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Proportion of population with sustainable access to an improved water source Proportion of population with access to improved sanitation J OCELYN W IDMER , P H D MPH Proportion of population with sustainable access to an improved water source


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Proportion of population with sustainable access to an improved water source

  • Proportion of population with access to improved sanitation

JOCELYN WIDMER, PHD MPH

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Proportion of population with sustainable access to an improved water source

  • Proportion of population with access to improved sanitation

JOCELYN WIDMER, PHD MPH

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HALVE, BY 2015, THE PROPORTION OF THE

POPULATION WITHOUT SUSTAINABLE ACCESS TO SAFE DRINKING WATER AND BASIC SANITATION

  • PROPORTION OF POPULATION WITH SUSTAINABLE ACCESS TO AN

IMPROVED WATER SOURCE

  • PROPORTION OF POPULATION WITH ACCESS TO IMPROVED SANITATION
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ENSURE ACCESS TO WATER AND SANITATION FOR ALL

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SLIDE 5
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ISLAND OF HISPANIOLA

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SCALABILITY OF A COMMUNITY-BASED APPROACH TO IMPROVE WATER POINT ACCESS, FUNCTIONALITY & PUBLIC HEALTH IN HAITI

WATER POINT MONITORING PROJECT: JUNE 2012 – JUNE 2013

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MONITORING WATER POINT FUNCTIONALITY MEASURING WATER QUALITY TRACKING WATER-RELATED PERCEPTIONS / BEHAVIORS DATA COLLECTION METHOD

DEVELOPED USING ANDROID-BASED TABLET SYSTEM

PROJECT HIGHLIGHTS

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GEOGRAPHIC VARIABILITY

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SOURCE TYPE

WHERE IS THE WATER COMING FROM?

EXTRACTION SYSTEM

HOW IS THE WATER GETTING OUT OF THE GROUND?

WATER POINT TYPE

WHERE ARE THE PEOPLE GOING TO COLLECT WATER?

DEFINITION OF WATER SOURCE

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WATER USAGE BEHAVIORS & PERCEPTIONS OF WATER IN AREA

ESTABLISH COMMUNITY PRESENCE / DEFINE CHARACTERISTIC OF AREA

INVENTORY OF 550 WATER POINTS IN STUDY AREA

NO WATER SAMPLES COLLECTED

WATER QUALITY SAMPLING & RE-INVENTORY OF WATER POINTS

STORM HIT 8/24-8/25 (RAIN FOR 36-HR PERIOD) ~ 460 WATER POINTS (NOT ALL ACCESSIBLE DUE TO FLOODING) BAG TESTS + 20% MICROBIOLOGICAL SUBSAMPLE (NOT CLEAN)

ATTEMPT BASELINE WATER QUALITY SAMPLING & RE-INVENTORY

OF WATER POINTS

DRY CONDITIONS ~ 446 WATER POINTS (DUPLICATES, CLOSED, ETC…) BAGS + RE-SAMPLING OF MICROBIOLOGICAL SUB-SAMPLE (~ 72) COORDINATED SAMPLE COLLECTION WITH MICROBIOLOGY TEAM

RESAMPLE SUBSAMPLE AFTER SANDY (= ISAAC)

STORM HIT 10/24 (RAIN FOR 36-HR PERIOD) SAMPLE COLLECTION MIRRORED SUBSAMPLE AFTER ISAAC ~ 57 WATER POINTS

FULL RE-INVENTORY WITH FULL MICROBIOLOGICAL TESTING

369 WATER POINTS (EFFORT TO REMOVE DUPLICATES) JUN 2012 JUL 2012 AUG 2012

TROPICAL STORM ISAAC

OCT 2012 MAR 2013

7/4-7/12 8/26-9/1 10/12-10/19 3/18-3/28

OCT 2012

TROPICAL STORM SANDY 10/29-11/2

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INDICATION OF WATER SATURATION IN AREA DURING FALL 2012 SAMPLING

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INDICATION OF WATER SATURATION IN AREA DURING FALL 2012 SAMPLING

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INDICATION OF WATER SATURATION IN AREA DURING FALL 2012 SAMPLING

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INDICATION OF WATER SATURATION IN AREA DURING FALL 2012 SAMPLING

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STUDY AREA

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  • DATA COLLECTION AIDED BY RECOGNITION OF TEAM IN CERTAIN

AREAS (ASSIGNED SAME WATER POINTS EACH SAMPLE RUN)

