrating Cardic Vascular Diseases (CVD) and Underlying Risk Factors Screening and Services into Existing HIV/AIDS Program- Kabore
Women-Specific cancers: Challenges and opportunities- Tsu
Project HOPE: Addressing Diabetes around the World- Block

 

Lunchtime Roundtables

Community-Based Social and Behavior Change for Family Planning

Adrienne Allison, Project Director, Birth Spacing Integration, International Programs Group, World Vision

New FP messages about Healthy Timing and Spacing of Pregnancy foster new alliances and partnerships within communities. The sessions covered the following questions: What is your experience in building support for FP using these messages among groups that previously did not support FP?  What are best practices?  What are the best approaches to introducing these new concepts to previously resistant people and groups?

MCHIP Update

Leo Ryan, PVO/NGO Support Team Leader, MCHIP

MCHIP is USAID’s Flagship Program for Maternal and Child Health, and CORE Group is an important MCHIP collaborating partner.  This roundtable covered MCHIP’s priority initiatives, country presence, new tools and resources, and opportunities for collaboration through the CORE Group.

Maternal and Child Health Integrated Program- MCHIP- Ryan

New ENA Training and BCC Tools Available through CORE Website

Agnes Guyon, Senior Child Health & Nutrition Advisor, JSI Research & Training Institute

The Essential Nutrition Actions (ENA) framework is an operational framework for managing the advocacy, planning and delivery of an integrated package of preventive nutrition actions encompassing infant and young child feeding (IYCF), micronutrients and women’s nutrition. The actions were all highlighted in the Lancet Series on Maternal and Child Undernutrition as having demonstrated impact.  Using multiple contact points, ENA targets health services and behavior change communication support (BCC) to women and young children during the first 1,000 days of life – from conception through the first two years of life – when nutrient requirements are increased, the risks of undernutrition are great, and the consequences of deficiencies most likely to be irreversible. The tools now available include the booklet of key messages, a training guide for health workers, and a training guide for community volunteers. French versions of these tools will also soon be available. Agnes Guyon has been one of the key champions of the ENA framework over the past 15 years.

 

Concurrent Sessions

Operational Research:  Methods, challenges, emerging lessons and opportunities

Florence Nyangara, PVO/NGO Support Team Research & Evaluation Advisor, MCHIP
Dennis Cherian, Deputy Director, Health and HIV, International Program Group, WVUS
Alyssa Davis, Health Advisor, Burundi, Concern Worldwide

This interactive session provided an opportunity for participants to share ideas, challenges, and lessons learned from implementing operations research to test innovations. The sessions included an overview of the OR studies conducted by Child Survival and Health Grants Program (CSHGP) innovation grantees followed by practical examples from two representatives  grantees. Common tips and traps for conducting operations research, based on the experiences of CSHGP Innovation grantees over the past 3 years. Two innovation grantees, World Vision and Concern Worldwide, presented their experiences in identifying and developing innovative solutions to overcome their program challenges, implementing OR studies to test the innovations, and the lessons they learned.

Operations Research: Methods, Challenges, Emerging Lessons, and Opportunities- Nyangara
Operations Research: Methods, Challenges, emerging Lessons and opportunities- Cherian
The Care Group Model: Operations Research in Burundi?- Davis

Community Case Management Updates & Improvements

Dr. Serge Raharison, Child Health Technical Officer, MCHIP
Sarah Andersson, Country Technical Manager, SC4CCM Project, JSI Research & Training Institute, Inc.
Shannon Downey, Community Health Program Manager, CORE Group

Community case management (CCM) is one promising approach to reducing childhood mortality; however, evidence shows that CCM is hampered by inconsistent availability of appropriate, quality and affordable medicines. The Improving Supply Chains for Community Case Management (SC4CCM) Project is a learning project focused on finding affordable, simple, and sustainable supply chain solutions that address the unique challenges of community health workers. The project works in three sub-Saharan countries: Malawi, Ethiopia and Rwanda. The first activity of the SC4CCM project was to conduct baseline assessments, in collaboration with the MOH, to gather information on the current status of the CCM supply chain, and identify opportunities for testing innovative supply chain strategies that may significantly impact product availability. Please join us for a presentation of key findings from the baseline assessments and the proposed intervention strategies for these countries to address the findings.

CCM Benchmarks, framework and indicators as a tool for documenting country programs- Raharison
Supply Chains for CCM: Preliminary Baseline Results and SC Intervention Areas- Andersson

Practical Family Planning Integration – What does it really mean?

Jennifer Bergeson-Lockwood, Technical Advisor, Community-based Family Planning; Global Health Fellow, USAID
Linda Bruce, Director, Building Actors and Leaders for Advancing Community Excellence in Development (BALANCED) Project
Victoria Graham, Senior Technical Advisor, Bureau of Global Health, USAID;  Rebecca Levine, MCHIP
Sadia Parveen, Reproductive Health Specialist, Child-Fund
Winnie Mwebesa, MCHIP

What are potential entry points to integrate family planning into existing health and development programs?  How do family planning integrated programs work in the field?The focus of this dynamic panel is practical FP integration – discussing how programs integrate FP in the field. The session features a panel of integration experts who will offer three different examples of approaches to FP integration. This session will include time for questions and contributions of other examples from the audience, as well as a brief review of the CBFP materials and resources available.

