Spring 2015 Global Health Practitioner Conference

In by Marc Pitre

The CORE Group Spring 2015 Global Health Practitioner Conference brought together representatives of CORE Group Member and Associate Organizations and other community-focused global health practitioners, policy makers, researchers, private sector partners and donors to exchange and learn about community health approaches and good practices; connect with their global health peers; and plan Working Group activities for the remainder of FY15 and for FY16.

The Spring Conference drew 311 participants from 93 organizations and 11 countries (Australia, Bangladesh, Canada, France, India, Ireland, Malawi, South Sudan, Switzerland, United Kingdom, and United States ). With USAID’s Maternal and Child Survival Program and Eastern Mennonite University, the conference offered a full pre-conference workshop on “Community health in conflict settings: trauma-aware programming and practice” and CORE Group offered a workshop on “Facilitation techniques to make working groups lively and fun”. The Conference hosted 5 plenary sessions, 24 concurrent sessions, 5 lunch roundtable sessions, 8 working group planning sessions, and 20 new info circuit tables. Of the total number of attendees, 132 presented or facilitated during one or more of these sessions.

Conference Review


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Session Summaries & Presentations


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Monday, April 13, 2015

Pre-Conference Sessions

Community Health in Conflict Settings: Trauma-aware Programming and Practice
(co-hosted by USAID’s Maternal and Child Survival Program)
Daria Nashat, Consultant; Barry Hart, Eastern Mennonite University; Áine Fay, Concern Worldwide

This well-attended workshop provided public health practitioners with useful strategies for implementing trauma-sensitivity into health programing and day-to-day operations in conflict and post-conflict situations. The day was divided into several different sessions, covering how high stress and trauma impact body, mind, and behavior; practical tools for resilience, self-care, and staff-care for public health practitioners and their teams; and quick assessment tools and key questions for trauma-sensitive project cycle management. After the lunch break, Áine Fay of Concern Worldwide presented a case study on a recent Ebola project, and an engaging discussion followed. Several tools, a recommended reading list, and a resources list also were shared. Barry Hart, a professor at the Center for Justice and Peacebuilding with Eastern Mennonite University, and Daria Nashat, an independent consultant who teaches at the Summer Peacebuilding Institute, facilitated the workshop. Additional training on trauma-sensitive programming is available through the institute, with information online at emu.edu/cjp/spi/.

To access trauma-awareness and resilience resources and materials that were taught during the workshop, as well as learn about opportunities to sign up for related workshops, please visit http://www.emu.edu/cjp/star/.

Facilitation Techniques to Make Working Groups Lively and Fun!
Lynette Friedman, Consultant; Lani Marquez, University Research Co., LLC

Working Groups are a great opportunity to connect with colleagues across organizations and advance a collective technical or programmatic agenda. However, facilitating a working group can sometimes feel like “herding cats”. This mini-workshop built skills in techniques for energizing participatory groups in discussion and decision-making. Participants explored strategies for encouraging member interest, facilitating active member engagement and participatory meetings, and mobilizing commitment to act.

Handout 1: Facilitation Techniques to Make Working Groups Lively and Fun

Handout 2: Designing Participatory Meetings and Brownbags

Handout 3: Tips for Making Virtual Meetings Effective

Workshop Notes

Working Group Co-Chair Planning Session

This session was for Working Group co-chairs and Board of Directors only.

Board of Directors Meeting

This meeting was for the Board of Directors only.


Tuesday, April 14, 2015

OPENING, WELCOME & OVERVIEW

Welcome
Karen LeBan, Executive Director, CORE Group

Overview
Lynette Friedman, Facilitator

Board Overview
Judy Jewis, Chair, CORE Group Board of Directors

KEYNOTE

Advancing Community Health across the Continuum of Care: A Health Systems Perspective  *Listen to webinar recording*
Sara Bennett, Johns Hopkins University

Alignment between the priorities of those working in community health and health system agendas has not always been strong. This presentation argued that due to (i) the increasingly inter-sectoral nature of global health challenges (2) the rising burden of non-communicable diseases and the concomitant interest in promoting more people-centered health services, as well as (3) the growing recognition of the importance of social accountability in health, the concerns of community health and health systems will become increasingly aligned in the future. High quality, responsive health systems will need to engage communities as partners in governance, ensure responsive service delivery, support home-based care, and supplement facility-based services. In order for this community-oriented renewal of health systems to occur, there must be a greater focus on supporting innovation in health systems, facilitating learning by all stakeholders throughout reform processes, and managing the political economy of health systems change.

Keynote

WORKING GROUP TIME

Community Child Health
Co-Chairs: Alfonso Rosales, World Vision; Alan Talens, World Renew

The Community Child Health Working Group reviewed technical accomplishments from FY15, discussed current priorities and strategic directions for working group members, and began drafting its FY16 workplan.

HIV/AIDS
Co-Chairs: Gloria Ekpo, World Vision; Jean Claude Kazadi Mwayabo, Catholic Relief Services

The HIV/AIDS Working Group reviewed technical accomplishments from FY15, discussed current priorities and strategic directions for working group members, and began drafting its FY16 workplan.

M&E
Co-Chairs: Todd Nitkin, Medical Teams International

The M&E Working Group sought a new chair and explored member interests and new activities.

The group reviewed technical accomplishments from FY15, discussed current priorities and strategic directions for working group members, and began drafting the FY16 workplan.

Malaria
Co-Chairs: Suzanne Van Hulle, Catholic Relief Services

The Malaria Working Group reviewed technical accomplishments from FY15, discussed current priorities and strategic directions for working group members, and began drafting the FY16 workplan.

Nutrition
Co-Chairs: Jen Burns, International Medical Corps; Justine Kavle, PATH; Kathryn Reider, World Vision

The Nutrition Working Group reviewed technical accomplishments from FY15, discussed current priorities and strategic directions for working group members, and began drafting the FY16 workplan.

Safe Motherhood & Reproductive Health
Co-Chairs: Carolyn Kruger PCI; Tanvi Monga, ICF/MCHIP; Amy Metzger, Christian Connections for International Health

The SMRH Working Group discussed updates on RMNCH research, innovative programming, and emerging issues.

Social Behavior Change
Co-Chairs: Kamden Hoffman, INSIGHT: Innovative Social Change in Global Health, LLC; Paul Robinson, International Medical Corps; Lenette Golding, Futures Group

The CORE Group SBC Working Group invited everyone to join it during the Working Group sessions. On Tuesday, the group had a participatory share session and speed consulting activity to take a peek at its annual work plan and see where the group is.

Tuberculosis
Co-Chairs: Anne Detjen, The International Union Against Tuberculosis and Lung Disease; Gagik Karapetyan, World Vision; Petra Stankard, PSI

The TB Working Group reviewed technical accomplishments from FY15, discussed current priorities and strategic directions for working group members, and began drafting the FY16 workplan.

LUNCHTIME ROUNDTABLES

Care Groups in Emergency Settings
Moderator: Tom Davis, Feed the Children; Sandra Wilcox, International Medical Corps; Florence Amadi, Curamericas Global

The Care Group approach has proven instrumental in addressing issues of food insecurity and nutrition within many development contexts. A recent International Medical Corps analysis indicates that Care Groups can be highly effective in emergency situations as well. Care Groups help women bond with other women in emergency settings, encouraging sharing and learning. Through a TOPs-funded IMC grant, Sandra Wilcox, Arianna Serino and Harley Stokes conducted literature searches, surveys and site visits to assess the impact of Care Groups in emergencies and developed guidelines for their use. Sandra presented preliminary findings from the study and key elements of this guidance. Also, in this session Florence Amadi of Curamericas illustrated how Care Groups are contributing to the prevention of the spread of the Ebola Virus Disease in Liberia and how this approach, along with other strategies, is being used to establish a community-owned surveillance system to identify emerging infectious diseases.