  • CONSISTENT TEAM COLLECTING DATA
  • COORDINATION BETWEEN TEAM AND MICROBIOLOGISTS
  • DATA COLLECTION PROCESS IS OCCURRING IN WAYS THAT MSPP

AND DINEPA HAVE PROPOSED (TEAM-BASED)

  • NOT GETTING INFORMATION BACK TO COMMUNITIES
  • SOME AREAS PROHIBITING WATER SAMPLE COLLECTION
  • INTERVENTION STRATEGY UNIQUE BECAUSE OF REGIONAL SCALE

(MANY OFFERS TO PUT IN POINT SYSTEMS-WILL THIS

PERPETUATE THE PROBLEM?)

SIGNIFICANT POINTS LIMITING FACTORS

SOME POINTS ON SIGNIFICANCE& LIMITATIONS

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  • MONITOR OPERATIONAL PERFORMANCE OF WATER POINT
  • ASSESS MANAGEMENT MODELS USED
  • IDENTIFY WATER POINT REPAIR PROCESS
  • DEVELOP UNIQUE POINT IDENTIFICATION SYSTEM

SYSTEM FOR ADDING NEW WATER POINTS SYSTEM FOR CLEANING / CLOSING WATER POINTS

MONITORING & INTERVENTIONS

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MSPP + DINEPA DECADE-LONG, NATIONAL PLAN FOR

THE ELIMINATION OF

CHOLER IN HAITI

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CHALLENGE OBJECTIVE 1 IN STUDY REGION

  • INCREASE ACCESS TO POTABLE WATER TO AT LEAST 85% OF

POPULATION

PROPOSED SHORT TERM INTERVENTION

  • TEAM CARRY OUT WATER TEST (ALREADY DOING THIS)
  • ESTABLISH COMMUNITY HEALTH CLUBS (VERY POSSIBLE)
  • [DINEPA] AT RISK RESIDENTS ARE GIVEN CHLORINE TABS (NOT

ADDRESSING SCALE OF PROBLEM)

  • ADDRESS TARGET AREAS: MEDIUM/LARGE CITIES + RURAL AREAS

(LEAVING STUDY REGION OUT WHERE THERE CLEARLY IS A PROBLEM)

EXPECTED SHORT TERM RESULTS:

  • IN LARGE/MEDIUM CITIES, RISK OF TRANSMISSION ELIMINATED (REPAIR

WATER POINTS + ADD NEW)

  • RESULT 2.1: RIVER WATER V. POTABLE WATER (WE HAVE DATA THAT

SHOWS PEOPLE DON’T NECESSARILY DRINK POTABLE WATER WHEN AVAILABLE)

STUDY RESPONSE TO MSPP CHOLERA ERADICATION PLAN

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MONITORING & EVALUATION

  • COMMITTEE WILL CONVENE TWICE A YEAR (CHANGE OCCUR FASTER

THAN THAT CURRENTLY)

EPIDEMIOLOGICAL SURVEILLANCE

  • 5.5: INSTALL LAB SPACE FOR WATER-QUALITY SURVEILLANCE;

PROVIDES RELIABLE INFORMATION FOR TIMELY DECISION-MAKING

(CHALLENGE WITH THIS ALREADY)

PREPARATION OF NATIONAL MICROBIOLOGICAL, IMMUNOLOGICAL, ENVIRONMENTAL & SOCIO- ANTHROPOLOGICAL AGENDA

  • MULTI-DISCIPLINARY APPROACH (ALREADY DOING THIS)
  • TRAINING OF COMMUNITY-BASED TEAM (ALREADY DOING THIS)

BOTH MSPP & BOTH MSPP & DINEPA POINT TO TEAM AS DINEPA POINT TO TEAM AS FUNDAMENTAL FUNDAMENTAL TO THE SOLUTION & THE TEAM IS AT THE HEART OF HOW TO THE SOLUTION & THE TEAM IS AT THE HEART OF HOW THIS PROJECT THIS PROJECT FUNCTIONS FUNCTIONS

