Integrating Community-Based
Strategies Into Existing Health
Systems: The Unique Role Of INGOs
CORE Group Global Health Pra...
Why Community-Based Strategies?
• Significant progress towards reaching the MDGs for
maternal and child health
• Dispropor...
The Changing Role of INGOs
• INGOs have traditionally served as implementing
organizations (boots on the ground) for commu...
A New Framework
• Dearth of literature on INGO contributions to scaling-
up community-based health strategies
• This paper...
The Process
• Examined findings from 82 Child Survival and Health
Grant Program projects from the last 10 years
• Sent que...
Integration of community-based maternal, newborn, and
child health (MNCH) service delivery, prevention and
promotion strat...
Case Studies
1) Learning for Leverage
• Future Generations (Peru)
• CARE (Bangladesh)
2) Thought Leadership
• Haitian Heal...
Small Group Discussion
• What are your suggestions for ways to better depict
the integration process? What is missing from...
Next Steps
• Finalize the case studies
• Revise the conceptual framework based on feedback
from today
• Develop the discus...
Thank you!
• Please send additional feedback and inquiries to:
Will Story, PhD, MPH
Carolina Population Center
University ...
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  • We looked for mechanisms through which these projects influenced district, national, or global level uptake of maternal and child health interventions.
  • Policy environment: Shiffman, Guiding institutions: Shiffman“Learning for leverage”: Fowler“Thought leadership”: Ahead of the curve“Joint venturing”: UvinIntegration: UvinChange in institutional norms: ShiffmanKey factors:
  • Integrating Community-Based Strategies into Existing Health Systems_Will Story_5.6.14

    1. 1. Integrating Community-Based Strategies Into Existing Health Systems: The Unique Role Of INGOs CORE Group Global Health Practitioner Conference Silver Spring, MD May 6, 2014
    2. 2. Why Community-Based Strategies? • Significant progress towards reaching the MDGs for maternal and child health • Disproportionate number of maternal and child deaths between and within LMICs • Due to ineffective programs that lack community involvement and participation • Strategies to promote community participation have the potential to enhance sustainability, improve efficiency and effectiveness, and lead to greater agency for the poor
    3. 3. The Changing Role of INGOs • INGOs have traditionally served as implementing organizations (boots on the ground) for community- based health programs in LMICs • Despite programmatic success, the model of using INGOs as direct service providers or capacity builders for direct service delivery has been criticized • INGOs are being urged to shift to a model that leverages their strengths and experiences to influence systems, thereby having impact at scale • Scale: Integration of community-based strategies into existing structures and systems at the district, national, or global level
    4. 4. A New Framework • Dearth of literature on INGO contributions to scaling- up community-based health strategies • This paper will present: • A new conceptual framework that shows how INGOs can catalyze the integration of community-based strategies into existing systems • Six case studies that illustrate the application of the framework • The practical implications and limitations of the framework
    5. 5. The Process • Examined findings from 82 Child Survival and Health Grant Program projects from the last 10 years • Sent questionnaires to 10 INGOs representing different sizes, different countries of operation, and different community-based interventions • Combined INGO responses with evidence from literature review on scale-up, implementation science, and evidence-informed policy making • Six case studies were selected to represent the three pathways described in the framework
    6. 6. Integration of community-based maternal, newborn, and child health (MNCH) service delivery, prevention and promotion strategies into existing public or private structures and systems at the district, national, or global level. Change institutional norms and provide a platform for effective collective action “Thought leadership” through training, information sharing, and learning “Joint venturing” through like-minded partnerships Key Factors for Success: Participation of policy-makers/ stakeholders, po licy community cohesion, influe ncing systems change, etc. Guiding institutions: INGOs “Learning for leverage” by demonstrating program effectiveness Policy-enabling environment: Created by prior advocacy or timely “policy windows” Conceptual Framework
    7. 7. Case Studies 1) Learning for Leverage • Future Generations (Peru) • CARE (Bangladesh) 2) Thought Leadership • Haitian Health Foundation (Haiti) • Helen Keller International (Nepal) 3) Joint Venturing • Concern Worldwide, International Rescue Committee, and World Relief (Rwanda) • ChildFund International, Plan International, Catholic Relief Services, Africare, Counterpart International and World Vision (Senegal)
    8. 8. Small Group Discussion • What are your suggestions for ways to better depict the integration process? What is missing from the framework? • What are other key factors that help the three mechanisms succeed? • What are some of the other important characteristics of a policy-enabling environment? • How can this framework be used to inform policy and practice regarding the future role of INGOs? • What are the limitations of this framework?
    9. 9. Next Steps • Finalize the case studies • Revise the conceptual framework based on feedback from today • Develop the discussion around the implications and limitations of this type of a framework • Develop draft manuscript by the end of the month • Send manuscript for review by all case study authors • Submit manuscript for publication in peer-reviewed journal by July 2014
    10. 10. Thank you! • Please send additional feedback and inquiries to: Will Story, PhD, MPH Carolina Population Center University of North Carolina at Chapel Hill wstory@unc.edu

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