Care Groups in Emergency Settings

Building Capacity in Childhood TB – the New Union/WHO Online Training for Healthcare Workers
Anne Detjen, Health Specialist, Childhood TB, United Nations Children’s Fund (UNICEF) and Consultant, Childhood TB & Child Lung Health, The International Union Against Tuberculosis and Lung Disease (The Union)

The Union, in collaboration with World Health Organization, has recently launched an interactive online course, Childhood TB for Healthcare Workers. The six-module curriculum covers how to diagnose, treat and prevent childhood TB. The modules are interactive and ask participants to make decisions about patient care in various settings through case examples. During the roundtable participants had the chance to have a glimpse of the course and its innovative approaches where participants have to interact, take decisions and manage cases in various health care settings. The self-paced course is designed for healthcare workers at the secondary and primary level of the healthcare system. One full module is dedicated to TB prevention, focusing on household contact screening and provision of preventive therapy. Childhood TB for Healthcare Workers is the first major offering of The Union’s new Childhood TB Learning Portal (https://childhoodtb.theunion.org/). The Learning Portal offers a variety of resources aimed to support countries’ efforts to address the 10-step plan outlined in The Roadmap for Childhood TB, published in 2013. The Roadmap stresses the urgent need for training and reference materials on childhood TB for health workers. Childhood TB for Healthcare Workers is offered at no charge, and learners receive a certificate of completion. Within a first week of its launch on March 24, more than 300 people from over 65 countries registered for the course!

CONCURRENT SESSIONS

Small Data Add Up: Data for Decision Making on the Ground and in Real Time
Moderator: Todd Nitkin, Medical Teams International; Dora Curry, CARE; Mark Kabue, Jhpiego; Jitendra Awale, CORE Group Polio Project/India; Henry Perry, Johns Hopkins University

Participants and panelists shared their emerging practices and experiences utilizing data in primary health facilities, among community-based health workers and with communities themselves. Using a panel discussion (rather than a formal presentation), we discussed practical ways of building the capacity of end-users (who collect data routinely) to effectively make use of the data they collect, some effective strategies for advocating for collecting relevant “new” data that are not normally collected in the existing data systems, and opportunities to improve the quality of and better utilize existing routine MOH data collection systems. A dedicated moderator facilitated input from the session participants.

Small Data Add Up

Cross-cutting Themes in Community Health/Engagement from the CSHGP FY2014 Cohort
Moderators: Emma Sacks and Melanie Morrow, USAID’s Maternal and Child Survival Program (MCSP)/ICF International; Alan Talens, World Renew; Sara Riese, Johns Hopkins University; Lynne Miller Franco, EnCompass, LLC

In this session, we presented findings from an analysis of cross-cutting themes from the most recent cohort of the USAID Child Survival and Health Grants Program, focusing on community engagement strategies, as well as service delivery and quality improvement efforts. We highlighted two programs: The Center for Human Services’ Quality Improvement Initiative in Benin and World Renew’s Peoples’ Institutions Model in Bangladesh. Participants also heard how USAID’s flagship global maternal and child health program, MCSP, is using the Community Health Platform to advance community and civil society engagement, as well as had a forum to discuss the platform and various strategies for improving child survival.

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Adolescent Nutrition: Research and Programmatic Experience
Moderator: Jen Burns, International Medical Corps; Julie Ruel-Bergeron, Johns Hopkins University; Peggy Koniz-Booher, John Snow, Inc; Marion Roche, Micronutrient Initiative

This session provided an overview of programmatic and research experience on adolescent nutrition by academic institutions and implementing partners. First, nutritional issues commonly faced by adolescent girls from low- and middle-income countries were presented by Julie Ruel-Bergeron from the Johns Hopkins Bloomberg School of Public Health (JHSPH). She shared work that she did in reanalyzing Demographic and Health Survey Data from Zambia, Bangladesh, and Burkina Faso, coupled with describing existing and recommended platforms through which to reach adolescent girls. Findings were shared from research led by the JHSPH, such as the impact of early pregnancy on adolescent girls’ growth. Next, Peggy Koniz-Booher from the SPRING project shared an overview of a literature and programmatic review on improved nutrition for adolescents, pregnant and lactating women, and women of reproductive age. Findings from a technical meeting coordinated by SPRING, FANTA-III, and PAHO on recommendations on key dietary practices to be used in strengthening policies and programs were presented. In light of the World Health Assembly target to decrease anemia by 50% among women of reproductive age, Marion Roche from the Micronutrient Initiative shared potential interventions to respond to this goal. Specifically, she shared a landscape analysis, programmatic experience with weekly iron and folic acid (IFA) supplementation for adolescent girls, and strategic thinking around weekly IFA to reduce anemia in adolescent girls.

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Improving the Quality and Scale of National Integrated Community Case Management (iCCM) Activities through Programmatic Harmonization
Moderator: Alfonso Rosales, World Vision US; Dyness Kasungami, USAID’s Maternal and Child Survival Program/JSI; Jane Briggs, SIAPS/Management Sciences for Health; Sarah Andersson, John Snow, Inc.; Karen Waltensperger, Save the Children

Overview: The CCM Task Force is a global forum leading global dialogue and supporting introduction and scale-up of government-led iCCM programs. It is a movement of about 200 registered individuals representing more than 50 organizations involved in funding and or implementing iCCM programs in over 60 countries globally. This presentation gave an overview of the Task Force, including goals and objectives, leadership structure, roles, and responsibilities of the Steering Committee, the secretariat, and members. The presentation highlighted work of the current subgroups, such as the “Supply Chain Management sub-group”, resources, and tools and explained how you can join and contribute or access available resources to support scale-up of iCCM programs at the country level to achieve impact. Likewise, the panel included NGOs’ experiences supporting national iCCM programs at scale in three contexts: Malawi, Mali, and Zambia, as well as an innovative approach to scaling up a mobile health supply chain management system, which facilitates the use of logistics data for decision making in the context of Malawi.

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CONCURRENT SESSIONS

Integrated Community Case Management & Nutrition
Moderator: Paige Harrigan, Save the Children; Lynette Friedman, Consultant; Saul Guerrero, Action Against Hunger UK; Maureen Gallagher, Action Against Hunger US

Nutrition is crucial to both individual and national development. Recent estimates suggest that improving access and coverage of specific nutrition interventions could save hundreds of thousands of lives every year. In spite of this potential, the reach of many of these interventions remains limited. Integrated Community Case Management (iCCM) of childhood illnesses may be a logical platform, perhaps currently a missed opportunity, for increasing the reach and coverage of treating malnourished children and potentially preventing malnutrition.

In 2014, a number of key stakeholders in iCCM and nutrition came together to explore existing experiences in iCCM and nutrition. In a meeting in May 2013, experiences were shared and participating agencies prioritized the conduction of a review of experiences linking iCCM and nutrition. Outcomes of this first meeting were presented at the October Fall meeting during a joint Community Child Health (CCH) and Nutrition Working Group session. The review was completed in December and a second meeting, involving a larger group of iCCM and nutrition experts, took place in NY, when preliminary results were shared and discussions held on proposed next steps. Considering the important role that the CORE Group has in iCCM, this session proposed to bring together key information and have a discussion on next steps and the involvement of CORE Group in this global initiative of iCCM and nutrition.

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Driving the Advocacy Agenda for Non-Communicable Diseases: Crafting Your Message
Moderator: Arti Patel Varanasi, Advancing Synergy, LLC; Mychelle Farmer, Jhpiego; Nikita Ramchandani, Abt Associates; Joy Baumgartner, Associate Director of the Evidence Lab, Duke Global Health Institute and Scientist I, Social and Behavioral Health Sciences, FHI 360; Heather White, Population Services International

Non-communicable diseases (NCDs) are responsible for 2/3 of deaths each year. NCDs and their behavioral risk factors are major challenges for health and sustainable development. This session highlighted approaches to integrating prevention and control of NCDs into existing health platforms. Participants learned about the role of NCDs within primary care, health promotion, and advocacy programs and the use of social marketing strategies to communicate NCD prevention and control. The session included small group exercises to craft key messages to support the NCD advocacy agenda, and participants learned about effective programs that integrate NCD services.

Driving the Advocacy Agenda

Social Drivers of the HIV and AIDS Epidemic: Are we addressing the right drivers?
Moderator: Suzanne Leclerc-Madlala, USAID; Timothy Mah, USAID; Shepherd Smith, Institute for Youth Development; Gloria Ekpo, World Vision US

Effective HIV prevention strategies should address social, behavioral, and structural barriers in accessing existing HIV prevention, treatment, and care services for vulnerable and priority populations, as no one cap fits all. The session engaged a panel of experts from youth organizations, INGOs, and USAID to discuss current issues on social and behavioral drivers of the HIV epidemic. The session shared experiences from the field of what might be fueling the epidemic among youth, especially adolescent girls; public sector and uniformed workers; and key priority populations, including people using drugs, sex workers, men having sex with men, and other most-at-risk-populations. Panelists highlighted common drivers, what might be missing, proven interventions to address the epidemic, and funding priorities in this area. The session engaged participants in an interactive dialogue, reflection, and collaborative activity to identify other social barriers driving the epidemic, what might be missing, and solutions to address them in HIV programs.