RESPONSE TO MSPP CHOLERA ERADICATION PLAN

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COMMUNITY ACTION TEAM

CHRISTIANVILLE, HAITI

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SLIDE 23

Samaritano Segundo . Verón June 2015

Impact Assessment

Focus Investigation on

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Ella Trinkle

BA, Global Justice and Policy; Spanish James Madison University (current)

Alyssa Henriquez

MURP, Urban and Regional Planning University of Florida (current) BS, Environmental Policy and Planning Virginia Tech

Lida Aljabar

MURP, Urban & Regional Planning Virginia Tech (current) BA, Public & Urban Afgairs Virginia Tech

Nazana Weeks

MS, Civil Engineering (Transportation) Virginia Tech (current) BE, Civil Engineering, Macaulay Honors College The City College of New York

Erin Gloeckner

MPH, Public Health Virginia Tech BA, Communication Virginia Tech

Madeline Hynes

BS, Human Nutrition, Foods and Exercise Virginia Tech

College of Design . Construction + Planning, University of Florida

Project Contributors

The interdisciplinary group of Project Contributors represent disciplines of urban planning; transportation engineering; environmental policy and planning; public health; human nutrition, food and exercise; and global justice

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Project Rationale

Punta Cana Ecological Foundation Precedence | Impact Assessment Water in Samaritano Segundo

Philosophy + Investment in Water Water as an Emergent Theme History of Water Management System Video Perspective (Spanish)

June 2015 Proposal to Punta Cana Ecological Foundation

Narrative Background on Water Water Theme Infographic January 2015 Impact Assessment Notes from Carrasco Notes from Jake Kheel

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6/12

1 2 3

6/20 Full Schedule Pre-Test Survey [English] Focus Group Protocol Storyboards Pre-Test Survey [Spanish] Survey [English] WhatsApp Video Call [English] Interview Protocol Terms + Defjnitions Survey [Spanish] WhatsApp Video Call [Spanish]

Approach

June 2015 Field Work

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By the Numbers

Project Findings

INFOGRAPHIC INFOGRAPHIC INFOGRAPHIC INFOGRAPHIC

[98%]

  • f respondents has access to the

community water system

Some households have elected to construct and use their own wells.

[2] Number of times per week water is distributed by the water system manager, Jorge

Many households in this community support multiple families, because of this, some households run

  • ut of water from the system weekly, and some evey

day.

[94%]

  • f respondents said that their water

service would be cut if they missed a payment for the community water system [100,000] (RD) Estimated cost of a pump for second well that exists in Samaritano Segundo [90%]

  • f respondents rated the quality of water

from the community water system as good [5] Number of years ago the community water system was last tested by Grupo Punta Cana

The quality of the water was reported satisfactory.

[55%]

  • f people use bottled water when they

require water for cooking [45%]

  • f people use water from the community

water system when they require water for cooking [$50] (RD) Cost to buy water from the colmados [$30] (RD) Cost to buy water from a water truck that visits the community twice a week

It is reported that the water from the truck is of lower quality than those from the colmado

[45%]

  • f respondents have been advised to

take precautions with the water that comes from the community water system [71%]

  • f respondents have reported no

health issues associated with using water from the community water system

Local doctors have advised women that they should not use well water to wash their private parts, as doctors have linked use of the well water to vaginal infections.

[90%]

  • f respondents use water from the

community water system for bathing/ personal hygiene [93%]

  • f respondents treat the water that is

pumped into their water tanks with chlorine before use [2013] Year the Ministry of Health conducted in person training for the treatment of water [3] Caps of liquid chlorine per 500 gallons of water is the current practice for treating water in Samaritano Segundo

People can normally tell when their water is under or

  • ver chlorinated based on the taste, smell or texture of

the water.

[38%]

  • f respondents use septic/cistern to

collect waste water from their home

This was mostly interpreted as greywater and not blackwater.

