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Session 5 Selecting PHE Interventions 1 Session Objective From a conceptual model, identify: • The intervention(s) that addresses the interdependencies between population, health and environment factors at a local site 2 Intervention Type 1. Single sector – impacts a sectoral objective – Example: Measles vaccination that impacts child survival 3 Intervention Type 2. Value Added – adds value in one sector as a result of work targeted at another sector – Example: Improved cooking stove (ICS) to conserve trees/forests also yields social benefit (time-saving), economic benefit (fuel-saving) and health benefit (ARI-prevention) for humans 4 2. Value added (2nd example) Moringa Tree (Moringa oleifera ) • • • • Perennial softwood native to sub-Himalaya Fast-growing, drought resistant, thrives in poor soil Targeted as agro-forestry intervention (alley-cropping) Also adds value for: Human health (leaves/seeds are edible and highly nutritious) Animal husbandry (food/fodder) Livelihood (seeds processed into cooking oil) Climate adaptation (trees make good wind breakers) Environmental health (seeds used for H2O purification) Alternative energy (biogas production) 5 Intervention Type 3. Linked - two or more sectoral interventions that are conceptually linked, operationally coordinated and generate results that go beyond the expected sectoral impacts – Example: An environmental hygiene intervention (organic waste management) linked to an agricultural intervention (composting) impacts sanitation in the homestead (expected), crop production (expected) and the nutrition status of children in the homestead (unexpected) 6 IPOPCORM Interventions Objective (short-term outcome) 1. Reproductive health outcomes improved in coastal communities List of Interventions • • 2. Community capacitated to implement CRM strategies including alternative livelihood • • 3. Public/policymakers’ awareness and support for PHE increased • • • CBD – targeted at the health sector but also adds value to CRM as it creates alternative livelihood opportunities Habitat enhancement Community based distribution (CBD) of contraceptives Protected area management Environmentally friendly enterprise development (EED) Coastal clean-up campaign Adolescent sexual and reproductive health IEC Micro-credit for EED Which of the above is a value-added intervention? 7 Interventions Work at Different Levels Individual Delivered to one person at a time; seek to modify knowledge, attitudes, beliefs, and self-efficacy Group Designed to influence individual behavior but delivered in a group setting and reinforced by peer pressure and support from other group members Community Seek to change attitudes, norms, and values of an entire community or target population Structural Aim at modifying the social, economic, and political structures and systems; may affect legislation, media & the market place 8 IPOPCORM Interventions – Work at Several Levels? Intervention Individual Group Community Structural Policy advocacy Peer education about FP/RH CBD of contraceptives Youth ecology camp Participatory coastal resource assessment & mapping Establish fish sanctuary Passage of local ordinance banning use of cyanide in fishing 9 “Evidence-based” Interventions What & Why? • Set of activities or procedures that has been validated through experimental studies or rigorous evaluation • Enhances the effectiveness of your PHE project and chance of success • Enables members of the leadership team to build on the experience of others See Participant Manual: List of Evidence-based PHE Interventions Can you suggest other examples of evidence-based interventions related to environmental outcomes? 10 TASK – Select Interventions Step One: Review your Conceptual Model, hierarchy of Objectives and Results Chains and identify a critical factor (desired outcome) for each sector Step Two: Using the list of Evidence-Based Interventions, select those that match your desired outcomes (create your own, if necessary) Step Three: For each intervention, identify Level & Type Step Four: Input your selection into the Worksheet Time: 50 minutes OBJECTIVE Results Chain Factor INTERVENTION Level of Intervention 1 Worksheet for each Objective 1 Value-Added Intervention per Objective Type of Intervention 11 Intervention Selection Worksheet Examples OBJECTIVE Result Chain Factor INTERVENTION Level of Intervention Type of Intervention (desired outcome) RH outcomes improved Access to family planning information and products increased CBD system and social marketing scheme for contraceptives Structural Referral mechanism for clients who want sterilization Individual Single sector Acceptance and use of FP improved Peer education for married women of reproductive age Individual Single-sector Street drama encouraging people to plan their families and to protect their coastal resources to improve food security from the sea Community Safer sex education for teens engaged in unprotected sex Individual Unintended pregnancy among youth reduced Interactive board game with IEC messages encouraging youth to become stewards of their sexuality and the environment Value added (FP, Livelihood) Linked (RH-CRM = food security) Value added (FP, Health) Group Value added (RH, Environment) 12 OBJECTIVE Result INTERVENTION Level Type Chain Factor CB-CRM capacity developed Critical habitats protected by community Participatory coastal resource assessment (PCRA) Group Value Added (CRM, Governance) Marine tenurial agreement Structural Single sector MPA management Committee and Plan Group Value Added (CRM, Governance) Establishment of MPA (i.e., fish sanctuary, mangrove reserve) Community Single sector Illegal fishing stopped with community involvement Surveillance (patrolling) of MPA Community Single sector Enforcement effort by deputized fish wardens Group Single sector Behavior change communication targeted to illegal fishers Individual Single sector Fishing effort reduced Environment-friendly enterprise development (EED) Group Value Added (CRM, Economic) Micro-credit facility for EED Individual Value Added (CRM, Economic) CRM gains sustained Integrate FP into CRM agendas and village development plans Structural Linked (CRM-RH-EED) 13