CORE Group Spring Meeting 2013

“Capacity Strengthening for Global Health: Partnerships, Accountability, Integration, Learning (PAIL)”

 

Meeting Report
At-A-Glance Agenda
Program Booklet
Monday Pre-meeting Presentations
Tuesday Presentations
Wednesday Presentations
Thursday Presentations
Friday Presentations

 

CORE Group extends a very special thank you to our Spring Meeting 2013 Event Sponsors:

Gold Sponsor

Gold Sponsor

Bronze Sponsor

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Monday, April 22, 2013

Pre-Meeting Sessions

Understanding Why, When, and What It Will Take To Do Scientifically Sound Operations Research (OR) in Your Program

Wednesday, April 24, 2013

Power Breakfast Roundtables

Power Breakfast Roundtables provided attendees with four 25-minute opportunities to network, promote and learn about 18 various projects, topics or tools. Please note, most roundtables did not include a powerpoint presentation.

Development: What Is It and How Is It Acheived?-Henry Mosley

Plenary

State of CORE Group

Karen LeBan, Executive Director, CORE Group

Karen provided an update on CORE Group strategic planning, membership trends, and activities. She also shared highlights from CORE Group’s collaboration with TOPS, MCHIP, and CGPP.

State of CORE Group- LeBan

Lunch Roundtables

Massive Open Online Courses

Henry Perry, Senior Associate, Department of International Health, Johns Hopkins Bloomberg School of Hygiene and Public Health

Dr. Perry recently taught a course in January on Coursera (a MOOC, or massive open online course) on Health for All through Primary Health Care, for which 15,000 people around the world registered. In the session, he described the course and share his experience in teaching it. The course will be re-taught beginning on May 29th and again in October.

Momentum is Building Fast! CHW Principles of Practice (PoP) 

Fe D. Garcia, Sr. Advisor, Child and Adolescent Health and Development

Fe introduced PoP and invited participants to participate in shaping the draft CHW Principles of Practice.

Program Strategies to Reduce Post-Partum Hemorrhage and Pre-Eclampsia/Eclampsia: A Practical Review of Research Findings

John Varallo, Maternal Health Senior Technical Advisor, MCHIP/Jhpiego
Khatidja Naithani, Program Officer, MCHIP/Jhpiego; Rehana Gubin, Global Health Practice and Policy Research Technical Advisor, MCHIP/Jhpiego

Post-partum hemorrhage (PPH) and pre-eclampsia/eclampsia (PE/E) continue to be leading causes of maternal death in developing counties. The MCHIP maternal health team recently published the findings from two integrative reviews in the journal BMC Pregnancy and Childbirth. The first review examined the safety of magnesium sulfate in the management of PE/E. The second review examined program strategies to reduce PPH through distribution of misoprostol for use at home birth. This presentation discussed the review findings and highlighted steps that participants can take to incorporate these lessons into country programs.

Program Strategies to Reduce Post-Partum Hemmorhage and Pre-Eclampsia- Varallo, Naithani, Gubin

Working People’s Health: Integrating Workplace Health into Primary Health Care

Sarah Shannon, Executive Director, Hesperian Health Guides

The impact of work (where most of us spend the greater part of our waking hours) on physical and mental health is often considered to be outside the realm of primary health care. However, without a concept of health that includes work as a primary determinant, working people in urban, peri-urban, and rural communities have few tools to understand and take action on workplace conditions and chemical exposures that greatly impact their health and wellbeing and that of their families. Sarah shared experiences of promoting workers’ health both inside and outside the workplace, and of working to integrate workplace health into community-based primary health care programs.

Concurrent Sessions

PD/Hearth: Alive, Well, and Getting Better

Melanie Morrow, Director of Maternal Child Health, World Relief
Diane Baik, Nutrition Technical Advisor, World Vision Center of Expertise
Hazel Simpson, Deputy Chief of Party, WALA Project, Catholic Relief Services Malawi
Jennifer Burns, Nutrition Technical Specialist, Counterpart International

Since it was popularized twenty years ago, PD/Hearth has been implemented by many PVOs in a many contexts with varying degrees of success. PD/Hearth has three goals: behavior change, sustainability, and recuperation, but success has been almost exclusively measured by recuperation rates. Large reviews or evaluations of PD/Hearth raised concerns about quality of implementation, impact on population-level behavior change, and the level of staff involvement which impeded taking the approach to scale through government health services. As evidenced by the recent Nutrition Working Group survey, many NGOs have persisted with PD/Hearth, making adaptations and creating solid processes to assure capacity and minimize labor intensity. This session reviewed recent experiences showing that PD Hearth has great potential for enhancing improvements in infant and young child feeding practices when implemented in conjunction with other health and nutrition promotion approaches.

