multi-dimensional programming the rubik's cube challenge to community health ester indriani
TRANSCRIPT
Applications of Multi-Dimensional Approach to Health:
Challenges and Lessons Learned
Esther Indriani, MPH Regional Health and Nutrition Advisor
World Vision South Asia and Pacific Region
Key Lessons Learned of Multi-Dimensional Approach
• It’s complex • It can be done •We need to look at intended & unintended results
Asking children is a good way to start…
“If we can earn our own income, we can tell our parents not to marry us early, because we are self-reliant.”
Principles for Integrated Approach
• Issues are multi-dimensional • Common Goal • Common target group • Common programme area • Common indicator for success • Complementary projects and activities,
efficient use of resources
India • Integrated Programming for Child
Health (IPCH) • Aim: Reduction in malnutrition • 4 years 2012-2015 • Impacting 3,7 million people
including 350,000 children under 5 • 17 states, 72 districts • Targeted poor and hardcore poor
with underweight child for a package of Health, Nutrition, and Livelihood interventions
Final Evaluation IPCH (Team Leader: Dr. Marc Debay, Loma Linda University) Oct 2015 • Average Annual Reduction
Rate of Underweight Over 3 Years + 13.1%
• 4 X faster decrease in underweight than in 100 highest malnutrition prevalence districts over previous 7 years
Source: Final Evaluation Report of IPCH 2015, WV India and Loma Linda University
WV India’s Resolution to do Integrated Approach
Bangladesh: Nobokoli Project
• 4 years 2013 – 2017 • Aim: To reduce malnutrition • impacting 1,4 million people including
181,135 children under 5 • in 7 districts, 18 upazilla • Focusing on pregnant & lactating women
and children under two for a package of Health, Nutrition, and Livelihood interventions
• Targeting poor & ultra poor HHs*: • With underweight child under 2, or • With Pregnant Woman * based on income and land ownership
• Increased production • Increased consumption • Improved dietary diversity • Improved income and savings • Increase women’s empowerment • Improved nutrition
7, 276 children
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
90.0
100.0
November'15
December'15
January '16 February '16 March '16
23.8 25.1 27.0 28.1 28.9
35.0 36.6 37.5 38.4 38.4
41.2 38.3 35.5 33.5 32.7
Prevalence of underweight of ED children for Nobokoli areas
Moderate & severe Mild NormalIntegrated monitoring
Baseline (July-Oct 2014) Mid Term (Jan-Mar 2016) done by ICDDR,B
Underweight and Wasting Comparison between Baseline and Mid Term Survey
Things We are Learning for Multi-Dimensional Approach to Health
• COMPLEXITY • TIME • COMPETENCE • PARTNERSHIP • COORDINATION • SCOPE
Untying the knot - together
Creative and innovative examples of multi-dimensional programs are changing the lives of women, children and communities around the world.
We can no longer say that we don’t know what to do, or we don’t know how.
We need to learn, share and act TODAY.