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Multi-dimensional Programming The Rubik's Cube Challenge to Community Health ESTER INDRIANI; LEE PO CHA

The document discusses frameworks for conceptualizing community health programs. It notes that prior models like wheels, shapes and bubbles fail to fully capture the dynamics and relationships involved. The Rubik's Cube is presented as a metaphor for the multi-dimensional nature of community health. The document outlines a World Cafe discussion to explore experiences with successful and less successful community health programs. Participants will draw pictures and share to discuss what dimensions contributed to or hindered outcomes. The goal is to better understand how to envision the multiple interconnected components involved in holistic community health. A panel will then provide perspectives from different community health actors.

Health & Medicine◦
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MULTI-DIMENSIONAL PROGRAMMING: The Rubik’s cube challenge to community health
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
Why the cube? To try to grasp all the dimensions of community health, and understand what makes programs successful,
We have tried so many models….
And Frameworks….
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…..
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
Wheels.... SHAPES
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
Remember this? CORE’s attempt to represent the multisectoral platform and interaction of key CIMCI program elements
But these don’t capture the dynamics, relationships, movement… they are too FLAT
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, ……………..
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
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!
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
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
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
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
Esther Indriani Regional Specialist for Maternal Child Health and Nutrition, World Vision South Asia and Pacific Ocean Region
Lee Po Cha Executive Director Immigrant & Refugee Community Organization (IRCO), Portland, Oregon