Example: biology

Urban Health LL - Environmental Health at USAID

Environmental Health PROJECTENVIRONMENTAL Health PROJECTENVIRONMENTAL Health PROJECTENVIRONMENTAL Health PROJECTENVIRONMENTAL Health PROJECTA dvancing Environmental Health for Disease Prevention:Past Experiences and Future Prioritieslessons Urban Slum ResidentsUrban HealthEHP and its predecessor projects havebeen addressing the needs of peopleliving in marginalized Urban settings forover 15 years. Beginning with watersupply and sanitation in peri-urbansettlements, activities have evolved tobroader hygiene improvement and childhealth interventions for the Urban poorwho might live at the fringes of a city orin pockets of poverty in the middle ofone. Most recently, EHP has worked toset these efforts within the broadercontext of Urban s Urban Health portfolio has includedtwo large programs and several smallerscale activities.

ENVIRONMENTAL HEALTH PROJECT Advancing Environmental Health for Disease Prevention: Past Experiences and Future Priorities lessons learned www.ehproject.org

Tags:

  Health, Project, Health project

Information

Domain:

Source:

Link to this page:

Please notify us if you found a problem with this document:

Other abuse

Transcription of Urban Health LL - Environmental Health at USAID

1 Environmental Health PROJECTENVIRONMENTAL Health PROJECTENVIRONMENTAL Health PROJECTENVIRONMENTAL Health PROJECTENVIRONMENTAL Health PROJECTA dvancing Environmental Health for Disease Prevention:Past Experiences and Future Prioritieslessons Urban Slum ResidentsUrban HealthEHP and its predecessor projects havebeen addressing the needs of peopleliving in marginalized Urban settings forover 15 years. Beginning with watersupply and sanitation in peri-urbansettlements, activities have evolved tobroader hygiene improvement and childhealth interventions for the Urban poorwho might live at the fringes of a city orin pockets of poverty in the middle ofone. Most recently, EHP has worked toset these efforts within the broadercontext of Urban s Urban Health portfolio has includedtwo large programs and several smallerscale activities.

2 The centerpiece ofEHP s Urban Health programming is theUSAID/India Urban Child Health andNutrition Program, with slum-basedneonatal Health and hygiene improvementactivities in Indore, Jamshedpur, Kolkataand Agra. Other key components areadvocacy and technical assistance to theGOI in developing Urban Health strategiesand increasing the knowledge base ofurban child Health information. Theprogram is two years old and will continueto be funded by USAID /India beyond theend of second large Urban Health activityat EHP is the Asia Near East (ANE) Urban Health Initiative, funded by theAsia Near East Regional Bureau. Since2001, EHP has carried out activitiesaimed at increasing our understandingof Urban child Health conditionsthroughout the region and has proposedprogram strategies that could beeffective for USAID .

3 The Initiative hasincluded a desktop study of child healthin slums of Asia and Near East, an on-the-ground Health and hygieneimprovement program in a slum in Cairo(the Cairo Healthy NeighborhoodProgram) in partnership with theUSAID/Egypt Mission and MakingCities Work ( USAID /EGAT UrbanPrograms), and the sponsoring of anurban Health workshop for all ANEM issions held in Agra, India, inFebruary 2004. Key program lessonsare emerging from the Cairo HealthyNeighborhood Program and from theIndia Urban Child Health also conducted an Urban healthassessment for the USAID /GhanaMission prior to its 5-year strategydevelopment, which led to the inclusionof an Urban focus in one of its keyhealth programs. In addition, EHPparticipated in the final evaluation ofthe USAID -funded CARE/MadagascarUrban Environmental Health /FoodSecurity Key Lesson Learned: Focusingchild Health interventions in urbansettings is crucial.

4 Evidenceshows that the Health status ofchildren in Urban poor settings isas bad and often worse than inrural areas. Urban poor childrenunder-five suffer more and die moreoften from diarrhea and acute respiratoryinfections than rural children. Lesson 1: For an Urban Health initiativeto be sustainable, it is critical to identifyand involve the universe of stakeholdersin the activity at various times and invarious ways. Stakeholders can be fromthe community, the local and nationalgovernment, private sector, non-governmental sector, etc. This approachis essential to effective Urban programs. The principle of stakeholder involvement is partof EHP s approach to development work. It hasbeen particularly effective when applied tourban program settings. In Egypt, thecomplexity of the governance structure for thetarget neighborhood was unraveled and the rightpeople who have power to act were brought tothe table.

