Does 1+1=3? Proving the integration hypothesis


An interconnected approach to improving handwashing behaviors

By Hanna Woodburn, Deputy Secretariat Director, Global Public–Private Partnership for Handwashing (PPPHW); Program Officer III, FHI 360

Photo: Jessica Scranton/FHI 360

Each year on Global Handwashing Day, hundreds of millions of people around the world gather to celebrate the power of handwashing with soap to save lives. This day also provides an opportunity to consider the current status of the hygiene sector and catalyze further action. As we look toward the future of hygiene behavior change, we need to ensure that we are maximizing the broader topic of integrated development and fully considering its relationship to hygiene.

Integrated development, which can be defined in many different ways, is increasingly being discussed within the international development community, and FHI 360 plays an active role in convening this conversation. I recently had the opportunity, on behalf of the Global Public–Private Partnership for Handwashing (PPPHW), to attend an event hosted by FHI 360 titled Does 1+1=3? Proving the Integration Hypothesis, which brought together expert panelists from academia, government, donors and nongovernmental organizations.

I took away many key learnings from this event, but the one that stuck with me most is this: If we hope to move the needle on the most entrenched development challenges, we need to consider the benefits that could be offered by combining services or sectors. (more…)

Integrated development: Advancing the conversation

By Patrick Fine, Chief Executive Officer, FHI 360

A version of this post originally appeared here on The Huffington Post. Reposted with permission.

Patrick FineThe global challenges we face today are more complex, more demanding and increasingly, more interconnected than ever before. Shouldn’t the solutions we seek be more integrated, too?

Last month in New York, FHI 360 brought together a group of distinguished leaders from across the development community to advance the conversation about integrated development. In a panel discussion, titled “Does 1+1=3: Proving the Integration Hypothesis,” representatives from the United Nations, Bill & Melinda Gates Foundation, U.S. Agency for International Development (USAID), academia, international nongovernmental organizations and others offered diverse perspectives on the topic.

The discussion began with a deceptively simple question: What do we mean by integrated development? “We know when it’s lacking,” said Kiari Liman-Tinguiri, adding that while we need to move forward, we also need the solid evidence to show where and when synergy and integration work.

It is not as simple as co-locating projects and programs or layering related interventions such as polio shots and vitamin distribution, added other panelists. Mark Viso, CEO of PACT, noted that vertical integration is messy, is often difficult and requires tackling systemic issues, such as capacity. It is also critical to create an enabling environment and engage business and markets. University of Washington professor Judd Walson added, “It’s integrating staff, management and funding, and you don’t often see that.” (more…)


In her own voice: A youth leader explains why mentoring and girls’ education are vital in Kenya

Photo by Zack Langway/Johnson & Johnson

Juliah, 18, is a peer educator who participates in FHI 360’s Four Pillars PLUS project in Kenya. Funded by the GE Foundation, the project uses a model of student scholarships, professional development for teachers, mentoring of girls and community participation to improve the quality and relevance of education for orphans and other children, especially girls, in secondary school. Another component of the project is addressing the challenges of youth employment by helping young women successfully transition from school to the workforce.

Juliah was invited to New York City by Johnson & Johnson. She is participating in a youth storytelling session related to Millennium Development Goals 4 and 5 on improving the health of children and women.

Q: What challenges do girls in Kenya face in receiving a quality education?

A: First, there is the barrier of poverty. The high cost of school fees often does not allow girls to enroll in school, because they cannot afford the books, supplies and uniforms. Even if they can pay their fees, they often cannot afford menstrual hygiene products, and without them, their learning is interrupted due to school absence. Next, discrimination in society and school makes it difficult for girls. Girls are only seen as future mothers, wives and caretakers. They are not seen as capable of tackling difficult subjects such as math and science. Because of this, girls often have low self-esteem and lose interest in school. They also fear sexual harassment and violence, which can make traveling to and from school dangerous. Finally, girls are expected to take on many more household duties than boys and often cannot devote adequate time to their studies, causing them to fall behind.

Q: How has the Four Pillars PLUS project made a difference to you?

A: Four Pillars PLUS paid for my school fees at a boarding school, where I was able to get a quality of education that many girls could not. At boarding school, I had more time to study because I no longer had to do chores until late in the evening. I did not have to fear for my safety as I did when I walked long distances between school and my home each day. As a result, I studied hard and finished secondary school with a B+ average.

