HoPE for Sustainable Development: Development Results from Integration in East Africa
The (SDGs) are an ambitious framework for reducing poverty and improving the lives of billions of people. They were agreed to last year by governments at the United Nations and cover developing and developed countries alike. But how will governments, NGOs, and other organizations go about actually accomplishing them over the next 15 years?
Paula Caballero, global practice director for the environment and natural resources at the World Bank, urged institutions to seek out new ways of doing development, from food security to global health efforts. 鈥淚t is through partnerships and through innovation that we can really start to make use and really incentivize these new frameworks that we have agreed to.鈥
One such approach is known as population, health, and environment, or PHE. Speaking at the 浪花直播 Center on June 21, Pamela Onduso, a senior technical advisor on youth advocacy and partnership at , defined PHE as 鈥渁n integrated approach to improve access to health services, especially family planning and sexual and reproductive health, while at the same time helping communities to manage natural resources and conserve the critical ecosystems on which they depend.鈥
Supported by Pathfinder International, the U.S. Agency for International Development, MacArthur Foundation, and Packard Foundation, the , or HoPE-LVB, has employed the PHE model to address food insecurity, weak health infrastructure, environmental degradation, high maternal and infant mortality, and inadequate water, sanitation, and hygiene.
鈥淭he PHE approach advances the conversation about how multi-sector programming and multi-stakeholder partnerships are critical to the success of the SDGs,鈥 said Onduso.
鈥淲ith the End in Mind鈥
Much of Pathfinder鈥檚 work is focused on women鈥檚 health, but with HOPE-LVB there was a conscious effort to expand beyond that comfort zone.
鈥淚f you really want to make a dent on maternal mortality, that鈥檚 not a standalone goal,鈥 said Caballero. 鈥淵ou need an entire system, you need roads, energy, education鈥o help that woman deliver that baby in a difficult situation. It鈥檚 not just an isolated target.鈥
Four years ago, the project was designed 鈥,鈥 said Onduso. That end was scalability 鈥 moving from success in a handful of communities to many more.
Dorah Taranta, a project manager for Pathfinder International Uganda, explained that the HoPE-LVB team first identified key partnerships 鈥渂oth for implementation but also for sustainability.鈥 These partners included actors from the government, civil society, and environmental sector who would strengthen the project鈥檚 interventions and increase the odds of change perpetuating beyond the length of the initial funding cycle. They interviewed key community groups to include women, youth, farmers, young mothers, beach management units, and facility- and community-based health care providers.
鈥淧reviously, communities depended on projects that come and go鈥
Taranta said they realized that 鈥渁t all levels, an individual, or a group, or a department cannot reach the needs of all that we serve. We need partnerships, we need to work together.鈥 This also included outreach to local government. 鈥淲e have been able to bring ministries of health, population, [and] natural resources to come together and think about the best way to reach the communities they serve.鈥
After conducting group and individual interviews, the team determined which interventions were relevant and whether they could be successful. For example, members of a beach management unit explained how overfishing was affecting the daily catch and shared suggestions for how HoPE-LVB could help the community to take a more active role in protecting their natural resources.
Champions and Model Households
These insights allowed HoPE-LVB to that included 鈥渦pgrading the skills of service providers from health, agriculture, animal husbandry, and fisheries, conducting PHE-integrated community dialogues, outreach and door-to-door education and services, and supporting the establishment of PHE village committees.鈥
Women and men met together to discuss 鈥渋ssues affecting reproductive health, their incomes, and issues affecting the environment,鈥 said Taranta. With the information drawn from these community meetings, participants 鈥渉ave been able to come up with environment-friendly income generating activities.鈥
Next, they employed a 鈥渕odel household鈥 approach of tracking behaviors and championing those that achieved success. 鈥淎t the household level we are able to see what these households, what these individuals are doing to change their lifestyles,鈥 said Taranta. 鈥淲hat are they doing to preserve the natural resources they depend on? What are they doing to promote what they have learned?鈥
The team then moved toward addressing broader systems. They considered how to empower women, Taranta said. 鈥淗ow do we work with public health facilities? How do we build partnerships between public and private facilities?鈥
Finally, after identifying 鈥渃hampions鈥 across sectors, districts, and villages, they did a training of trainers, passing on advocacy tools that spread through multiple communities and encourage ownership. The goal was to give individuals 鈥渁 voice to demand their rights and to demand for services,鈥 said Taranta.
鈥淎 Do-able Miracle鈥
Caballero praised HoPE-LVB as a proof of concept, rather than a pilot, because it鈥檚 shown it can change people鈥檚 behaviors. 鈥淧ilot has the small mentality of something finite鈥nd proof of concept has implicit in it how we are going to take this forward.鈥
She called the approach a 鈥渄o-able miracle.鈥 While there may be some high up-front costs, the long-term savings are 鈥渋ncredible,鈥 she said. 鈥淭hese efficiencies, the linkages, the way that men have been involved, all these unexpected, amazing breakthroughs鈥 actually lower the transaction costs over time.
Currently in its third year of a five-year funding cycle, the project will conclude in 2017, and the next two years will bring a focus on scaling up, said Onduso.
鈥淧reviously, communities depended on projects that come and go,鈥 said Millicent Kodande, a monitoring and evaluation officer with Pathfinder International Kenya. But she pointed to the prevalence of clean cookstoves as evidence that the impact of this project is more lasting.
鈥淭hese clean cookstoves use a single or two pieces of firewood for cooking in the kitchen, have less smoke, and are more efficient for use at home,鈥 Kodande said. 鈥淪o many women have adopted it because when you have less fuel, you can still cook for your family, but there is less indoor pollution in the households.鈥
And they have a positive multiplier effect within the household. 鈥淚t has improved communication at home,鈥 Kodande said, 鈥淸men] are more interactive with the family, following up on homework, and ensuring that, when the woman is busy getting water, he is also helping with the cooking.鈥
Integration across sectors has contributed to improving resilience in the region, said Charles Kabiswa, director of programs at Ecological Christian Organization in Uganda. HoPE-LVB has helped communities set up climate change adaptation measures and improve food security, agricultural sustainability, and health, all of which contribute to people鈥檚 ability to bounce back from shocks and stressors.
鈥淚t is about doing development differently,鈥 said Caballero. 鈥淚t isn鈥檛 really about changing economies, it is about changing mindsets鈥nd when people are given an opportunity, it unleashes potential.鈥
This event was co-sponsored by the U.S. Agency for International Development - Evidence to Action Project.
Event Resources:
Written by Sreya Panuganti, edited by Schuyler Null.
Feature Photo Credit: , courtesy of flickr user Michell Zappa.
Speakers


Vice President, Sustainable Markets, Pact

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Environmental Change and Security Program
The Environmental Change and Security Program (ECSP) explores the connections between environmental change, health, and population dynamics and their links to conflict, human insecurity, and foreign policy. Read more
Maternal Health Initiative
Housed within the 浪花直播 Center's Environmental Change and Security Program, the Maternal Health Initiative (MHI) leads the 浪花直播 Center鈥檚 work on maternal health, global health equity, and gender equality. Read more