PD Hearth and Nutrition Weeks in Rwanda- Morrow and Kabadege
PD Hearth: Alive, Well, and Getting Better

Forget Focus Group Discussions: Alternative Methods to Understand Community Realities

Lenette Golding, Senior Technical Advisor in Social and Behavior Change Communication, CARE

Using a combination of lecture, discussion, and practice, this session engaged participants to learn and apply participatory research methods for the development and implementation of health programming. The session started by briefly covering the theoretical underpinnings of participatory research as well as the role that participatory research can play in developing and implementing health programming. Participants evaluated participatory research activities that can be used in different situations and for different research objectives. Participants also had the opportunity to work in teams and practice participatory research activities and analyze the results produced by their efforts.

Forget Focus Group Discussions- Golding

Mars vs. Venus II: Leveraging NGO-Corporate Partnerships for Health in Developing Countries

David Wofford, Director, RAISE Health Initiative, Meridian Group
Joe Miklosi, Director of Government Relations, Project C.U.R.E.

Public Health often views itself as operating in a different universe from corporations and private workplaces. While public-private partnerships have assumed an increasingly important role in development projects, there remain large opportunities to maximize corporate partnerships to improve health conditions in the developing world. Joe Miklosi of Project C.U.R.E. and David Wofford of Meridian Group International, Inc. presented two models of leveraging private resources for your projects and integrating corporate social responsibility standards into health systems strengthening initiatives.

Mars vs. Venus II- Wofford & Miklosi

Trauma-Informed Community Health Workers

Elaine Zook Barge, STAR Director, Center for Justice and Peacebuilding, Eastern Mennonite University

In times of disaster, disease and conflict, communities worldwide are impacted by trauma, pain and violence. Trauma affects how we think, feel, and behave and unhealed trauma often leads to more violence as victims act out against others or become self-destructive. This workshop addressed the impact of trauma on the body, brain and behavior of individuals and communities and highlight some processes for addressing trauma, breaking cycles of violence, and building resilience which are part of the STAR (Strategies for Trauma Awareness and Resilience) Model which will be introduced.

The STAR Model provides an integrated bio-psycho-social-spiritual framework that can be used by community health workers, teachers, clergy, government leaders, lawyers, or medical and mental health professionals who are working with individuals and communities on the immediate and long-term effects of trauma.

Parul Christian, Professor at the Johns Hopkins Bloomberg School of Public Health Department of International Health (and the Department’s Center for Human Nutrition).

The Nutrition Working Gorup joined tthe Safe Motherhood and Reproductive Health Working Groups to hear about how prenatal nutrition is connected to “fetal programming” or long-term metabolic and health outcomes. Some are terming this connection “epigenetics;” it has also been referred to as “the Barker Hypothesis;” An update was also provided on major country-level and research activities USAID’s global flagship nutrition project is conducting.

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Thursday, April 25, 2013

Plenary

Sustainability and Accountability: Of What? To Whom? How Do We Know When We Have It?

Janine Schooley, Senior Vice President for Programs, PCI
Eric Sarriot, Director, Center for Design and Research in Sustainable Health & Human Development (CEDARS), ICF International
Patricia Murray, Program Associate for Health, Plan International USA

Sustainability has long been one of those words that is used more than it is understood, that every proposal for funding has to address, but that very seldom gets measured. During this session, PCI, Plan USA and CEDARS made the argument that testing for sustainability, both during and post projects, is essential for achieving lasting impact. The session engaged participants in thinking through how best to test for sustainability and how best to overcome challenges and constraints related to sustainability and its measurement. Participants also strategized on how best to attract resources to be able to do more sustainability testing, especially post project.

Post-Project Sustainability Study- Schooley
Testing for Sustainbility: Lessons from the Post-Intervention Study in Taita-Taveta District, Kenya- Murray

Concurrent Sessions

Measuring Local Capacity Strengthening: The Good, the Bad, and the Ugly

Carol Underwood, Senior Research Advisor for Research and Evaluation, Johns Hopkins Center for Communication Programs
Carol B. Makoane, Technical Officer for HIV/AIDS Programs, Project Concern International

Local ownership and decision-making are essential elements of effective development. How do you define ownership, and how do you have contributed to improving it? How to incorporate local ownership and decision-making from the program-design phase? What are good examples to learn from? In this session, participants learned from two different LCS measurement experiences, and engaged in group work to further identify the most common barriers, pitfalls and dilemmas and recommendations for measuring capacity and its impact.