[43%]

  • f respondents report using the most

water to wash their clothes [98%]

  • f respondents drink from only bottled

water [27%]

  • f respondents report that breaks in

pipes have happened since gaining access to water

Water pressure in Samaritano Segundo is extremely low and is said to be the biggest problem in accessing water for the community

[40%]

  • f respondents report running out of

water from the community water system more than 2 times per month

1

98% 2

94% $100,000 90%

5

55% 45%

$50 $30

45%

71%

90% 93%

2013

3

38%

43% 98%

27%

40%

[1] Functioning well for entirety of Samaritano Segundo

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Proportion of population with sustainable access to an improved water source

  • Proportion of population with access to improved sanitation
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SOAR Analysis

Results

RESULTS

  • How are Strengths, Opportunities and Aspirations tangibly translated into

action? While Samaritano Segundo was able to self-identify its Strengths, Opportunities and Aspirations, without adequate resources, the community was not able to articulate an actionable way forward beyond the status quo. Below outlines areas for action that would need to be facilitated by the Punta Cana Ecological

  • Foundation. A more detailed explanation is outlined under Collective Impact.

(1) Impact Driven by Punta Cana Ecological Foundation (immediate) Stabilize and begin to monitor water situation in Samaritano Segungo (2) Impact Driven by Samaritano Segundo (facilitated by FEPC) Empower Samaritano Segundo to continue with current efgorts despite

  • utside intervention and do so by connecting their expertise with
  • ther needs in peer-to-peer relationships across Verón

(3) Impact Driven by Outside Consultation In consultation with outside expertise, develop programs aimed at health and fjnancial literacy around water resources, utilizing technology for transparent/democratic monitoring and evaluation

ASPIRATIONS

  • Considering Strengths & Opportunities, who should the community become?
  • How can the community make a difgerence for others in Verón and relevant

stakeholders?

(1) Water Treatment A reservoir-based treatment system should be integrated into the existing water system and its management structure so that water can be properly treated before distribution through the existing system (2) Black + Grey Water Treatment A community-based sewer system needs to be developed so that it treats blackwater and greywater before discharge, therefore diverting potentially untreated wastewater from the aquifer in Samaritano Segundo; In addition to the infrastructure, proper training need to be embedded in the existing water management structure (3) Bolstering Additional Community Infrastructure Paved roads would provide easier access to the community, creating some protection for the water infrastructure that is susceptible alongside the community’s main dirt road. Increased impervious surfaces throughout the community would also reduce dust-affjliated health problems (mainly respiratory and ocular) but attention would need to be paid to balancing impervious/pervious surfaces to ofg-set environmental threats.

OPPORTUNITIES

  • How does the community collectively understand outside threats?
  • How can the community reframe threats to see opportunities?
  • How can the community best partner with others?

(1) ฀Improving Resiliency of Water System The community water system can become more resilient as it is extremely vulnerable to breaks due to its exposure and proximity the unpaved roadway (2) Facilitating Financial Literacy in the Community Funds need to be used for their intended purposes rather than being diverted when an emergency arises Additional funds should be collected towards an emergency fund

STRENGTHS

What does the community do really well? What do strengths reveal about available skills? (1) The community has a highly organized community board (2) The community members have a high level of trust in the community leadership (3) There is a high level of civic engagement and community participation among the community members (4) There is a functioning system in place to deliver water to the community, with an associated management strategy

Opportunities Strengths Aspirations

What is a SOAR Analysis

A SOAR Analysis is a way to take a traditional SWOT Analysis and made the information gleaned through data analysis actionable for the community and relevant stakeholders. This SOAR analysis applies to Samaritano Segundo based on results from January and June 2015 fjeldwork. The same analysis could be done with Domingo Maiz based on work from the January 2015 Impact Assessment.

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Limitations

S u r v e y D e s i g n

Because of limitations in survey design, data collection and analysis, it was not possible to establish the relationship between cost, volume and frequency related to water. The dynamics of water in Samaritano Segundo are too complex to create

  • ne equation to determine individual/household water use across these three

variables. COST: The data revealed one consistent cost associated with drawing water from the community water system (300 RD) VOLUME: It was not clear how much water an individual could have for the set price, since water was turned on for a specifjc amount of time and/or until water ran out; there was no clear relationship between cost and volume of container used to collect water FREQUENCY: Questions with volume became more complex with how frequently an individual/household could access the community water system – and if additional water could always be purchased from the community water system; distance from the water source and frequency of availability to water were also not clear, since it was reported that water often ran out or substantially lost pressure to service homes further away from the water source

