WELCOME
Welcome
Judy Lewis, Chair, CORE Group Board of Directors; Lisa M. Hilmi, Executive Director, CORE Group; Lillian Shirley, Director, Public Health Division, Oregon Health Authority
KEYNOTE
Shawn Baker, Director of Nutrition, Bill & Melinda Gates Foundation
Shawn Baker, Director of Nutrition for the Bill & Melinda Gates Foundation, walked the conference attendees through the Foundation’s recent “refresh” of its nutrition strategy, and how it was catalyzed by the larger global awakening to the crucial importance of nutrition to health and development. He showed how discussions within the Gates Foundations reflect the major themes of the global nutrition agenda. In particular, he addressed how progress requires both a recognition of the complex, multi-sectoral nature of the solutions and a focus on priorities and allocation of roles and responsibilities in manageable parts; the importance of strengthening the ability to deliver proven approaches; how political and social resources are as crucial as technical tools in scaling up nutrition; and the role the NGO and research communities can play in the movement.
Listen to a recording of the welcome and keynote session.
Keeping the Complexities of Multidimensional Nutrition Strategies Simple and Doable
PLENARY
Multi-dimensional Programming: The Rubik’s Cube Challenge to Community Health
Esther Indriani, World Vision South Asia and Pacific Ocean; Paulina Bayiwasi, Ministry of Health, Ghana; Lee Po Cha, Immigrant & Refugee Community Organization; Katherine Jones Debay, Loma Linda University School of Public Health
The origins of community and global public health and nutrition problems are rooted in a variety of multidimensional causes, addressed through multidimensional solutions with constellations of actors. Like the Rubik’s cube, there are 42 quintillion possibilities but only one correct solution – healthy thriving people. Public health and nutrition problems are not engineered plastic Rubik’s cubes subjected to trials and errors of individual players. Rather there are multiple actors sometimes working together and sometimes at odds to address public health and nutrition problems. This session explored how various actors have different perspectives on the multi-dimensional aspects of public health and nutrition problems, how they consider the individual, household, community ecosystem, and globalization in designing and imple- menting programs, and how global health practitioners can apply the lessons from these different perspectives. Through group discussions participants explored multi-dimensional programming challenges. A panel of practitioners from an international NGO, local government health agency, and a community-based organization discussed how they have addressed the challenges to create successful programs.
Reflection Questions for the Conference:
• How can I master the Rubik’s cube to be more effective in addressing the multi-dimensional aspects of public health and nutrition problems?
• What am I learning/hearing at the CORE conference that will help me master the Rubik’s cube?
By the end of this session, participants had:
• Described the most critical dimensions for effective community health programming.
• Described examples of how successful programs consider the multi-dimensional aspects of a community, national, global public health and nutrition problem in resource constrained settings.
• Defined the challenges global health practitioners face supporting solutions that address the multi-dimensional aspects of public health and nutrition problems.
Listen to a recording of the plenary session.
Multi-dimensional Programming: The Rubik’s Cube Challenge to Community Health_DEBAY
Applications of Multi-Dimensional Approach to Health: Challenges and Lessons Learned_INDRIANI
VIDEO: Esther Indriani shares highlights from the session.
LUNCHTIME ROUNDTABLES
Can a TV Spot Change Behavior?: Help Shape Alive & Thrive’s Set of “Lessons Learned” on Role of Mass Media in Nutrition
Lenette Golding, Alive & Thrive, FHI 360
During lunch, conference attendees had the option to stop by the A&T table and offer your doubts and support for the kinds of lessons Alive & Thrive (A&T) staff are drawing from our data. Participants weighed in on topics like: Can TV or radio spots address nuanced and complex issues? For what kinds of behaviors is mass media alone likely to move the needle? Why do we say that mass and interpersonal communication are mutually reinforcing? What is the relative cost of mass media and at-scale interpersonal communication? Alive & Thrive is one of the few programs to assess the contributions mass media may be making in achieving rapid large scale improvements in infant and young child feeding practices.
CONCURRENT SESSIONS
Telesphore Kabore, USAID’s Maternal and Child Survival Program, Save the Children; Susan Igras, Institute for Reproductive Health, Georgetown University; Feven Mekuria, CARE International; Moderator: Joseph Petraglia, Pathfinder InternationalThe centrality of social norms and normative change to the broader goal of behavior change is indisputable. In this panel, presenters explored the role of normative change in community action-based SBC through examination of different elements: 1) the “reflection and dialogue” dimension of normative change as part of a community action-based SBC project using Social Analysis and Action (SAA) as a case in point; 2) the “action planning” dimension of normative change as part of a community action cycle; and 3) the “social networking and diffusion” dimension of normative change using Tekponen Jikuagou as a case in point. Panelists spoke of “dimensions” and “cases in point” as they aimed to generalize the norm-changing potential of community action beyond the scope of any given project/activity.
By the end of this session, participants had:
• Practiced guiding the dynamics of a reflection/dialogue discussion highlighting the role of norms.
• Practiced the translation of priority issues into an action phase focused on normative change.