5 Stakeholder meetings have includedelected parliament members as well as officialsfrom the local and governorate (provincial)levels of government. Coupled with regulartelephone communications and meeting minutes,decision makers at senior levels have becomebetter informed about the problems andactivities in the slum India, this process has led to the creationof partnerships and context-appropriatestrategies, promotion of ownership, improvedresource utilization from varied sources andelimination of duplication of efforts. In theGhana Urban Health assessment, identifyingstakeholders helped create an urbanorganogram of use to both the GOG andUSAID in developing Urban components tohealth programs. Lesson 2: There is very little good dataon Urban poor, at-risk populations.

6 Thisimpedes advocacy for governments anddonor organizations to address thehealth needs of these populations andhinders the development of appropriateprograms. We need to organize moreand better Urban data collection toolsand strategies, including mapping ofslums and bring evidence of need andconditions into the program planningand advocacy part of the ANE Urban Health Initiative,EHP conducted a desktop study on Urban childhealth in the ANE region. The conclusion thatlittle useful data were available on the subjectled EHP to address the problem of goodavailable data on the Urban poor through anumber of activities. EHP has been workingclosely with EGAT/ Urban Programs toimprove both the indicators and the datacollection process for sampling Urban slumpopulations, leading to the development of aseparate EH module specially adapted tourban settings.

7 In addition, EHP/India hadconducted a large baseline survey in the cityof Indore and has reanalyzed DHS data forlarge Urban agglomerations such as Mumbaiaccording to a standard of living are that infant and child mortalityrates and malnutrition are worse in urbanchildren than in rural Egypt, the Cairo Healthy NeighborhoodProgram is finalizing a quantitativeneighborhood Environmental assessment and awater quality assessment to complement aqualitative situation analysis. Results of thedata collection are shaping programapproaches and influencing maps and data information generated byproject activities have been in great demandby local officials and of this sort has not generally beenavailable for local users. Lesson 3: USAID may not haveadequate resources dedicated to urbanhealth, but many other sources can be identified and leveragedthrough stakeholders meetings andadvocacy India and Egypt, meetings with urbanstakeholders where evidence-based, Environmental and Health conditions in urbanslums were presented for discussion andaction, previously unknown resources financial, material and organizational werebrought to the attention of programimplementers.

8 In India, technical assistanceto the stakeholders in proposal developmentled to formulation of plans for improvingservices and increasing coverage using newlyidentified resources. Lesson 4: Environmental factors andlack of services contribute significantlyto Health problems in poor urbansettings. Lack of water and sanitation istop on the list. Any Urban Health effortParticipatory Mapping in Indore Slumshould consider an Environmental healthcomponent, and the HygieneImprovement Framework (access tohardware + hygiene promotion + enablingenvironment) is a useful programorganizing tool. Health sector agenciescan partner with municipal agencies,private providers and donor programswhose role it is to provide WSS meetings are good venuesfor this collaboration (see Lesson 1).

9 In the qualitative and quantitative surveysundertaken or reviewed by EHP, Urban slumresidents place problems with adequatedrinking water and excreta disposal at the topof their complaints about inadequate high incidence of hygiene relateddiseases corroborate this problem. In Indore,EHP is working with both the community andthe municipal corporation to find slum-specific approaches to improving brought Indore officials on a study tourof Pune where the city has successfullyaddressed slum sanitation. The community isdeveloping a plan for maintaining arehabilitated toilet block. NGOs and CBOsare conducting hygiene behavior changepromotion in slums. In the Cairo slumneighborhood, water and sanitationimprovements are being supported through agrant from Making Cities Work, whilecomplementary hygiene promotion is beingcarried out via adult literacy and communitypromoters using materials featuring urbanhygiene themes.

10 Combining hardware andsoftware interventions leads to improvedchances for Health impact. Lesson 5: Principles and processes ofcommunity participation andempowerment are as important if notmore so when developing and carryingout Health programs in Urban slums ascompared to working with ruralcommunities. Lack of services andofficial neglect of Urban slums stemlargely from the Urban poor not having avoice in requesting their due from themunicipal and national structuresgoverning them and often from officialignorance. A two-tiered approach toempowerment and change is oftenrequired, with activities at the level ofthe individual local community inconjunction with changes in policy athigher levels of government USAID /CARE Madagascar UrbanEnvironmental Health Program put as mucheffort into a community-driven development process as in infrastructure process involved helping neighborhoodsform development committees who produced aNeighborhood Development Plan after carefulanalysis of problems of infrastructure,services availability and Health Development Plans are now being usedby the Municipal Government of Antananarivoas the basis for improvements to theneighborhoods, legitimizing the grassrootswork of the neighborhood India.


Related search queries