Community Capacity: Means to Improved Health Practices or an End-in-Itself- Underwood
Building Bridges Between Civil Society and Governement Through Capacity Building of the CSO Sector: Experience and Results from Botswana- Makoane

Strengthening and Expanding iCCM

Paul Freeman, Clinical Assistant Professor, Dept. Global Health at University of Washington
Alfonso Rosales, Maternal & Child Health Technical Specialist, World Vision
Yves Cyaka, Malaria and Child Survival Technical Advisor, Population Services International

Presenters in this session illustrated key findings and tools in expanding iCCM, including the case-control EOP evaluation of the USAID funded iCCM project implemented in rural Benin by Management Sciences for Health (MSH), July 2009 to 2012; the development process of developing the various tools, a description of them, and preliminary results on the applicability of tools among illiterate CHWs; and the expansion efforts and share preliminary results from an endline study that measured impact on child mortality.

EOP Evaluation of BASICS iCCM Project Benin 2009 to 2012- Freeman
Integrating Newborn Interventions into Community Case Management in rural South Sudan- Rosales
CIDA CCMImpact Project: Cameroon- Cyaka

Innovation and Integration: How mHealth Can Strengthen the Work of CHWs

Sarah Shannon, Executive Director, Hesperian Health Guides
Gwyn Hainsworth, Senior Advisor for Adolescent Sexual and Reproductive Health, Pathfinder
Eric Silfen, Chief Medical Officer, Philips Healthcare
Marie Solange Ngueko, CIDA Program Coordinator, ACMS/Population Service International Cameroon
Kelly L’Engle, FHI360 (Moderator)

This session will provided an overview, and examples, of the different ways that mHealth tools can support CHWs  — ranging from data collection, clinical decision support, content delivery, training, and telemedicine. Presenters shared successes and challenges in implementing a variety of mHealth tools into projects that build capacity of CHWs and other frontline health workers.  An interactive discussion among participants and presenters explored the potential and channels to integrate mHealth activities into community-based health programs and information systems.

Innovation and Integration: How mHealth Can Strengthen the Work of CHWs- Shannon
Leveraging Mobile Technology to Strengthen the Work of Community Health Workers- Hainsworth
Innovation and Integration- Silfen
mHealth- Ngueko

Lunch Roundtables

PowerPacked PowerPoint Presentations

David Marsh, Senior Advisor, Save the Children

This session included an introduction to and demonstration of a “self-instructional” slide-deck that illustrates 50 tips plus questions and answers to share experience.

PowerPacked PowerPoint- Marsh

Approaches to Improve Malaria Outcomes through Changing Knowledge, Attitudes, and Behavior: Evidence, Information gaps, and Recommendations for the Future

Debra Prosnitz, Program Manager for Malaria Communities Program and Technical Advisor for CSHGP, ICF International

This roundtable presented the results of an analysis of a select group of CSHGP projects, which examines the comparability of malaria-specific quantitative data and availability and depth of qualitative data to determine whether outcomes and impact of behavior change communication strategies and messages can be systematically assessed across the larger portfolio of projects. Gaps in information and recommendations for improved data collection and reporting were summarized.

A Review of the Approaches to Improve Malaria Outcomes through Changing Knowledge, Attitudes, and Behavior in USAID’s Child Survival and Health Grants Program- Prosnitz

K4Health Family Planning Advocacy Toolkit Focus Group

Adrienne Allison, Project Director, Birth Spacing Integration, World Vision
Elizabeth Futrell, Technical Writer, Knowledge for Health, Johns Hopkins Center for Communications Programs

Participants were introduced to the first “field trial” of the newest K4Health Toolkit on Advocacy for Family Planning.

Adolescent Health

Mychelle Farmer, Technical Advisor for Health and HIV, Catholic Relief Services
Beth Outterson, Advisor, Adolescent Health, Save the Children

The adolescent health lunch roundtable discussed our existing project assessing adolescent health programs within CORE Group and proposed new projects for the coming year. Please join us if you share our desire for innovative approaches to adolescent health in the context of CORE Group programs.

Concurrent Sessions

Newborn Health

Steve Wall, Senior Advisor for Technical Support, Save the Children/Saving Newborn Lives

Participants learned about new secondary analysis of Saving Newborn Lives research highlighting how local care-seeking behaviors influence the design, implementation and potential effectiveness of implementation.  Participants also discuss newborn health approaches related to participatory community approaches, equity, private sector, and scale-up.