Receiving mentoring helped me to deal with discrimination. It allowed me to see myself as a person with the same opportunities as boys. (more…)


Pushing for progress on maternal, newborn and child health

By Dr. Timothy Mastro, FHI 360 Director, Global Health, Population and Nutrition

Photo: Jessica Scranton/FHI 360

The numbers are shocking. Each year, 2.8 million babies die during their first 28 days of life, while almost 800 women die every day in pregnancy or childbirth.

A vast majority of these deaths are preventable through simple interventions: providing mothers and their children with access to basic, quality health care, especially during pregnancy and childbirth; encouraging mothers to breastfeed; and treating diarrhea and pneumonia, two of the leading killers of children under 5 years of age.

Despite the impressive progress that has been made in recent years, achieving the Millennium Development Goals (MDGs) on reproductive, maternal, newborn and child health (MDGs 4, 5 and 6) by 2015 will require an all-out global push.

In June, the U.S. Agency for International Development (USAID) announced a major realignment of US$2.9 billion of its resources to “save up to half of a million children from preventable deaths by the end of 2015.” In addition, USAID introduced an ambitious strategy, Acting on the Call: Ending Preventable Child and Maternal Deaths, to dramatically increase progress in 24 countries that account for 70 percent of child and maternal deaths.

This is an important policy shift — one that has the potential to have great impact on development by saving the lives of 15 million children and nearly 600,000 women by 2020. FHI 360, a member of the Advisory Group for Acting on the Call, supports USAID’s commitment. We have seen how evidence-based interventions in maternal, newborn and child health are making a difference in communities around the world. (more…)

A new commitment to advancing integrated development

FHI 360 is launching a major initiative in New York City during CGI’s Annual Meeting through a Clinton Global Initiative (CGI) Commitment to Action. This investment will help FHI 360 and its partners explore the benefits and challenges of integrated programing. We will study whether and how integrated programs produce an amplified impact, and if so, to what degree these approaches are cost-efficient and sustainable.

In a video message, CEO Patrick Fine called the commitment an unprecedented opportunity for FHI 360 and its partners to collectively reflect on what the development community is doing well and how we can leverage resources to build a better, safer and more prosperous world for all.

FHI 360 makes a commitment to integrated development from FHI 360 on Vimeo.



Building momentum for sexual and reproductive health in the post-2015 dialogue

By Tricia Petruney, FHI 360 Technical Advisor and Ward Cates, FHI 360 Distinguished Scientist and President Emeritus

A version of this post originally appeared here on The Huffington Post. Reposted with permission.

Sexual and reproductive health, which includes access to family planning and HIV prevention and treatment, is increasingly being linked to progress across all areas of development. As the United Nations Open Working Group (OWG) on Sustainable Development comes closer to finalizing the post-2015 global development goals, a growing crescendo of voices is commenting on where we stand with regard to meeting the sexual and reproductive health needs of the world’s girls, women and couples and is offering ideas on how to move ahead. We are also seeing important shifts in policy.

There are many examples that illustrate the lively dialogue that is now happening on sexual and reproductive health.

An article in the journal Contraception acknowledges that although significant, measurable progress on sexual and reproductive health has been made in the two decades since the International Conference on Population and Development (ICPD), momentum on key areas of family planning has slowed in recent years.

New commentaries in the Bulletin of the World Health Organization and The Lancet summarize the evidence for why universal access to family planning should be a key component of the post-2015 development agenda. Additional commentaries in The Lancet and Global Health: Science and Practice Journal offer actionable recommendations for meeting global demand for family planning. Finally, Womenatthecenter.org, an exciting new website, is sharing “inspiring, interconnected stories of women’s reproductive health and rights, empowerment and environmental sustainability.” (more…)

Does 1+1=3? Proving the integration hypothesis

By Patrick Fine, Chief Executive Officer, FHI 360

A version of this post originally appeared here on The Huffington Post. Reposted with permission.

Last month, we began the 500-day countdown to the conclusion of the Millennium Development Goals (MDGs). Policymakers, the private sector, civil society groups and academics worldwide are all taking stock of progress in achieving the eight MDGs and asking, “Where are the gaps? What can we do differently? What would a post-2015 framework look like?”

While we don’t yet have the answers to these questions, it is clear that there is much more work to be done. We are now living in a world where emerging economic, technological and demographic shifts have created more sophisticated and demanding challenges. From dramatic climate changes and rapid urbanization to a growing youth bulge, these shifts are putting previous investments at risk and forcing us to rethink how to tackle increasingly complex development challenges.

We need to get smarter about how we approach development.

