Multi-dimensional Programming The Rubik's Cube Challenge to Community Health

1. MULTI-DIMENSIONAL
PROGRAMMING:
The Rubik’s cube challenge
to community health

2. The Rubik’s cube challenge to
community health - plenary
• Brief Introduction to the session
• The World Café Rubik’s Cube Challenge:
combination of World Café and speed dating
• Panel representing different perspectives and
experience

3. Why the cube?
To try to grasp all the dimensions of community
health, and understand what makes programs
successful,

4. We have tried so many models….

5. And Frameworks….

6. The Community Health Framework
WHY should we care about
community health?
Community health is foundational to
attaining many of the SDGs.
WHERE can we find examples
of effective models and
innovations for community
health?
This framework includes a library of
existing models across each component
of community health as well as detailed
case studies.
TOOLKIT
HOW can we take action to
strengthen community health
ecosystems?
A five step process can help leaders
bring the right data to bear for decision
making, and set up sustainable
community health programs with clear
accountability.
WHAT is needed to create a
strong community health
ecosystem?
An ecosystem of heath specific and
health enabling actors and structures,
both formal and informal, working
together and supported by the agency,
access, and resources needed to ensure
the health of community members:
• Agency, e.g., awareness of needs,
empowerment, and ability to act;
• Access, e.g., access to care, access to
referral systems; and,
• Resources, e.g., financial resources,
medical suppliers.
HOME
LOCAL
COMMUNITY
DISTRICT /
NATIONAL
HEALTH
SPECIFIC
COMPONENTS
DISTRICT &
NATIONAL
CARE
COMMUNITY
LEVEL CARE
COMMUNITY
MEMBERS
FAMILY
MEMBERS
LOCAL
COMMUNITY
DISTRICT &
NATIONAL
COMMUNITY
HOME LEVEL
PROVIDERS
HEALTH
ENABLING
COMPONENTS
AGENCY
ACCESS
RESOURCES
ANALYZE
BOTTLENECKS
DEVELOP OR
STRENGTHEN
PROGRAMS
SET TARGET
OUTCOMES
UNDERSTAND
EXISTING
COMPONENTS
IMPLEMENT,
MONITOR &
EVALUATE
And more frameworks…..

7. Community health can be visualized as a series of components
working together to serve community members (1/2)
DISTRICT &
NATIONAL
LEVEL CARE
COMMUNITY
LEVEL CARE
COMMUNITY
MEMBERS
FAMILY
MEMBERS
LOCAL
COMMUNITY
DISTRICT &
NATIONAL
COMMUNITY
COMMUNITY HEALTH
HOME
LOCAL
COMMUNITY
DISTRICT / NATIONAL
HOME LEVEL
PROVIDERSFormal or informal actors
and structures focusing
exclusively on health
Formal or informal actors
and structures that play a
supporting role in health
HEALTH
SPECIFIC
COMPONENTS
HEALTH
ENABLING
COMPONENTS
AGENCY, e.g., awareness of needs, empowerment and ability to act
ACCESS, e.g. access to care, access to referral systems
RESOURCES, e.g. financial resources, medical supplies
Source: Dalberg analysis
WHY WHAT HOW WHERE
Agency - the capacity for purposive action, the ability to make decisions and to pursue goals free from violence,
retribution, and fear Kabeer, Naila. 1999. “Resources, Agency, Achievements: Reflections on the Measurement of Women’s Empowerment.” Development and

8. Wheels....
SHAPES

9. http://www.mtyhd.org/index.php/data-publications/public-health/social-determinants-of-health/health-in-all-policies/
Monterey County Health Department
Bubbles or flowers

10. Remember this?
CORE’s attempt to
represent the
multisectoral
platform and
interaction of key
CIMCI program
elements

11. But these don’t capture
the dynamics,
relationships,
movement… they are
too FLAT

13. Sectors: public, private, business, non-profit;
or agriculture, employment, education, economy-
poverty, environment, built environment, civil society,
governance, energy…;
or RMCHAN, FP, RH, WASH, NUT,HIV, TB, FS, EPI, HSS,
SBC…
Determinants: Individual, family, community, culture,
society, poverty, beliefs, geography, climate, conflict,
disasters, politics, justice, gender, sex, health system,
…. Community, partnerships, stakeholders, assets,
funding, donors, constituents, policy, advocacy,
human resources, logistics, supplies, access,
utilization, communications, management, data,
research, ……………..

14. How have you
solved/built it?
What did you
miss?
What does it look
like to you?
What are the facets of
your cube?
The Rubik’s cube has 42 Quintillion possibilities but only one correct
solution

16. World Café
Built on the assumption that…
People already have within them
the wisdom and creativity to
confront even the most difficult
challenges; that the answers we
need are available to us; and that
we are wiser together than we are
alone.
Sounds like CORE Group!

17. Three progressive rounds of conversation
ROUND ONE – 10 MINUTES!!
• Think of a time you were involved in a
successful community health program. In
addition to your hard work, what “dimensions”
made that success possible?
• Draw a picture or map, write a note, and share
with your table mates in 1 minute about that
experience.
• One person remains

18. ROUND TWO – 10 MINUTES!!
Think of a time you were involved in a program that did
not meet the expectations of the community,
organizations, partners or funders. Maybe it wasn’t a
failure, but not a complete success.
• What dimension was missing that you now
recognize? How can these factors improve
future programs?
• Draw a picture or map, write a note, and tell
your table mates in 1 minute about that
experience.
• One person remains

19. ROUND THREE – 10 MINUTES!!
Now, after thinking about your experiences, and
hearing those of others,
• How do you envision the multiple dimensions
involved in community health and
development?
• Draw a picture or map, write a note, and tell
your table mates in 1 minute about what you
envision

20. Panel
• Video presentation from CRS Ghana’s partner
District Health
• World Vision International regional and WV
national perspective
• IRCO US CBO working cross-culturally, with
many stakeholders and partners

21. Esther Indriani
Regional Specialist for Maternal
Child Health and Nutrition, World
Vision South Asia and Pacific Ocean
Region

22. Lee Po Cha
Executive Director
Immigrant & Refugee
Community Organization
(IRCO), Portland, Oregon