(1) Because Fulcrum App did not have an offmine GPS location option, it was not possible to track the location of each survey; data collected was not geo-referenced, which was a limitation in analyzing trends based on location within the study area and distance from the water pump (2) Data collected about usage of the community water system could have been skewed because the survey did not account for the households using another household’s private wells; in this case, the respondent’s water source was categorized as “other” (3) The amount of time available for data analysis was limited, resulting in minimal time to perform in-depth analyses; this limited the scope of identifjed trends, and thus limited the extent of recommendations

(1) The method used to administer surveys may have afgected the quality and quantity of data collected; surveys were administered via the convenience sample method; the survey team went house to house in addition to approached people in public spaces (e.g. streets, colmados) to gather survey responses; the surveys were administered by the team, which could have afgected the number and types of people surveyed (conversely, this meant that the surveys were administered correctly and fully) (2) There were a number of time constraints in thee fjeld; surveys were only administered during two specifjc times of day: mid-afternoon and early evening; the seasonal nature of employment in the region could have caused local population fmuctuations; these factors could have afgected the availability of a wide range of survey respondents and general community dynamics Use of translators created the opportunity for gatekeeper bias (3) Administering surveys in Spanish by Spanish-speakers of varying fmuency could have afgected the intent of questions and understanding

  • f responses

(4) Surveys were administered during a time of controversial national governance that could have afgected the willingness of some respondents to answer the race demographic question or even be willing to complete the survey (5) Weather played a role in the number of surveys that were administered, and the type of people being surveyed, because many people were in and out of homes and businesses

(1) Questions were formulated based on the capabilities of Fulcrum App, the mobile data collection application that was used to collect survey responses; due to the limitations of the App, questions had to be worded and formatted according to the options available in the App (2) The surveys were originally written in English; translation of the survey into Spanish could have altered the intended meaning behind certain questions, words, and/or phrases

D a t a C

  • l

l e c t i

  • n

D a t a A n a l y s i s F i n d i n g s

Project Findings

There are series of limitations that impact the validity and reliability of the study. Time constraints in the fjeld limited the amount of time that could be allocated to survey design, and data collection and analysis. Due to time constraints, the data collection was done using convenience sampling in Samaritano Segundo, which is also a limitation of the study. Even though the study utilized translators, there was still a language barrier between English and Spanish.

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Trends + Key Takeaways

The KEY TAKEAWAYS of the assessment are based on the fjndings from the survey, focus groups or interviews. The research team also discovered phenomena

  • ccurring in the community

that were not captured in the aforementioned data collection

  • instruments. These TRENDS

have been deemed integral to the community and should be considered in the decision- making process moving forward. Together, the key takeaways and trends provide relevant stakeholders a comprehensive understanding of how integral water is to Samaritano’s governance structure and resource stewardship, two characteristics that could positively impact

  • ther

communities in Verón.

(1) The Samaritano Segundo has a community board that is highly

  • rganized and engaged in the community

The members of the community are primarily homeowners and are not subjected to the seasonal hiring cycle (in contrast to Domingo Maiz), so there is a better chance for a sustainable return on investments in water- related infrastructure (2) At the household level, most residents efgectively maintain and manage infrastructure themselves, rather than relying on an outside body to do so (3) There is a clear understanding among individuals that the water from the community system is not safe to drink (98%). There was a clear divide between people who used the water from the community system for cooking and those who used bottled water. (1) While only a handful of community members have private wells, there is a growing trend of households to convert to a private well. The initial start- up costs are signifjcantly higher to have a private well but households ultimately have on-going access to water. (2) Currently, water usage among households is not regulated. While the system of RD $300 per month for one tank or RD $500 per month for two tanks is in place, some members often receive less than a full tank. Furthermore, members can pay the water system manger more money to have their tank refjlled, but the additional payment does not go towards the electricity cost of using the pump. (3) There was a higher likelihood for households to receive less water from the community water system if they were further from the pump.

