Building an Implementation Science Collaboration on Urban Health in East Africa ECSA-HC Best Practices Forum 2018 Ester Elisaria, Ifakara Health Institute Jane Wanyama, Infectious Diseases Institute Francis Obare, Population Council Kenya Emily Peca, URC
Health Evaluation & Applied Research and Development (HEARD) Approach Opportunity to apply approach to nutrition/WASH among poor urban adolescents/children in East Africa
ECSA-HC Roundtable Consultation Objectives • Assess the context and determinants of Roundtable hosted by: ECSA‐ urban health challenges and opportunities HC, June 2017, Dar es Salaam to advance nutrition and WASH Participants : interventions for the poorest children in urban settings; City authorities, national water and sewerage • Review the relevant available evidence from corporations/companies, Sub‐Saharan Africa; non‐governmental organizations, UN • Consider existing initiatives addressing agencies, USAID, nutrition and WASH efforts for children in academics, researchers, urban settings; and representatives of ministries of health and • Propose a set of implementation science education. priorities to advance the health of children in urban areas through nutrition and WASH.
Roundtable consultation Priorities 1. Conduct implementation science activities to contribute to reduction in the know-do gap related to WASH and nutrition challenges among the urban poor. 2. Review and document the multi-sectoral mechanisms and promising practices for WASH and Nutrition in the region. 3. Conduct an urban health policy analysis with a view to developing a prototype urban health policy, 4. Establish a mechanism to maintain urban health on national and regional agendas in eastern and southern Africa through creation and coordination of a community of practice (COP) on urban health 5. Highlight urban health during the forthcoming ECSA-HC Best Practices Forum
Implementation Science Collaboration on Urban Health in East Africa: Multi-country Assessment Team
Assessment Principles • Given much of health is produced outside of the health sector, we need a multi‐sectoral and systems lens • Draw from existing information e.g. literature, data, and policy review. • Use of participatory community‐based processes facilitated by organizations with established presence in the urban spaces of interest. • The assessment findings will inform implementation platforms, policy/advocacy and research agendas —and will serve as the basis for future work. • The aim is to produce findings relevant for uptake at the local, national and regional levels .
Assessment Design Elements Overall Questions : What contributes to poor nutrition among children living in urban slums/informal settlements? What are solutions to effectively address their needs ? Assessment Domains Formal and Socio‐ Informal Programs economic and Policies & Key Actors Environment Systems for and cultural Strategies and Platforms al factors Healthcare/ Initiatives vulnerabilities Food Methods Key (Focus Literature Analysis of Stakeholder Systems Informant Group Review Existing Data Mapping Mapping Interviews Discussions)
Assessment Products 1 2 3 Country‐ Country‐Specific Cross‐country Synthesis Report specific Community Case Urban Profile Study Policy/ Program Data/Evidence Policy Inventory Gaps/Recs Gaps/Recs Key actors and Data Inventory System and services platforms that can improvements be leveraged Annotated Bibliography Promising Next set of approaches to be Implementation replicated/scaled Science Questions Key Actors & Program Matrix
Next Steps • This marks the unofficial “soft launch” of the three country assessment; • Implementation will begin, July/August pending final technical review; • Preparation for the International Conference on Urban Health to be held in Kampala, November 2018 (workshops and sharing of prelim findings); • Community/National Stakeholder engagement around results; • Final synthesis of findings to be shared during ECSA‐ HC‐ hosted forum in 2019.
Moving Evidence to Action Look forward to continued discussion around: • Decision‐maker needs to ‘Want to avoid being improve the nutrition and data rich and WASH outcomes of information poor!’- children/adolescents in urban areas Participant from Roundtable Discussion • How we can best facilitate the packaging and sharing of evidence to inform action • How we can continue this conversation among member states.
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