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Integrating Family Planning with Nutrition and Food Security
Moderator: Linda Sussman, USAID; Ellen Smith, HPP/Futures Group; Reshma Naik, HPP/PRB; Reena Borwankar, FANTA/FHI 360

Drawing on reviews by the USAID-funded Health Policy Project and FANTA project, this session highlighted compelling evidence showing how family planning (FP) can impact nutrition and food security. Illustrative evidence included how birth spacing can improve nutritional outcomes, such as low birth weight and stunting. The session also covered how, by helping to prevent unintended pregnancies, FP can slow the pace of population growth, reduce strains on agricultural resources, and improve food security. It also highlighted programmatic experiences, including models, platforms, and promising practices for this type of integration. With knowledge of the evidence and practical lessons learned from real world settings, this session positioned participants to work toward the integration of FP into nutrition and food security programs.

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Wednesday, April 15, 2015

ANNOUNCEMENTS, DAILY SCHEDULE, AND UPDATES

Board of Directors Slate
Judy Lewis, Chair, CORE Group Board of Directors

NEW INFORMATION CIRCUIT

TABLE 1 | Accurate and Acceptable Tools for Community Health Workers to Detect Childhood Pneumonia
Hosted by: Kevin Baker, Programme Coordinator – Pneumonia Diagnostics, Malaria Consortium

Pneumonia remains the number one infectious killer of children in the world. While timely case management could save many lives, there is an apparent lack of tools for effective diagnosis of symptoms to guide treatment actions. Malaria Consortium is currently conducting a large scale evaluation of pneumonia diagnostic tools in Sub-Saharan Africa and Southeast Asia. The project’s aim is to identify the most accurate and acceptable respiratory rate timers and pulse oximeters for the detection of childhood pneumonia symptoms by community health workers and first-level health facility workers in Ethiopia, South Sudan, Uganda and Cambodia. This New Info Circuit table presented the study design and share preliminary findings from the initial stages of the project.

TABLE 2 | Addressing Disrespect and Abuse of Women During Pregnancy and Childbirth
Hosted by: Anjali Madeira, MPH, RN, American Refugee Committee

Respectful Maternity Care (RMC) is gaining momentum in the international community as a framework for advancing the quality of care for women in childbirth. This discussion focused on: 1) understanding the causes of disrespectful and abusive maternity care practices, 2) examining the short and long-term impacts of poor care on women, newborns and families, and 3) identifying potential interventions and opportunities for organizational collaboration to address the challenge. We also presented preliminary results from a recent qualitative study on birth perceptions conducted among Burmese mothers and maternity care providers in and around refugee camps in Thailand.

TABLE 3 | Advocacy at the Right Place and Right Time: The Entry Point Mapping Tool
Hosted by: Jeremy Kanthor, DAI/USAID Health Finance and Governance Project

Civil society organizations (CSOs), particularly those working in the health sector, frequently seek opportunities to influence public health policy or share feedback on the quality or accessibility of health services. While these organizations may have important contributions to make, they often are not aware of the most effective and accessible entry points to use. Entry Point Mapping provides a methodology for systemic review and identification of mechanisms, forums and public platforms by which civil society organizations can participate in health sector policy formulation, program implementation, and oversight. The New Info Circuit Table presentation included an interactive overview of the Entry Point Mapping approach with practical lessons from the tool’s application in Bangladesh. Entry Point Mapping is a strong compliment to the CORE Group’s work on social accountability.

TABLE 4 | Community Communication Tools for SBCC re: MNCH Norms
Hosted by: Susan B. Aradeon, Independent Consultant

Community Communication is a Social and Behavior Change Communication approach that empowers health workers and volunteers (including non-literate, low-status women) to facilitate health promotion sessions disseminating MNCH decision-making information while providing space for group reflection. Thirty volunteers lead multiple, small groups of their own peers during four sessions spread over a month sharing healthier information and attitudes. The volunteers rely on innovative, participatory communication tools that enable their group members to learn, recall and then share the health information themselves. Thus, the community members become the communicators spreading social approval for adoption of healthier behaviors and generating healthier MNCH norms. Table participants practiced several interactive health communication tools: the Vaccination Hand, the Maternal Danger Signs Body Tools and the Diarrhea Transmission Mime. They experienced the benefits of Rapid Imitation Practice–our participatory method for learning and teaching that makes it easier for the volunteer health promoters to own the tools and health information. Table participants discussed the advantages of these Community Communication tools and similar communication tools being used by other programs. The UKaid-funded Community Communication e-Manual and Job Aids for MNCH sessions developed during PATHS, JHCCP and Mannion Daniels sub-contracts were available.

TABLE 5 | Compiling and Sharing of Community-based Innovations in HIV/AIDS among Various Stakeholders
Hosted by: TJ James, Independent Consultant

Various Stakeholders has experimented and developed innovations in various aspects of HIV/AIDs management. Many of these innovations are not coming to limelight and confined to reports and conference proceedings. The novel idea proposed is to compile these innovations and sharing among various stakeholders for further adaptation, refinement and development, without reinventing the wheel again. I have worked as the Technical Manager for the SHARE project implemented by VHS Chennai and supported by USAID. The project is essentially for knowledge transfer between India and Africa. I have noted there are several innovations that have already been done in both India and Africa , which were unnoticed and neglected. We have compiled more than 70 innovations in various aspects of HIV/AIDS care, and many of these innovations could be replicated, adapted and shared among various stakeholders.

TABLE 6 | Digital Content Library for Health Workers
Hosted by: Lesley-Anne Long, mPowering Frontline Health Workers

mPowering presented its content platform, which connects frontline health workers to free digital training resources on mobile devices. We provided an introduction and demo of the site on several devices. Participants were able to practice accessing and uploading content, and participated in a question and answer session.

TABLE 7 | Do Rights Matter? How to Take a Rights-based Approach to Family Planning Programs, and Why We Should
Hosted by: Elizabeth Arlotti-Parish, EngenderHealth

Reproductive rights are human rights. But so what—as long as we can give more women greater access to family planning services and commodities, why does it matter how we do it? Here’s why: with a rights-based approach, it is not just the outcomes that are important (though a rights-based approach does improve sexual and reproductive health outcomes), the process is important as well. With voluntary, rights-based family planning, the client is empowered to make the ultimate decision regarding his or her reproductive health. A rights-based approach may include clinical training and supply chain improvements, and rights-centered versions of many other traditional family planning interventions, but it also goes beyond the clinic door and takes a holistic view of the factors at the individual, community, and even policy levels that affect the client’s ability to make that decision. But how can one program do ALL that? Human rights is a BIG issue, and we just work on health programs. How can we even figure out where to start? How do we know what will have the biggest impact? (Can’t we just go back to making sure the supply chain works?…) This table discussion introduced participants to two tools, the Voluntary Rights-Based Family Planning Framework, and Checkpoints for Choice, which guide users through a practical process to introduce NGO staff, ministry of health actors, clinicians, and communities to the basic tenets of human rights and identify gaps where their family planning programs may include subtle or overt coercion or barriers to clients’ rights being met, at the facility level and beyond. Once these issues are identified, the tools help participants adapt existing activities to ensure that clients’ rights are met, often in ways that do not require additional funding or new activities. With a rights-based approach, implementers often do not need to do different things, they just need to do things differently. We introduced these tools, shared EngenderHealth’s experience in rolling them out with the Ministry of Health in Uganda, and brainstormed next steps for expanding their use and generating evidence on their effectiveness.

TABLE 8 | Family Planning through Faith-based Health Networks: Where We Are & Where We Could Go
Hosted by: Lauren VanEnk, Institute for Reproductive Health

The Institute for Reproductive Health (IRH) at Georgetown University has teamed up with four faith-based health networks in East Africa—Caritas Rwanda, Action Familiale Rwandaise (AFR), Uganda Catholic Medical Bureau (UCMB), and Uganda Protestant Medical Bureau (UPMB)—to improve the capacity of their family planning programs. Each of these faith-based health networks, which include both Catholic and Protestant organizations, had a demonstrated commitment to family planning even before the project began. The aim of the project is to assess their current scope of family planning activity and strengthen it by expanding the method mix through fertility awareness-based options consistent with their faith traditions and improving access to services. A special emphasis is given to equipping community-based health agents as service providers and sensitizing religious leaders as family planning champions. The capacity building strategy addresses six fundamental building blocks of strong family planning programs: Provider training, Awareness raising/Demand Generation; Supportive Supervision, Data Collection, Commodity Logistics, and Creating a Supportive Environment. Participants in this session developed an appreciation for the contribution of faith-based health networks in family planning service provision, gained an understanding of the current state of family planning programs in select faith-based health networks in Africa (what are partners doing, what are the gaps, what is the intervention), and discovered a capacity building strategy for improving family planning programs.