On September 23rd in New York, as world leaders gather at the United Nations, an important conversation will be taking place down the street. Moderated by Al Jazeera journalist Femi Oke, a discussion titled “Does 1+1=3? Proving the Integration Hypothesis” will bring together academics, funders and representatives of governments, business and implementing organizations to reignite a discussion on integrated approaches to human development. (more…)


Perspectives on how implementation science can improve global health

By Theresa Hoke, Director, Health Services Research, FHI 360 and Rose Wilcher, Director, Research Utilization, FHI 360

Photo courtesy of Kelsey Lynd

What is implementation science, and what can it do for the field of global health?

Earlier this month, FHI 360 brought together over 150 public health specialists, researchers, scholars and donors in Washington, DC, for a day-long symposium to wrestle with these questions.

One clear conclusion emerged: There is no single definition for implementation science. Symposium speakers used definitions including: the scientific study of methods to promote the integration of research findings and evidence-based interventions into health care practice and policy (U.S. National Institutes of Health); the application of systematic learning, research and evaluation to improve health practice, policy and programs (U.S. Agency for International Development); and the study of methods to improve the uptake, implementation and translation of research findings into routine practices (U.S. President’s Emergency Plan for AIDS Relief).

Despite the lack of consensus on definitions, symposium participants agreed that implementation science can make essential contributions to global health. Setting implementation science apart from other research disciplines is its focus on how to implement proven interventions in real-world contexts, delivered at scale. Noting that implementation occurs within complex systems, Greg Aarons of the University of California, San Diego, introduced participants to frameworks that help us consider the interaction of factors that affect the success of the implementation process. (View the symposium’s presentations and webcast.) (more…)


Family planning: A look at the past, the present and the future

By Ward Cates, FHI 360 Distinguished Scientist and President Emeritus

Photo: Jessica Scranton/FHI 360

In 1971, the world was a different place demographically. Our planet was mostly agrarian, family sizes were large and birth control was unavailable. That year, FHI 360’s heritage organization, the International Fertility Research Program, was created to perform clinical trials of emerging contraceptive technologies, such as oral hormonal contraception and intrauterine devices (IUDs). These studies helped jump-start global family planning programs, creating health services for women where none had previously existed.

1994: Setting a new agenda
Fast forward to 1994, the year of the International Conference on Population and Development (ICPD). This pivotal global event caused a seismic shift in family planning, from concern about population growth to a commitment to reproductive rights and justice. Women’s empowerment took center stage. Issues related to sexually transmitted infections, especially HIV, were folded into the sexual and reproductive health agenda.

The ICPD also strengthened voluntary family planning as a fundamental human right. This enabled women and couples to determine the timing and spacing of their pregnancies. With control over their fertility, women improved both their personal health and their career aspirations. Family size preferences decreased, and the demand for more effective, longer-acting contraception increased.

Family planning drives development
Today, the shift from larger to smaller families represents one of the most important transformations in developing regions. This shift was made possible in large part by the increased availability of modern contraception. Demographers have traditionally defined “modern” as any method other than “traditional” (for example, natural family planning and withdrawal). During the past two decades, evidence has demonstrated the contributions that family planning can make to global health and development, including progress toward the Millennium Development Goals. (more…)

Civil SocietyTechnology

Anticipating the impact of cutting-edge technology on democracy and development

By Wayan Vota, Senior Mobile Advisor, FHI 360 and Matthew Pietz, Director, Civil Society, FHI 360

Photo: Menno van Dijk/iStockPhoto

What might nongovernmental organizations, governments and world leaders have done differently if, fifteen years ago, they could have predicted the transformative effect that mobile phones and Internet access would have on the world’s poorest countries? What can we do now, if we look far enough down the road, to anticipate the next waves of revolutionary technology?

Technology has brought us to the doorstep of a world once only imaginable. Google cars now drive themselves across California. An autonomously piloted drone can be purchased on Amazon.com. Computers are acting more and more like people. This year, one passed the Turing test, a measurement of a machine’s ability to mimic human behavior. There are working prototypes of spray-on skin and mind-controlled prosthetic limbs. A thousand robots can work together to complete a common task. Things are changing fast.

These technologies will shape the future of the world and change development as we know it.

Funders, governments, practitioners and technology leaders need to anticipate the impact of emerging innovations on democracy and human rights and plan accordingly. Technology can empower activists and dictators alike. To be prepared, we should start asking questions, such as: How will development and civic engagement change when citizens in the most remote parts of the world have access to the Internet? How might drone journalism provide safe, reliable access to conflict-affected parts of the world? How can wearable technology innovations like Google Glass make citizens freer or, conversely, be misused by governments to monitor and control citizens? (more…)