Care Seeking for Newborn Illness: A Changing Paradigm?- Steve Wall

Environmental Enteropathy: Going Beyond Nutrition to Understand Child Growth and Development

Laura Smith, PhD Candidate, Cornell University
Julia Rosenbaum, Behavior Change Specialist, FHI360
Renuka Bery, WASH integration Specialist, FHI 360

Infants and young children in low income countries are frequently ingesting high quantities of fecal bacteria and pathogens through mouthing soiled fingers and play items, and soil and poultry feces in the environment. Frequent childhood infections from such exposures affect mother-child interaction and child feeding behavior, with cumulative negative consequences on growth and development. Recent evidence suggest that chronic fecal-oral transmission of pathogenic and non-pathogenic microbes inflame the small intestine mucosal lining and result in a highly permeable gut, with impaired barrier and absorptive functions, and subsequent  chronic immune stimulation. Evidence is mounting that these processes contribute to stunting and may also cause anemia, both well-described risk factors for deficits in child development. A feces free environment is critical to reducing exposure to pathogenic microbes. This session examined the results of fecal-oral transmission to small children, and explored solutions to addressing this problem. Presenters highlighted community-led total sanitation, explored interventions to provide a clean play and infant feeding environment and discussed the required behavior change and appropriate technologies, designed for rugged environments and conducive to increase child protection without limiting infant play and exploration.

EE: Going Beyond Nutrition to Understand Child Growth and Development- Smith
Total Sanitation- Rosenbaum
A Day in the Life- Bery

Highlights from FY 2012 Final Evaluations of Three CSHGP’s Operations Research Projects

Elena McEwan, Senior Health Technical Advisor, Catholic Relief Services
Jennifer Nielsen, Senior Program Manager for Nutrition and Health, Helen Keller International Dennis Cherian, Acting Senior Director, Health and HIV, World Vision
Florence Nyangara, Senior Research and Evaluation Specialist; MCHIP/ICF International (Moderator)

This session featured three Child Survival and Health Grants Programs that conducted Operations Research studies since FY2008 through FY 2012/13. The projects were funded by USAID for five-years to test innovative solutions to overcoming programming barriers for the uptake of high impact maternal, newborn, and child health interventions. The studies were conducted in Nicaragua, Nepal, and Afghanistan by CRS, HKI, and World Vision, respectively. The presenters presented their findings and how they were achieved.

AAMA Operations Research Process: 2008-2012- Nielsen

Write Better First Drafts and Save Time! Tips for Forceful Writing

David Marsh, Senior Advisor, Save the Children

Ever since earning a MINUS 20 on his first sophomore writing assignment in high school, David Marsh has strived (striven?) to improve his writing. Now he thinks he can improve others’ writing. Come and see.  This session will be an interactive presentation with time to practice editing and writing, applying the suggested guidelines.

Grammar?- Marsh
Grammar for Qualitative Statements- Marsh
Quiz- Marsh

Heroes, Tools, and the Community “Link”

Mary Beth Powers, Chair, Frontline Health Workers Coalition
Sarah Shannon, Executive Director, Hesperian Foundation
Gloria Ekpo, HIV/AID Technical Specialist, World Vision

This workshop introduced participants to some innovative efforts to develop greater recognition and appreciation of the lifesaving care that health workers provide around the world, including the REAL Awards and World Health Worker Week. Participants learned about the World Health Worker Week engagement toolkit that provides guidance on ways to mobilize communities, partners, and policy makers in support of frontline health workers. This session also provided an overview of the writing and design strategies used by Hesperian to create accessible health information for CHWs, focusing on the use of images in Hesperian materials which are critical for low-literacy audiences and trainings across languages, in particular.

Frontline Health Workers- Powers
Innovations for Developing Low-Literacy Materials to Empower Community Health Workers- Shannon
Making the Community “Link”: Experience from the Community Linkages Project in Swaziland- Ekpo

Early Childhood Development

Nicole Richardson, Early Childhood Development and Orphans and Vulnerable Children Specialist, Save the Children
Julia Rosenbaum, Deputy Director and Senior Behavior Change Specialist, WASHplus Project/FHI360
Antony Duttine, Rehabilitation Technical Advisor, Global Health , Handicap International
Patricia Murray, Program Associate for Health, Plan International; Hanna Jamal, Program Associate, Plan International
Shannon Senefeld, Global Director of Health and HIV, Catholic Relief Services

This session shared promising practices in ECD programming and also encouraged practioners to think about new and innovative ways to address ECD. The session included four presentations covering 1.) the Essential Package; 2.) Integrating WASH, Nutrition andECD; 3.) ECD and Disabilities; and 4.) ECD, Disabilities, and Emergencies.