TABLE 9 | Findings from a Formative Assessment of Emergency Contraception Pills at the Community Level in Uganda
Hosted by: Leigh Wynne, Advancing Partners & Communities Project

While community-based family planning provision is one of the most efficient ways to ensure access to family planning services in underserved areas, emergency contraceptive pills (ECPs) remain relatively under-used globally and more so in rural areas. A few countries, such as Uganda, India,and Bangladesh, provide ECPs at the community level, but they remain exceptions. With little time or effort, community health workers —male or female, paid or volunteer, literate or illiterate—can be trained to safely provide ECPs in their communities. Participants joined us to discuss community-based provision of ECPs and to hear the findings from a recent formative assessment in Uganda examining existing consumer knowledge and use of ECPs, as well as the capacity and barriers of provision of ECPs by community health workers.

TABLE 10 | High Impact Practices in Family Planning (Briefs, Interactive Map, and More!)
Hosted by: Ados Velez May, IBP Secretariat

High Impact Practices (HIPs) are effective service delivery or systems interventions that when scaled up and institutionalized, will maximize investments in a comprehensive family planning strategy. HIPs help programs focus resources for greatest impact. Participants used the interactive map to connect with other programs implementing HIPs and learn from other’s successes and challenges. We had a computer to take map submissions and show current posts.

TABLE 11 | How Can We Improve Family Planning Referrals If We Don’t Know What Works? Findings from a Situation Analysis of Community-Based Family Planning Referrals
Hosted by: Elena Lebetkin, FHI 360 – Advancing Partners & Communities Project

Given the current limitations of community health worker provision of family planning (FP) to short acting methods, clear evidence is needed on the most effective, cost efficient, and scaleable ways to get women the FP methods they want at the time they need them. The current literature on referrals, especially for community-based FP referrals, is minimal. This New Info Circuit Table described the findings from the Advancing Partners & Communities Project Situation Analysis, which reviewed the evidence on current models of community-to-facility referrals for long acting and permanent methods of FP. The Situation Analysis included a review of published and grey literature as well as key informant interviews. Table participants discussed the findings, including recommendations on promising referral models that could be tested for effectiveness as well as an agenda for future research.

TABLE 12 | Improving Medicines Access and Use for Child Health- A Guide to Developing Interventions
Hosted by: Jane Briggs, SIAPS/MSH

“Improving Medicines Access and Use for Child Health—A Guide to Developing Interventions” represents an up-to-date and practical resource for those developing interventions to improve access to and use of medicines for child illness. It targets groups working in community organizations, health facilities, and district health offices or within larger health systems. The Guide adopts a structured approach to lead a team through five steps—from identifying and exploring problems to developing, implementing, and evaluating interventions—and includes a library of resources. The Guide could be particularly useful in a district strengthening type project. The session included an introduction to the guide and how to use it, as well as a demonstration of how to navigate the guide and its resources.

TABLE 13 | Incorporating Best Practices from the Private Sector to Build, Motivate and Manage CHW Cadres: Learning from Living Goods’ Evidence-based Model
Hosted by: Molly Christiansen, Living Goods

Living Goods empowers entrepreneurial community health workers to deliver life-saving products and services to the doorsteps of the poor. Recent RCT evaluation results show that Living Goods community health worker platform is reducing under five child mortality by over 25% in Uganda. Living Goods employs a business model that is highly cost-effective—it recovers 100% of the cost of the products, generates retail margin to pay and motivate the CHWs, as well as a wholesale margin to cover some of its operating costs, such that the net cost is less than $2 per person annually. Living Goods brings an entrepreneurial business model and best practices from the private sector to effectively build, motivate and manage high-performing CHW cadres.

TABLE 14 | Interventions to Improve Community Health Worker Motivation and Performance
Hosted by: Daniel Strachan, UCL Institute for Global Health

This table presented preliminary results from the inSCALE project’s cluster-randomised controlled trials in Uganda and Mozambique. The six-year project has evaluated the effect of innovations to improve community health worker (CHW) performance, motivation and retention. The innovations were designed in the context of integrated community case management of childhood illnesses (iCCM) with the aim of increasing coverage of appropriate treatment for sick children. Two innovative strategies were evaluated: an mHealth intervention in both countries and an additional community participatory intervention in Uganda. In the mHealth intervention, CHWs were given mobile phones with which they can send their weekly reports, receive immediate automated feedback on performance and access a closed user group with their supervisors in order to increase communication and support. Every month a motivational performance related SMS is sent out, and supervisors receive weekly automated actionable messages for CHWs who are performing at high or low standards. In Mozambique, the mHealth intervention also included a multimedia job aid, which uses an algorithm to guide CHWs through a consultation. The community participatory intervention focused on Village Health Clubs, which aim to improve child health through a community-led forum with the CHWs as the main focus point. Village Health Clubs are intended to provide a forum where CHWs and community members who are part of the club can work together to identify child health and CHWs challenges. They use village networks, knowledge, creativity and other community assets to help solve child health problems.

TABLE 15 | Linking Facility and Community Systems: Improving Utilization of HIV, Nutrition and Economic Strengthening Services through Referrals
Hosted by: Clinton Sears, FHI 360

The Livelihoods and Food Security Technical Assistance II Project (LIFT) has been working with 17 health facilities in Malawi’s Central Region (Lilongwe and Kasungu Districts) to improve access to food and economic support as a component of the continuum of care for vulnerable individuals affected by HIV and AIDS. The project established bi-directional referrals between health facilities and village savings and loan associations (VSLAs) and food support services. In order to do this, LIFT sensitized front line staff at clinics and VSLAs to the referral approach, trained 33 referral volunteers (RVs) who work closely with Ministry of Health frontline staff at the facility and community levels, and worked with VSLAs to make methodological adjustments to include clients referred from health facilities. Community-led sensitization campaigns by VSLA agents and RVs resulted in an ever-growing interest from VSLAs to accept referred clients, providing access to savings services and financial education within existing VSLA groups. In total 2,769 VSLAs (1,092 in Lilongwe and 677 in Kasungu) have been engaged to date and are ready to receive new clients. In the first 4 months of operations, a total of 1,213 referrals were made in the two districts (1,143 clients were referred from health facilities to VSLAs; 45 clients were referred from health facilities to food support; and 25 clients were referred from VSLA to a health facility). The level of utilization of referred services by clients ranged from 82% in Lilongwe and 97% in Kasungu. These referrals are improving the overall wellbeing and productivity of PLHIV, and aim to improve adherence to ART and retention in HIV-related care. This work has been a collaborative effort between CARE USA, CARE Malawi, and FHI 360. LIFT presented this new accelerated linkage approach and initial results, and discussed the methodology used to put these linkages in place, including utilization of existing community systems and local resources for improved uptake and sustainability. The presenter also discussed successes and challenges from the implementation experience, as well as overall client level impacts seen to date based on this extended continuum of care.

TABLE 16 | mHealth: Tools You Can Use
Hosted by: Laura Raney, MCSP/Jhpiego

Provided an overview of mHealth – the use of mobile and wireless technologies to support the achievement of health objectives. Handouts included 30 Common questions about mHealth (with answers and resources), handout on platforms for mobile data collection, and mHealth online resources.

TABLE 17 | New Resource to Improve Women’s Health through Community-based Action
Hosted by: Robin Young, Hesperian Health Guides

While information about women’s health proliferates on topics including sexuality, family planning, unsafe abortion, HIV, and violence against women, few resources exist which help health educators reduce stigma, foster dialogue, and include men in behavior change communication. To address this gap, Hesperian created new material based on the experiences of our global grassroots partners. This material included activities, stories, and tools derived from the experiences of women and communities globally to address social barriers, attitudes, and practices that harm women and girls. During development, the material was reviewed by professional health care providers and experienced organizers and was field-tested by community-based groups in 23 countries. Pre-publication field-testing found that 17 organizations in 14 countries reported increased comfort addressing controversial topics after field-testing. Over 80% of respondents reported feeling significantly more comfortable when presenting on topics, including “How gender roles affect health,” “Sexuality,” and “Violence against women,” than they had prior to the field-testing process. Field testing concluded in 2013. In February of 2015, Hesperian released a health education and community organizing resource titled Health Action for Women, which is currently undergoing a process to make it freely available online. Women’s health information is the most frequently accessed of Hesperian’s free online health information, with 2.5 million unique visitors to Hesperian’s digital material in 2014. Most popular search terms include, “Safe methods of abortion,” “Danger signs during pregnancy,” “genital infections” and “family planning.” Health Action for Women compliments this material by providing health educators with tools needed to take action to improve women’s health.