Practical Family Planning Integration: What does it really mean?- Lockwood
Reaching the hardly Reached with Integrated Approaches- Bruce
Zambia Family Planning Integration Project: Integrating MNCH into Programs- Praveen
Integrated approach to deliver MNCH-FP-Nutrition services- Mwebesa

 

Influencing the Influencers

Catherine Taylor, Global Program Leader, Maternal and Child Health and Nutrition, PATH
Leah Sawalha Freij, Senior Advisor on Gender, Extending Service Delivery Project/IntraHealth
Kiersten Israel-Ballard, Technical Officer, Maternal and Child Health and Nutrition, PATH
Lisa Mueller, Program Officer, PATH
Altrena Mukuria, Senior Country Program Specialist, Infant & Young Child Nutrition Project

 This session exploreed the power of involving community influencers to change health behaviors. Panelists from different organizations discussed effective strategies for identifying and engaging influential community members in global health programs. They presented research, lessons, and results from activities that have successfully influenced key influencers such as grandmothers, men, and community group leaders to improve infant and young child feeding practices, increase access to family planning services, and address gender inequities.

Mobilising Muslim Religious Leaders as RH/FP “Champions”- Sawalha
Infant Feeding Buddies: Strategies for supporting mothers for Optimal Inafnt and Young Child Feeding- Israel-Ballard
Engaging grandmothers and men: a family-focused approach- Mukuria

Working Group Time

Community Child Health and Malaria – Joint

Roll-out of RDTs to CHWs in Ngoma District, Rwanda
Anne Langston, Health Coordinator, International Rescue Committee Rwanda

RDTS were first introduced in Ngoma district in November 2010. Early data shows good uptake and a positivity rate in the expected range.  CHWs appear to be using the RDTs appropriately.  How their use will change community behavior remains to be seen.

Piloting CCM in Nimba County Liberia: Preliminary Results from EQUIP Liberia
Debra Prosnitz, Malaria Communities Program Advisor, MCHIP

Malaria Communities Program (MCP) EQUIP Liberia is one of three partners implementing a NMCP supported pilot of integrated community case management in Liberia. In April 2011 NMCP conducted an evaluation of the three CCM pilots. This sessions will share preliminary results, best practices and lessons learned from EQUIP’s pilot.

HIV/AIDS

Going Beyond the Buzz Word:  Building Sustainability in OVC Programming in Kenya
Facilitated by HIV/AIDS WG Co-Chairs Janine Schooley, Project Concern International and Shannon Senefeld, Catholic Relief Services
Roger Mutie, World Concern

This session included a highlighted presentation “Laying the Foundations for Sustainability: the ‘how’ and ‘why’ behind sustainable outcomes from an OVC care and support project in Kenya” by Rogers Mutie, World Concern. Rogers summarized the findings from an evaluative case study World Concern Development Organization (WCDO) undertook in Kenya in March 2011 to understand the factors that contributed to sustainability of its USAID/PEPFAR funded OVC Care and Support Project, which recently concluded following a 6 year project.

Laying Foundation for sustainability. The “how” and “why” behind sustainable outcomes resulting from an OVC Care and support in Kenya- Mutie

TB

How the community can be involved in treatment of TB and MDR-TB patients_Golubkov


Friday May 13, 2011

Daily Facilitator: David Dyjack

Plenary

Maternal Health Innovations

Catherine Carr, MCHIP
Abdelhadi Eltahir, Senior Advisor for Maternal and Newborn Health,  Pathfinder International
Alisha Graves, Senior Program Manager, Venture Strategies Innovations
James BonTempo, Learning Technology Advisor, MCHIP

Innovations to improve maternal, newborn and child health are a necessity and new tools must be developed to meet a wide range of challenges and risks that lead to maternal, newborn and maternal deaths. Postpartum hemorrhage (PPH) is the leading cause of maternal deaths worldwide and more than 25 percent of all maternal deaths are caused by PPH. Many mothers die within two hours from onset of the PPH due to delays in seeking health care services in a timely manner.
The presentations highlighted some innovative interventions and new technologies, including the appropriate use uterotonics including Misoprostol, and the use of Non-Pneumatic Anti-Shock Garments (NASGs).

Bon Tempro also presented on mobile and web technologies that are emerging mHealth areas used to improve maternal health. For instance, technologies such as SMS text messaging provide mothers, health care workers, and institutions with up-to-the-minute information critical to saving lives.

Prevention and Management of PPH: Utilizing Uterotonics and the Non-Pnematic Anti-Shock Garmet (NASG)- Eltahir
Protecting mothers from PPH at home births with misoprostol- Graves

Paradoxes of mHealth- BonTempo

Plenary

2, 4, 6, 8 Let’s Use Platforms to Integrate!

Steve Hodgins, Global Leadership Team Leader, MCHIP
Janine Schooley, MPH, Senior Vice President for Programs
Dora Ward, Senior Technical Advisor, CORE Polio Project, CARE

The session opened with a brief overview of “integration” followed by a focus on “platforms” as a way of achieving greater integrated programming. The specific examples of MCHIP and the CGPP were featured. Challenges with measurement of integration using platforms for multiple interventions were outlined.

Integration: What do we mean- Hodgins