Integrated Development Laura Ghiron , MPH ExpandNet Secretariat and - - PowerPoint PPT Presentation

A Three-Stage Approach to Scaling Integrated Development

Laura Ghiron, MPH

ExpandNet Secretariat and the Evidence to Action Project

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ExpandNet Definition of Scaling Up

“Deliberate efforts to increase the impact of innovations successfully tested in pilot or experimental projects so as to benefit more people and to foster policy and program development on a lasting basis.”

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HoPE-LVB Project sites

HOPE-LVB Integrated PHE Model

Key Interventions:

• Population

– Provision of family planning info & services – Education about population impacts

• Health

– Sexual and Reproductive health/rights – Maternal/newborn/child health – Water, sanitation and hygiene – Nutrition

• Environment

– Sustainable fisheries – Sustainable agriculture – Biodiversity conservation – Sustainable livelihood diversification – Tree planting/reforestation

Key Processes:

• Advocacy
• Participatory needs

assessment

• Community engagement
• Building capacity through

training & supervision

• Systems strengthening
• Participatory monitoring

& reporting

Gender equity, Youth

• Stage I: Design and demonstrate/test a scalable

model for integrated PHE in Kenya & Uganda’s LVB regions in ways that build towards future expansion and institutionalization

• Stage II: Develop a scaling-up strategy for

successfully tested interventions with stakeholders

• Stage III: Strategically manage implementation
• f the scaling-up strategy and process

HoPE’s systematic focus on scale up:

Keep the end of scale up in mind throughout project design and implementation (Stage I) Develop a scaling up strategy (Stage II) Strategically manage the scaling up process (Stage III)

A three-stage approach for systematic scale up

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ExpandNet/WHO guidance on designing pilot projects with scaling up in mind

Scoping meetings with stakeholders

Beach Management Unit in Rakwaro, KE Youth in Malongo, Uganda Subcounty officials in Bussi Uganda Uganda Population Secretariat

WHAT WAS INITIALLY PLANNED:

Agro-forestry interventions implemented primarily by project personnel directly with communities

….AFTER GROUP ANALYSIS BECAME:

Agro-forestry interventions implemented jointly with village environmental committees, subcounty environment officials, district environmental officers and community members

Example of what changed as a result of “beginning with the end [of scale up] in mind”

“One thing that I like about the approach HoPE-LVB uses is utilizing the MOH Community Strategy… using

• ur CHWs and using that strategy, they

didn’t employ other institutions, they use the already existing structures… already developed in the community.”

• Suba sub-county RH Coordinator, Homa

Bay, Kenya

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ExpandNet/WHO Nine steps for developing a scaling up strategy

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The Innovation User Organization(s) Resource Team ORGANIZATIONAL PROCESS COSTS/RESOURCE MOBILIZATION MONITORING AND EVALUATION

TYPE OF SCALING UP

Scaling-up Strategy

DISSEMINATION AND ADVOCACY

The elements of scaling up Strategic choice areas

Keep the end of scale up in mind throughout project implementation Develop a scaling up strategy Strategically manage the scaling up process

Some key institutionalization outcomes of using a systematic approach

• In Kenya, Homa Bay and Siaya Counties established

PHE steering committees which have incorporated and budgeted for PHE implementation in five-year County Integrated Development Plans

• In Uganda, the Ministry of Health has adopted a key

HoPE concept in their new strategy, while at district levels the government is replicating demonstration sites with minimal support from the HoPE team

• Regionally, Lake Victoria Basin Commission supporting

efforts of PHE working groups in five member-nations

Challenges to scaling PHE

• Existing national/regional policies promote

integration but lack implementation strategies

• Verticalized sectors, personnel and funding

streams are not conducive to implementing integrated approaches HOWEVER, largely because of the systematic approach to scale up, PHE has gained powerful momentum in East Africa, in spite of systemic

• bstacles.