TABLE 18 | Strengthening Community-Facility Linkages to Improve PMTCT
Hosted by: Chewe Luo, UNICEF

This session focused on strategies for strengthening community-facility linkages to support prevention of mother-to-child transmission (PMTCT) of HIV and improved maternal and infant health. We shared 11 promising practices and operational guidance for strengthening community-facility linkages and discussed opportunities for using these resources in different programming contexts.The 11 promising practices were identified through research on community-facility linkages for PMTCT, including lifelong antiretroviral therapy (ART) and maternal and infant health. A practice was defined as promising if there was a documented correlation with increased service uptake, adherence or retention, preferably in more than one setting. The methods used included literature review, stakeholder consultation and country visits. The promising practices are: 1) Individual client support by peers, community health workers, or “buddies”; 2) Participatory women’s groups; 3) Targeted food assistance; 4) Community case management; 5) mHealthfocused on client communication; 6) Active outreach, including home visits; 7) Positive male involvement in antenatal care and PMTCT; 8) Purposeful engagement of community leaders; 9) Engagement of local organizations; 10) Community-based HIV testing; and 11) Community-based distribution. Our session involved an interactive presentation and sharing of the evidence and experiences of our participants in their own programs. N.B. This research activity was commissioned by UNICEF with financial support from the governments of Norway and Sweden.

TABLE 19 | Using mHealth to Support Integration across the MCH Continuum
Hosted by: Steve Ollis, D-tree International

We demonstrated and described our tools developed in Malawi to support Health Surveillance Assistants (HSAs) to provide care to their communities. These mobile tools support the HSAs in the following areas: antenatal care, postnatal care, under 5 care, immunizations and stock management. We also discussed our plans to integrate additional health areas and sharing of referral information between the village clinics and health facilities. These tools will be in use in over 500 village clinics in hard-to-reach areas in Malawi by the end of 2015.

TABLE 20 | Using the Continuum of Care to Identify Barriers and Design Solutions for Community-based NCD Care in India
Hosted by: Dasha Migunov, Abt Associates

In response to the growing burden of non-communicable diseases (NCDs) worldwide and an urgent need for NCD support at the country level, HealthRise, a new project funded by Medtronic Philanthropy, aims to expand access to cardiovascular disease (CVD) and diabetes care for the underserved through demonstration projects in select sites in India, South Africa, the US, and Brazil. To guide the design of these demonstration projects, HealthRise uses a Continuum of Care framework that enables a quantitative and qualitative assessment of both the demand for CVD and diabetes care by individuals within a community and the supply of care delivered by a health system. HealthRise then uses the barriers, needs and opportunities identified by this assessment to engage multi-sectoral stakeholders in the design of community-based demonstration projects that address priority points along the continuum. At this table we provided an introduction to the HealthRise approach, including our Continuum of Care framework. We then explained how we used the Continuum of Care to first identify NCD care barriers and opportunities within our selected communities in India and then engage local stakeholders in the design of community-based interventions that address these barriers and leverage opportunities. Following our presentation, we engaged participants in a brief group activity that draws from the HealthRise India program as a case study.

WORKING GROUP TIME

Community Child Health (met with Malaria)
Co-Chairs: Alfonso Rosales, World Vision; Alan Talens, World Renew

The Community Child Health and Malaria Working Groups hosted a presentation on “Case Management and Care-seeking for malaria, pneumonia and diarrhea in Six African Countries after an Integrated Health Systems Strengthening Intervention.” The presenter was Debra Jackson, Senior Health Scientist, Knowledge Management & Implementation Research Unit, Health Section, UNICEF.

UNICEF shared the findings and conclusions of the external summative evaluation of the Integrated Health Systems Strengthening (IHSS) program-funded by UNICEF and DFATD Canada in targeted countries in Africa: Ethiopia, Ghana, Malawi, Mali, Mozambique, and Niger. The aim of the IHSS program was to strengthen health systems, with an emphasis on training and equipping front-line health workers to deliver a package of essential, high-impact interventions and services. A primary focus of the IHSS was on CHWs and scaling-up integrated community case management for diarrhea, malaria, and pneumonia. UNICEF commissioned the South Africa Medical Research Council to conduct the summative evaluation of the IHSS.

HIV/AIDS
Co-Chairs: Gloria Ekpo, World Vision; Jean Claude Kazadi Mwayabo, Catholic Relief Services

The HIV/AIDS Working Group reviewed technical accomplishments from FY15, discussed current priorities and strategic directions for working group members, and began drafting its FY16 workplan.

M&E
Co-Chairs: Todd Nitkin, Medical Teams International

The M&E Working Group sought a new chair and explored member interests and new activities. Participants joined the group to review technical accomplishments from FY15, discuss current priorities and strategic directions for working group members, and begin drafting the FY16 workplan.

Malaria (met with CCH)
Co-Chairs: Suzanne Van Hulle, Catholic Relief Services

The Malaria and Community Child Health Working Groups hosted a presentation on “Case Management and Care-seeking for malaria, pneumonia and diarrhea in Six African Countries after an Integrated Health Systems Strengthening Intervention.” See the CCH description for more information.

Nutrition (met with SBC)
Co-Chairs: Jen Burns, International Medical Corps; Justine Kavle, PATH; Kathryn Reider, World Vision

On Wednesday, the Nutrition working group joined the SBC working group. During this time they identified the human resources within the two groups and came up with a plan on how to collectively contribute to strategic program learning to advance social and behavior change in terms of nutrition programming. Additionally, they mapped existing technical briefs regarding SBC, nutrition, WASH, ECD, agriculture, adolescent nutrition, anemia, etc. by key stakeholders (e.g., USAID, SPRING, FSN, UNICEF, WHO).

Safe Motherhood & Reproductive Health
Co-Chairs: Carolyn Kruger PCI; Tanvi Monga, ICF/MCHIP; Amy Metzger, Christian Connections for International Health

The SMRH Working Group reviewed technical accomplishments from FY15, discussed current priorities and strategic directions for working group members, and began drafting its FY16 workplan.

SMRH Working Group

Social Behavior Change (met with Nutrition)
Co-Chairs: Kamden Hoffman, INSIGHT: Innovative Social Change in Global Health, LLC; Paul Robinson, International Medical Corps; Lenette Golding, Futures Group

On Wednesday, the Nutrition working group joined the SBC working group. During this time they identified the human resources within the two groups and came up with a plan on how to collectively contribute to strategic program learning to advance social and behavior change in terms of nutrition programming. Additionally, they mapped existing technical briefs regarding SBC, nutrition, WASH, ECD, agriculture, adolescent nutrition, anemia, etc. by key stakeholders (e.g., USAID, SPRING, FSN, UNICEF, WHO).

Tuberculosis
Co-Chairs: Anne Detjen, The International Union Against Tuberculosis and Lung Disease; Gagik Karapetyan, World Vision; Petra Stankard, PSI

The TB Working Group reviewed technical accomplishments from FY15, discussed current priorities and strategic directions for working group members, and began drafting its FY16 workplan.

LUNCHTIME ROUNDTABLE

CORE Group Country Partnerships in Selected USAID EPCMD Countries
Karen LeBan, CORE Group; Judy Lewis, CORE Board of Directors; David Shanklin, USAID’s Maternal and Child Survival Program; Alfonso Rosales, World Vision US

CORE Group and member organization staff summarized activities taking place in selected countries to address Ending Preventable Child and Maternal Deaths through USAID’s Maternal and Child Survival Program. Recent activities were discussed for Haiti and Ethiopia, as well as plans for entering additional countries.

