multi-dimensional programming the rubik's cube challenge to community health ester indriani;...
TRANSCRIPT
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 PROVIDERS Formal 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