• Learned how techniques of social networking can diffuse new ideas about healthier norms.
Collen Kaleda, The Community Project: Ethiopia; Rita Cooper, Engineer Without Borders: Portland Maine Professionals; Judy Lewis, University of ConnecticutThe Community Project (CP) is a multi-dimensional approach to education and health, housing and environment. CP engages Engineers without Borders(EWB), City Government of Debre Birhan including the Education Department, local universities, and a Community Development Committee (CDC). CP includes a school (1200 students), food-crop gardens and orchards for nutrition, healthy building and latrine design (urine-diverting toilets, composting, wash-up room for menstruating girls), handwashing station, soccer and trackfields for exercise,and a community center with a health station, community meeting space and vocational activities. CP provides an excellent case study of multi-dimensional programming encompassing education, health, nutrition, water and sanitation, recreation/exercise, and economic development. This provided the basis for small group work in the session focusing on illustrative examples of issues and challenges arising from multiple organizations, perspectives on health and education, and community priorities to discuss problem-solving and strategies for multi-dimensional work from the point of view of the community.
By the end of this session, participants had:
• Applied the components of a multi-dimensional approach to address issues arising from the implementation of a representative program from a low resource country.
• Identified different perspectives that the stakeholders (identified in the previous plenary) may have on these issues.
• Developed a “take home” strategy for improving program implementation and integration of multiple dimensions at the community level.
The Community Project: A Multi-dimensional Ethiopian Case Study
Jennifer Orgle, CARE USA; Dennis Mello, PCI; Jennine Carmichael, FHI 360; Bobbie Gray, Freedom From Hunger; Paul Rippey, Savings Revolution
Savings Groups (SGs) are self-managed, self-capitalized village-based savings and credit groups. SGs have become a com- mon component of community-based health and nutrition programs, and when they are used to complement another intervention, like MNCH, they earn a special name, SG+. In addition to their economic benefits, SG+ provide an effective platform for the dissemination of MNCH messages. Moreover, the less easily measurable factor of increased empowerment and confidence, particularly among female members, has also been noted. Representatives from Freedom from Hunger, CARE, PCI, FHI 360 and Savings Revolution shared experiences and lessons on how SG+ have been integrated into MNCH projects and contributed to their effectiveness. The session looked at examples of what is being done with SG+, review results and impact from such programs in the past and look ahead to some issues that are on the horizon and should be considered when adding an SG+ component to multi-dimensional community-based MNCH programs in the future.
By the end of this session, participants had:
• Discussed SG+ experience in several countries, outlining how this mechanism has added to and benefitted program effectiveness.
• Reviewed the results of SG+ programming based on rigorous research.
• Explored considerations and ideas for SG+ approaches in the future.
Savings Group as a Platform for Multi-dimensional Programming: Introduction
Savings Groups Plus: A Review of the Evidence_CARMICHAEL
Utilizing Savings Groups to Improve Maternal and Child Nutrition_ORGLE
Savings Groups: Post-Project Outcomes and New Technologies_RIPPEY
Jose Luis Alvarez Moran, Action Against Hunger UK; Jennifer Nielsen, Hellen Keller International; Justine Kavle, USAID’s Maternal and Child Survival Program, PATH; Maureen Gallagher, Action Against Hunger USThis session included the sharing of multisector nutrition projects and related research applied for program design, real time evaluation, and evidence building. Three projects bridging nutrition and health through agriculture, family planning and community health services presented diverse angles on the use of research for programming and health-related results.
By the end of this session, participants had:
• Learned about different types of research and how they can be used at various stages of the project cycle in nutrition-related multi-dimensional programming.
• Learned about how a rigorous methodology for operations research looking at program delivery in a nutrition-sensitive agriculture and health & nutrition program can identify weaknesses and inform program improvements. In a complex program such as this, monitoring delivery is especially crucial.
• Discussed opportunities and challenges to the different types of research methods shared when analyzing and improving nutrition multi-dimensional programming.
Using Process Evaluation to Strengthen Program Delivery_NIELSEN
PLENARY
Tim Frankenberger, TANGO InternationalResilience is increasingly seen as a unifying concept and policy instrument that uses humanitarian and development approaches to address the chronic vulnerability of populations exposed to recurrent shocks and stressors. Building resilience involves making investments that strengthen the absorptive, adaptive and transformative capacities of vulnerable populations to cope with and recover from specific shocks and stressors. Questions raised about resilience measurement are motivated by the need to assess and understand the dynamics that account for heterogeneous outcomes following shock exposure and the need to assess the impacts of the growing number of interventions that are meant to promote resilience. This presentation summarized TANGO’s research on the influence of key capacities that enable households and communities to mitigate, adapt to and recover from shocks and stressors. The focus of this work has been on the role of socialcapital, livelihood diversification and psycho-social factors in managing and recovering from climate related shocks.
Measuring Resilience: Evidence from Ethiopia, Kenya, Uganda, Niger and Burkina Faso
VIDEO: Tim shares highlights from his session