CONCURRENT SESSIONS

WHO Building Blocks Platform for Health Systems Strengthening: Where are Communities?
David Shanklin, USAID’s Maternal and Child Survival Program (MCSP)/CORE Group; Emma Sacks, MCSP/ICF International; Eric Sarriot, MCSP/ICF International

This was an interactive session to reconsider the WHO Building Blocks for Health Systems Strengthening (HSS). The session began with presentations on work achieved through the CORE Group Community Child Health Working Group and MCSP in recent months, including 1) advances by a small working group to identify gaps in the WHO Building Blocks and the need to broaden the advocacy of community health within the context of national health equity, 2) a linked literature review and the development of definitions of key terms and preliminary review of the evidence for shared understanding and consensus, and 3) how this work ties to larger issues of systems research and the advancement of USAID’s agenda of ending preventable child maternal death (EPCMD). These presentations were followed by small group work to advance the theme in the context of finalizing Sustainable Development Goals (SDGs) later this year.

WHO Building Blocks_Sacks

WHO Building Blocks_

Enhancing Nutrition and Food Security during the First 1000 Days through Gender-sensitive Social and Behavioral Change
Moderator: Kamden Hoffmann, INSIGHT: Innovative Social Change in Global Health; Megan Ivankovich, WI-HER LLC; Mahmuda Rahman Khan, USAID Bangladesh

Gender integration is increasingly considered a best practice and evidence suggests it leads to improved maternal and child health outcomes; however, the use of strategies to change gender-related behaviors surrounding nutrition has been insufficiently studied. CORE Group, together with partner WI-HER LLC, was awarded a USAID Technical and Operational Performance Support (TOPS) Program Micro Grant to strengthen the capacity of development practitioners working in nutrition and security to design, implement, and evaluate gender-sensitive social and behavioral change (SBC) programming in order to improve nutritional outcomes. This guidance is based on the 1000 Days Approach, which prioritizes the critical period between a woman’s pregnancy and her child’s second birthday to maximize impact, thus pregnant and lactating women and children under two are the target beneficiaries for this work. While the research focuses on work conducted in the USAID-funded Food for Peace countries that have active development projects, findings may be applicable to similar projects in other countries. After conducting a literature review, project audit, and practitioner interviews, a technical brief, field guide, and webinar are being developed that present the rationale, best practices, tips, and tools for integrating gender-sensitive SBC into project activities. This concurrent session provided an overview of the methodology used to conduct this work and present all research findings, with a focus on sharing clear approaches, recommendations, and tools to promote gender-sensitive SBC to improve nutrition outcomes within the context of nutrition and food security projects. In addition, guest speakers presented on projects that have successfully implemented relevant gender-sensitive SBC programming to improve nutrition outcomes. Finally, attendees engaged in a discussion about their experience implementing such programs.

Enhancing Nutrition and Food Security_Ivankovich

mHealth Across the Continuum of Care
Jeremy Wacksman, Mike O’Donnell, and Sheel Shah, Dimagi Inc.

Are you interested in mHealth but only aware of limited applications? Have you wondered how mHealth tools could support a program across the continuum of care? This session explored general ideas about how mHealth can be used to support care over time and coordination among different actors in the health system. Following an introductory presentation and facilitated discussion, the facilitators worked with break-out groups to dive into several specific case studies. These illustrated different types of use cases, and explored implementation feasibility, cost considerations, and interface with other aspects of care, and other parts of the public health system. Each group discussed their case study, outlined the key issues they saw, and made recommendations for the future of their project. Participants reported back their findings and the facilitators helped synthesize these into some key takeaways on how to think about mHealth across the continuum of care.

mHealth Across the Continuum of Care

Overcoming Financial Barriers to Health Services—What Can Communities Do?
Cassie Chandler, Freedom from Hunger; Catherine Connor, Health Finance & Governance Project; Tom Shaw, Catholic Relief Services; Molly Christiansen, Living Goods

Health financing is an essential input in the quest to improve health service access among the poor. Healthcare costs remain a significant obstacle, allowing improved health knowledge and geographical access to go only so far. This session explored and discussed different approaches for health financing at the community level. Panelists shared experiences around health microinsurance, health savings, and other strategies to increase the uptake of essential health services.

Overcoming Financial Barriers_Connor

Overcoming Financial Barriers_Shaw

PLENARY

Speed Networking
Jay Heavner, John Snow, Inc.

Speed networking is a fast-paced and fun way to make new connections with other public health professionals. This version came to you from Dar es Salaam and Johannesburg, where it was always the most popular session at the annual summit of suppliers of HIV/AIDS commodities for the Supply Chain Management System (SCMS) project. Participants brought at least 20 business cards to share; we brought the vuvuzela. Ready! Set! Get to know each other in three minutes! Now switch!

Speed Networking


Thursday, April 16, 2015

ANNOUNCEMENTS

Dory Storms Award Announcement
Gretchen Berggren, Consultant

Dory Storms

PLENARY

Evidence of Improved Impact of SBC Approaches: How Do We Ensure Replicability and Scale Up? An Action Dialogue among Researchers, Practitioners, and Host Country Governments  *Listen to webinar recording*
Moderator: Kamden Hoffmann; INSIGHT: Innovative Social Change in Global Health; Elizabeth Fox, USAID; Katherine Farnsworth, USAID; Lara Ho, International Rescue Committee; Jennifer Weiss, Concern Worldwide

The US Government, in collaboration with UNICEF and other partners, convened an Evidence Summit on Enhancing Child Survival and Development in Lower- and Middle-Income Countries by Social and Behavior Change in 2013. The Summit aimed to provide evidence to inform public health officials and health care workers on efficient, effective behavior change policies, strategies, and programs for child health and development. This plenary session gave a brief overview of lessons learned through the Evidence Summit process, and highlighted the key evidence. Panelists, representing the government and non-governmental sectors, discussed critical issues regarding how to effectively integrate and measured this evidence with existing and new programming and cross-cutting elements and SBC priorities in programming. Finally, the attendees had an opportunity for open dialogue with the panelists regarding how to put the evidence into action.

Evidence of Improved Impact of SBC Approaches

POSTER SESSION

Building Supportive Environments for Young Children in Kenya through Reflective Supervision
Poster By: ChildFund International; Presenter: Melissa Kelly

ChildFund International’s integrated early childhood project, Assuring the Essentials of Optimal Development for Infants and Young Children Affected by HIV and AIDS, is currently being implemented in Kenya with generous support by the Conrad N. Hilton Foundation. The project goal is to ensure that young children affected by HIV and AIDs enjoy good relationships with responsive caregivers. The project therefore aims to provide support, skills-building and links to services to caregivers at household and community levels through a comprehensive package of information and linkages to available services on child development, health, nutrition, education, child protection and economic empowerment to ensure caregivers’ are equipped to meet their own needs and the needs of young children aged 0-5 years in their care.

Assessing the continuum of care in South Asia and SubSaharan Africa
Poster By: Alyson Moran, USAID; Kavita Singh, University of North Carolina at Chapel Hill; Will Story, University of North Carolina at Chapel Hill

Increased global focus has been placed on the continuum of care to improve maternal health. The goal of the continuum of care approach is to provide women with essential reproductive health services before, during and after pregnancy and delivery. 86% of maternal deaths happen in South Asia and SubSaharan Africa. This study used DHS data from nine countries (Bangladesh, Nepal, Pakistan, Ethiopia, Malawi, Rwanda, Senegal, Tanzania, and Uganda) to determine where drop-outs occured on the continuum of care.

Household social capital and socioeconomic inequalities in child undernutrition in rural India: Exploring institutional and organizational ties
Poster By: Will Story, UNC

This study examines the relationship between social capital and child underweight, and explores the moderating effect of social capital on socioeconomic disparities in child underweight in rural India.Social capital is not only an important factor for the improvement of child heatlh, it can also play an important role in mitigating socioeconomic disparities in child underweight. In particular, soical connections to health providers and teachers might benefit households by increasing knowledge about better feeding practices and disease prevention or by connecting families to medical care and supplementary feeding programs. In addition, membership in bridging organizations may facilitate access to useful information for raising a child as well as improve the economic situation of the household, thereby providing acces to food and other household necessities.

Chikungunya and Dengue Fever Prevalence in the Caribbean: Dominica as a Case Study
Poster By: All Saints University School of Medicine; Presenter: Samuel Omidoyin

Chikungunya virus (CHIKV) and Dengue virus (DENV) infections cause incapacitating fever syndromes world-wide but are highly underestimated by public health and research programs. The correlation of the common vector organism with chikungunya and dengue virus infections was examined. It was observed that children (below 15 years) manifesting fever syndrome are slightly susceptible to test positive for Dengue Fever than Chikungunya. Adults manifesting fever syndrome are more susceptible to test positive for Dengue Fever than Chikungunya. In general, children are less likely to be seropositive. Women are more likely to be seropositive. Seropositives are less likely to own a motor vehicle. DENV and CHIKV seropositivity are closely associated.