KEY TAKEAWAYS: Trends in community confjrmed through data collection TRENDS: Prevalent threads in the data but that cannot be mapped to specifjc questions asked in survey, focus group or interview questions

Key Takeaways Trends

Defjnition of Terms

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Collective Impact

RECOMMENDATIONS derive from the SOAR Analysis and have been categorized across relevant stakeholder groups. These recommendations also map onto time increments for potential impact. Coupling the initial investment needed in water- related infrastructure with training and community obligations that link Samaritano Segundo’s strengths with other communities in Verón in a peer-to-peer capacity will embed accountability measures and will maximize return on the initial investment. Collectively, the series of recommendations will have the greatest impact if they are phased in as recommended and phases are evaluated so that each stakeholder group is held accountable for the collective impact.

(1) Test community water system water in Samaritano Segundo (2) Use Positive Legacy funds to purchase new pump for Samaritano Segundo in exchange for Samaritano Segundo serving in peer training capacity to Domingo Maiz

(1) Connect Samaritano Segundo with Domingo Maiz on water-related issues for ongoing peer-to-peer exchange (2) Identify point of contact in Samaritano Segundo who connects with FEPC at identifjed increments of time This will allow FEPC to have a presence in the community to troubleshoot/connect, but will do so in a decentralized, as- needed basis

(1) Develop community-based program whereby technology inspires accountability (2) Develop public health literacy campaign to improve understanding

  • f

water

  • related health issues

(3) Develop fjnancial literacy to improve how fee-for-service model can be sustainable and subsidize community needs

Impact Driven by Punta Cana Ecological Foundation Impact Driven by Community Impact Driven by Consultation

Timing for Impact

The Punta Cana Ecological Foundation should take the lead on investing in the immediate water-related infrastructure needs. If investments in resources are matched with measurable expectations of community involvement, the return

  • n investment will catalyze and be evident in subsequent phases.
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Linkages to Innovation

Innovative Ideas at Play (Precedence) Punta Cana Ecological Foundation The Community

Link Link Link Link Innovative Ideas at Play

  • Coworking.DO

Co-working spaces are popping up in urban areas and are based on principles of growth by creating sharing economies; co- working spaces are thought to accelerate development by connecting ideas, people, resources and problems so that locally- sourced solutions emerge

  • Garbage Clinical Insurance

Trash in exchange for health services at a local clinic in Indonesia

  • Poverty Spotlight Assessment Tool

Self-assessment mapping tool to connect community-based needs with appropriate resources and interventions; eliminates wasteful allocations by governments, NGOs and the private sector

  • Graduated Anti-Poverty Methodology

Systematic stages include handing out assets, followed by several months of cash transfers, followed by period of training and encouragement

FEPC as Knowledge Hub

  • Function as a solutions center
  • Provide co-working space so that

solutions learn from intended and unintended consequences of implementation

  • Facilitate transition from innovation

to implementation Knowledge Transfer to Practice

  • Verón Communities become v2.0

co-working space to implement, monitor and evaluate innovations

The Punta Cana Ecological Foundation should serve as an innovation hub and resource center to foster solutions that are implementable in communities throughout Verón. A Hub-and-Spoke model would:

  • Provide linkages to local context and economies

to create organic growth + scalability

  • Tie service needs (spokes) to resources (hub)

to better meet the needs of the communities in Verón

  • Infuse continuity of expectations across

solutions so that all ideas are subject to a measurable framework

  • Create a space with tolerance for error so that

unintended consequences of any one solution are worked into future solutions Innovation Hub + Spoke Model: An innovation-hub is an informal organization, which joins individuals, groups and communities to act as ideas catalysts for innovation and allows the interaction among real and virtual communities through its available infrastructure/resources. This model supports the exchange of experiences and knowledge to foster the innovation-to-implementation process throughout a network of spokes. Fundamentally, community-based projects must: (1) Focus on lifecycle approaches + systems- based impacts if projects are to be sustainable (2) Include monitoring and evaluation (M&E) as a prerequisite for project implementation so that data is generated from the start (3) Consider scalability from the onset, so that innovation is realized through connective potential across similar contexts IDEAS HUB SPOKE Community-Based Projects Moving Forward What is an Innovation Hub + Spoke Model Innovation Hub + Spoke Model applied to Verón

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Proportion of population with sustainable access to an improved water source

  • Proportion of population with access to improved sanitation