The Essential Package- Richardson
Why WASH, Nutrition, and ECD Matter- Rosenbaum
Early Childhood Development: Are we Failing When it Doesn’t Happen?- Duttine

But We Will Always Be Here!  How to Assure Sustainable Benefits after Food Aid Programs Shut Down

Beatrice Rogers, Professor of Economics and Food Policy, Friedman School of Nutrition Science and Policy, Tufts University

This session reported on the results of a four-country study assessing the sustainability of program activities and impacts after the programs themselves shut down.  The study was done in Bolivia, Honduras, Kenya, and India, and focused on the Title II Food for Peace programs that were terminated around 2009 as a result of a change in policy that restricted Title II programs to a limited set of high priority countries. The field work incorporated three rounds of qualitative interviews with key stakeholders (beneficiaries, local partners, community based organizations, people involved in the supply chain for agricultural products…) at the time of program exit and each year for the next two years, and a quantitative survey in each country which replicated the end line evaluation two years later, to provide quantitative estimates of program impact indicators two years after the programs ended.

But We Will Always Be Here- Rogers

No Longer Hidden: Putting Youth at the Center of the Post-MDG Agenda

Mychelle Farmer, Technical Advisor for Health and HIV, Catholic Relief Services
Beth Outterson, Advisor, Adolescent Health, Save the Children
Elizabeth Berard, Youth Advisor, USAID

This session focused on recent developments in adolescent health. The session started with panel presentations about the relationship of adolescent health to the post-MDG agenda, followed by a discussion to enhance our understanding of global policies in health and development, as they pertain to youth. Participants learned about the gaps in our global database in adolescent health, and engaged in small group discussions that will assist CORE Group to develop key messages that promote adolescent health within the post-2015 agenda.

Adolescent Health- No Longer Hidden- Farmer
The Incomplete Puzzle- Emerging Data on Adolescent Health- Outterson
USAID Policy on Youth in Development- Berard

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Friday, April 26, 2013

Plenary

A Promise Renewed and Emerging Global Health Priorities

John Borrazzo, Maternal and Child Health Division Chief, USAID

Since the 2012 global Call to Action event to End Preventable Child Deaths,172 countries have signed the A Promise Renewed pledge to accelerate declines in child deaths, reducing under-5 mortality to 20 or fewer under-five deaths per 1,000 live births, for every segment of society, by 2035. More than 400 civil society and faith-based organizations and more than 2,000 individuals have already pledged support. In this session, John discussed USG commitments to the pledge and other emerging USG global health priorities.

What’s Happened Since the Child Survival Call To Action- Borazzo

Ending Preventable Maternal and Newborn Death: the Global Newborn Action Plan and the USAID Maternal Health Strategy 

Lily Kak, Senior Advisor, Global Partnerships and Newborn Health, USAID
Mary Ellen Stanton, Team Lead, Maternal Health, USAID

The speakers presented the highlights of the evolving Global Newborn Action Plan and USAID’s draft Maternal Health Strategy including the strategic shifts and global targets proposed in these strategic documents. The audience had the opportunity to reflect and comment on these strategic shifts and targets through interactive small group discussions that focused on a few key questions posed by the speakers.

A Bold Endgame: Ending Preventable Maternal Deaths Worldwide by 2035- Mary Ellen Stanton
Global Newborn Action Plan- Kak

U.S. Government Action Plan on Children in Adversity: New Science for Old Problems

Neil Boothby, U.S. Government Special Advisor and Senior Coordinator to the USAID Administrator on Children in Adversity, USAID

The first-ever strategic guidance for international assistance for children, the U.S. Government Action Plan on Children in Adversity draws on new scientific advances to help protect and nurture the world’s most vulnerable children. Neil discussed how the Action Plan establishes a clear link between children’s wellbeing and the social and economic progress of nations. The Action Plan also recognizes that the roots of successful adulthood and productive communities are sown in the early years of life.

US Government Action Plan for Children in Adversity- Boothby

Highlights and Closing Remarks

Judy Lewis, Haitian Health Foundation and Chair, CORE Group Boardof Directors

Judy summarized at the end of the meeting, six learning outcomes essential to capacity development were discussed throughout the meeting. Raised Awareness and Enhanced Skills were linked to the “Altered Status” of mental health, child development, workplace health, and respectful maternal care. Improved Teamwork and Fostered Networks resulted in “Altered Processes” in improved iCCM collaboration and polio coordination among others;  and Formulated Policy and Implemented Strategies resulted in new “innovations” such as decreased stunting through WASH interventions and measurement of community capacity and sustainability.

End of Meeting Summary_Lewis