Safer Deliveries
Poster By: D-tree International; Presenter: Steve Ollis

D-tree International developed a comprehensive package using mobile decision support tools and mobile money to increase facility delivery rates among women in Zanzibar. For 15,000 women enrolled in the program, the facility deliver rate went from a baseline of 40% to 75%. The program included a mobile application to help TBAs and CHWs register pregnant women and make appropriate birth plans, as well as identify danger signs. We organized local transportation (taxi and boats) and pre-negotiated rates with them and the TBAs/CHWs then used mobile money to arrange for transport for their clients either during an obstetric emergency or for her delivery at a health facility.

Midwives Leading, Managing, and Governing to Save Lives
Poster By: Management Sciences for Health; Presenter: Kate Martin

Leadership, management, and governance skills are considered among the critical but neglected curriculum elements that medical, nursing, and public health professionals need for success in their roles in health service delivery. Recognizing this, the USAID-funded Leadership, Management, and Governance Project worked to bridge this gap and develop an in-service certificate course for midwives in leadership, management, and governance. This curriculum utilizes action-based learning to equip midwife managers with the leadership, management, and governance skills that they need to thrive in their complex roles. Putting leadership and management knowledge into practice, the course was designed to include a 6-month long participatory element where midwives would develop and implement quality improvement projects towards improving service delivery in their work places.

A global framework for integrating community-based MNCH strategies into existing health systems: Revaluing the role of INGOs
Poster By: CORE Group; Presenter: Karen LeBan

A conceptual framework was presented based on case studies from Future Generations, Care, HHF, HKI, Concern Worldwide, and ChildFund International.

WORKING GROUP REPORT OUT

Reports from Community Child Health, HIV/AIDS, M&E, Malaria, Nutrition, Safe Motherhood & Reproductive Health, Social & Behavior Change, and Tuberculosis Working Groups

Working Group Report Out

PLENARY

Applying Human Centered Design to Global Health Programs  *Listen to webinar recording*
Moderator: Anne LaFond, John Snow, Inc.; Darren Menachemson, ThinkPlace Foundation; David Milestone, USAID Center for Accelerating Innovation and Impact; Dianna Kane, Medic Mobile

Public health practitioners draw from a deep toolbox of approaches to design and implement effective programs. As we continue to tackle wicked problems in global health, we face the challenge that many public health interventions, particularly in the realms of technology and behavior change, do not work the same way in every setting and there is a high failure rate of new interventions. We must look to innovative methods for understanding the needs of the populations we serve in order to create desirable, feasible, and sustainable solutions tailored to the local context.

Human-centered design provides such a framework, with tested methods and techniques for understanding user needs and cultivating empathy. In this plenary session, our panelists—including a professional designer, implementer, evaluator, and innovator within USAID—unpacked how a human-centered design approach can be applied in public health programs and explore the value proposition of taking a human-centered approach to program development.

Applying Human Centered Design to Global Health Programs_1

Applying Human Centered Design to Global Health Programs_2

LUNCHTIME ROUNDTABLES

Integrated Community Case Management (iCCM) Task Force meeting
Dyness Kasungami, USAID’s Maternal and Child Survival Program/John Snow, Inc.

The CCM Task Force has been in existence for just over five years. Membership has grown and so has the number of countries implementing iCCM. The rich learning and experiences of all Task Force members is explored through bi-monthly teleconferences and meetings of the subgroups. As iCCM programs expand, opportunities and challenges emerge. Specifically, the CCM Task Force Steering Committee recently reviewed the role of the Task Force in light of most country programs being in the expansion phase ― as opposed to the introduction phase when the Task Force was constituted. This round table discussion invited CCM Task Force members and interested parties to explore how the CCM Task Force can adapt its roles and responsibilities to suit the times. As programs go to scale, tools, funding and the nature of partnerships change. Is the CCM TF still relevant? It is fit for purpose in structure and modus operandi?

Working Group Chair Meeting

This was a mandatory meeting for Working Group Chairs only.

CONCURRENT SESSIONS

A Hands-on Workshop Exploring Human Centered Design
Darren Menachemson, ThinkPlace Foundation

Designing the right public health intervention relies on building a sophisticated understanding of people and communities – their needs, habits, motivations, capabilities, and beliefs. In this hands-on session, participants learned how Human Centered Design can be used to build powerful insights that can help shape programs and solutions, from the product and service levels to the level of the health system as a whole. We did this by examining, and trying out, two important HCD tools:

  • Personas, which allow you to usefully synthesise what is known about a cohort that is a target of your program in a way that encourages empathy and insight.
  • Pathway mapping, which enables you to visually map out people’s interactions with products, services, and systems, and also identify points where some change or intervention could improve, shift, or even transform things.

A Hands-on Workshop Exploring Human Centered Design 

Prevention of Maternal Mortality
Moderator: Amy Metzger, SMRH Working Group; Jennifer Weiss, Concern Worldwide/Malawi; Mary Ellen Stanton, USAID; Lisa Noguchi, USAID’s Maternal and Child Survival Program/Jhpiego

This session included presentations from Mary Ellen Stanton, USAID, on the “Ending Preventable Maternal Mortality: USAID’s Maternal Health Vision for Action;” Lisa Noguchi, The Maternal and Child Survival Program/Jhpiego, on strategies for implementation of the Maternal Health Vision for Action; and Jennifer Weiss, CONCERN, on how maternal death audits increase community involvement and accountability as tenants of the Maternal Health Vision for Action.

Prevention of Maternal Mortality_

Prevention of Maternal Mortality_Weiss

Prevention of Maternal Mortality_Stanton

Combatting Ebola and Similar Outbreaks with Social and Behavior Change Strategies
Moderator: Paul Robinson, International Medical Corps; Mathias Pollock, Mercy Corps; Suzanne Van Hulle, Catholic Relief Services; Maya Bahoshy, International Medical Corps; Janine Schooley, Project Concern International

During the recent devastating outbreak of the Ebola Virus Disease (EVD) in West Africa, social and behavior change (SBC) strategies played an effective role during the emergency response. PSI and Mercy Corps conducted a Barrier Analysis in Liberia; International Medical Corps used its psychosocial teams and trusted links within the communities of Sierra Leone and Liberia to address the key SBC barriers and improve the adoption of health-seeking behaviors; PCI adapted its Care Groups in Liberia for community education on EVD prevention and protection, reduction of stigma and myths, early identification and referral of suspected cases, and the re-entry of survivors in their communities; and Catholic Relief Services is designing new community-led strategies drawing upon the successes of existing social and behavior initiatives. Presenters shared lessons learned and recommendations from their experiences in West Africa. Participants in small group discussions considered SBC approaches they can adapt to combat future outbreaks.

Combatting Ebola

Implementation Research – What Is It? Am I Already Doing It? How Can I Do It Better?
Jim Ricca, USAID’s Maternal and Child Survival Program/Jhpiego; Olakunle Alonge, Johns Hopkins University

What is Implementation Research (IR)? It seems a lot of people are talking about it, but is it just old wine in new skins? Just another name for operations research or other kinds of investigations we’ve already been doing? In this session we looked at a practical definition of IR, its relation to other kinds of research, and characteristics that make it unique. One of those unique features is the outcomes of IR studies. We reviewed some key IR outcomes and how to formulate answerable IR questions. After interactive presentations, there was small group work to pull these concepts together using a case study. Although the case study was fictional, it was based on a composite of real world examples.

Implementation Research

CONCURRENT SESSIONS

Reaching the Hard-to-Reach: Migrants, Nomads, IDPs, and Border Communities: Lessons from the CORE Group Polio Project
Moderator: Lee Losey, CORE Group Polio Project (CGPP); Jitendra Awale and Rina Dey, CGPP/India; Bal Ram Bhui, CGPP/Horn of Africa; Anthony Kisanga Lomoro, CGPP/South Sudan

Hard-to-reach groups are some of the most vulnerable to polio as they remain outside of traditional service delivery mechanisms for immunization and other health services. In this session, CORE Group Polio Project staff members highlighted some strategies they have developed to strengthen equity in local health systems by bridging the gap to marginalized communities. The session explored how the project’s community health volunteers in South Sudan work to overcome the challenges of a weak health system and worker shortage to reach mothers and children in need of immunizations and other public health interventions, as well as how CGPP-India developed a customized communication package to reach high-risk, hard-to-reach groups, including migrant slum dwellers and brick kiln workers. The session also explored how our country programs in the Horn of Africa seek to reach at-risk mobile populations through cross-border coordination.

Reaching the Hard-to-Reach

What’s New? Update on Babies Born Too Small
Moderator: Carolyn Kruger, Project Concern International; Alfonso Rosales, World Vision US; Suzanne Stalls, American College of Nurse-Midwives; Bina Valsangkar, Saving Newborn Lives

Prematurity is the leading cause of newborn death (babies in the first four weeks of life) and now is the leading cause of death in children under age 5. The panel presented the global big picture of evidenced-based interventions along the continuum of care. A suite of learning materials that address the care of pregnant women experiencing premature labor and birth was presented, addressing facility-based stabilization and referral. The results of trials for antibiotic regimens to prevent neonatal sepsis presented evidence on how simplified regimens can manage neonatal sepsis. An example of a community-based approach to mobilization and uptake of facility-based care, promoted by CORE Group and the Polio Consortium of Ethiopia, was presented, which included the promotion of newborn communications and interventions at community and family levels working in collaboration with the Ethiopia MOH. A discussion was centered on What Can We Do?

What’s New? Update on Babies Born Too Small

Maternal and Child Mental Health
Moderator: Shannon Senefield, Catholic Relief Services; Tom Davis, Feed the Children; Janine Schooley, Project Concern International

Mental health presents a large, unmet health need globally. WHO estimates place depression as the 9th leading cause of disability-adjusted life years (DALYs), and more than 400 million people are estimated to suffer from depression. However, despite the need, there has been limited focus on both prevention of mental health disorders and response options. The current panel presented data and programs from a variety of geographic locations and perspectives: 1) Could treatment of depression be a significant new tool in the reduction of malnutrition, 2) Integrating Health Education and Action for LIFE (HEAL) and Women Empowered for Increased Reilience, and 3) Depression and anxiety among caregivers in Kenya and the link to early childhood development. Following the presentations, attendees were invited to work together to identify possible ways forward to incorporate mental health into health programming.

Maternal and Child Mental Health_Davis

Maternal and Child Mental Health_Senefeld 

Strategies for Managing Human Centered Design Projects
Moderator: Dianna Kane, Medic Mobile; Jahera Otieno, Concern Worldwide US; Katie Waller, Concern Worldwide US; Soumya Alva, John Snow, Inc.

No matter where you are in a project’s cycle, design activities can add value to the quality and impact of your work. Representatives from Medic Mobile, Concern Worldwide US, and JSI shared lessons on how to incorporate design methods into projects before, during, and even after a project has been completed. We shared examples on working with both flexible and inflexible funders and how to advocate for, plan, and manage a design-centered engagement. Those who already believe in the value of human-centered design but find themselves struggling to operationalize it, joined us for this practical session on where the rubber meets the road.

Strategies for Managing Human Centered Design Projects 

Strategies for Managing Human Centered Design Projects_

Strategies for Managing Human Centered Design Projects_Alva


Friday, April 17, 2015

Poll Everywhere Conference Evaluations
Michelle Shapiro, Communications Officer, CORE Group

CONCURRENT SESSIONS

Malaria Control: Improving Health Outcomes for Mothers and Children
Moderator: Jane Coleman, USAID’s Maternal and Child Survival Program (MCSP)/Jhpiego; Rae Galloway, MCSP/PATH; Michel Pacqué, MCSP/John Snow, Inc.; Lisa Noguchi, MCSP/Jhpiego

While malaria is preventable and treatable and increased malaria control measures are dramatically reducing the burden of malaria globally, much remains to be done to realize malaria elimination. This session presented MCSP strategies and interventions to improve health outcomes for pregnant women, newborns, and children. In “Trends, causes and programs to address it”, the relationship between malaria and anemia was described, specifically folic acid supplements during pregnancy. In “iCCM: Challenges and Successes in Diagnosis and Treatment of Malaria in the iCCM and IMCI Platforms”, successes and challenges of appropriate diagnosis and treatment of malaria in children were highlighted. Then, in “Prevention of Malaria in Pregnancy: Promoting IPTp Early in the Second Trimester”, implementation of the recent WHO policy updates in relation to cultural norms and providers’ knowledge and skills was discussed.

Malaria Control: Improving Outcomes

Supporting National Community Health Worker Programs
Moderator: Joseph Naimoli, USAID; Alfonso Rosales, World Vision US; Megan Christensen, Concern Worldwide; Lee Losey and Rina Dey, CORE Group Polio Project

National community health worker programs are now emerging in many countries and in other countries that already have such programs, efforts are being made to strengthen them. While NGO programs have been pioneers in the development of CHWs in many countries and champions of their importance for health systems, NGO CHW programs have often been tailored specifically to the needs of the NGO and its donors rather than conforming to a national paradigm. The need for NGOs to support the national CHW agenda is becoming increasingly important. This session reviewed the policies and practices of the CORE Group members working with national CHW programs in various countries.

Supporting National Community Health Worker Programs_Losey

Supporting National Community Health Worker Programs_Dey

Climate Change: Implications and Promising Practices
Moderator: Whitney Isenhower, CORE Group; Gillian McKay, GOAL Global; Janine Schooley, Project Concern International

Two initiatives addressing and researching the effects climate change has on people’s nutrition needs and livelihoods presented for 30 minutes each. Project Concern International (PCI) is working with pastoralist populations in Ethiopia and Tanzania to pilot customized grazing maps so the populations can identify migration patterns to avoid drought and decrease mortality rates. The project is conducted in partnership with the World Food Programme and the Disaster Risk Management and Food Security Sector, with support from Google and USAID. GOAL is conducting research with Malawian communities to identify ways to mitigate risks caused by climate change, including flooding and drought. The research uses a behavior change focus with a gendered lens, and GOAL is developing recommendations for specific interventions that target men’s, women’s, girls’, and boys’ disaster risk reduction needs. For the remaining 30 minutes, participants had a discussion about climate change projects, defining climate change, and related issues.

Climate Change: Implications and Promising Practices

Climate Change: Discussion Notes

Early Childhood Development Training Curricula
Moderator: Lenette Golding, Futures Group; Miriam Labbok, University of North Carolina at Chapel Hill; Shannon Senefeld, Catholic Relief Services; Matthew Frey, PATH; Abiy Seifu, Episcopal Relief & Development; Karen Calani, Food for the Hungry; Kathy Parry, University of North Carolina at Chapel Hill

Miriam Labbok opened this session with a keynote speech on the importance of early childhood development (ECD) interventions, in particular, responsive feeding, and share information on how to apply ECD approaches to health and development programming. Following, the audience had the opportunity to listen to three of four presentations on ECD training curricula and discuss the contextualization, implementation and evaluation of the various curricula. The four ECD curricula that were covered during this session are: Parenting Support in Africa: A Facilitator’s Manual developed by CRS; 2) Reading & Responding to Your Baby by FG Guatemala; 3) Care for Child Development Package by UNICEF/ WHO and; 4) The Essential Package: Holistically Addressing the Needs of Young Vulnerable Children and Their Caregivers Affected by HIV and AIDS. This session provided audience members with the opportunity to engage with the presenters in small groups for a more personalized discussion.

Early Childhood Development

Early Childhood Development_Handout_Golding

PLENARY

Making Lemonade out of Lemons: How to Optimize Health System Strengthening Instead of Running from One Crisis to Another
Janine Schooley, Project Concern International; Gillian McKay, GOAL Global

This closing plenary “bookended” the opening keynote presentation, “Advancing Community Health across the Continuum of Care: A Health Systems Perspective”. It focused on how we must avoid letting everything Ebola-related stop, not building upon, transitioning and taking advantage of all the new infrastructure, momentum, and community engagement for broader health and development issues, including this and the next Ebola or similar crisis. After framing the session as the need to “recommission vs. decommission”, a case study of GOAL’s work in Sierra Leone and PCI’s work in Liberia was presented. Most of the session was facilitated group discussion, action planning and recommendation-generation, allowing us to put our collective heads and energies together re: how we can leverage/optimize all this investment and now transition to broader health system strengthening. Let’s avoid letting the Ebola response (and similar situations) become a tragic missed opportunity that CORE Group and its members could do something about!

Making Lemonade out of Lemons

CLOSING REMARKS

Conference Highlights and Key Takeaways
Judy Lewis, Chair, CORE Group Board of Directors

End of Meeting Summary