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EHP News March 2004

IN THIS ISSUE:

ADVANCING HEALTH OUTCOMES THROUGH MULTI-SECTORAL APPROACHES

NEPAL-INDIA CROSS-BORDER COLLABORATION FOR KALA-AZAR PREVENTION AND CONTROL

COLLABORATING WITH PAHO IN HYGIENE PROMOTION

ASSESSING THE EARLY WARNING AND REPORTING SYSTEM IN NEPAL

PUBLIC-PRIVATE PARTNERSHIP FOR HANDWASHING WITH SOAP INITIATIVE

EHP END-OF-PROJECT EVENT

NEW EHP PUBLICATIONS

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ADVANCING HEALTH OUTCOMES THROUGH MULTI-SECTORAL APPROACHES

The CORE Group and EHP are co-hosting a workshop March 23-25, 2004, in Washington, DC, on advancing child health outcomes through multi-sectoral approaches.

The objectives of the workshop are to develop key characteristics of an effective multi-sector platform (MSP) for C-IMCI; help participants identify opportunities for multi-sector programming in the field; and identify next steps to be taken by the CORE Group to enhance the evidence–base for the MSP and mobilize resources for cross-site learning.

The workshop will focus on the following MSP themes: communicating key family health practices through other sectors; addressing barriers and facilitating factors related to adoption of key family health practices; and mobilizing multi-sectoral resources for expanded local ownership of C-IMCI programming. Seven field-based case studies will be highlighted.

For information on the MSP meeting, please visit http://www.coregroup.org/ or email Sandy Callier at [email protected].

NEPAL-INDIA CROSS-BORDER COLLABORATION FOR KALA-AZAR PREVENTION AND CONTROL

Countries in the South Asian region share common borders. These countries are also home to re-emerging vector-borne diseases. Under USAID/Asia Near East (ANE) Regional Bureau’s strategy for infectious diseases, EHP is providing facilitative and technical support to help establish common surveillance procedures for priority vector-borne diseases in Bangladesh, Bhutan, India and Nepal (BBIN). The ANE program emphasizes support to: assist national institutions, share information, and monitor regional trends related to incidence and prevalence of malaria, kala-azar and Japanese encephalitis (JE), as well as malaria drug resistance (MDR).

Specifically, under the USAID/ANE-funded Nepal Infectious Disease Program, collaboration between the MOH/Nepal and the Ministry of Health and Family Welfare/India, has been strengthened to address cross-border prevention and control of kala-azar and malaria. A rapid study on population movement across the Nepal-Bihar border has been conducted, focusing on health-seeking behavior and treatment practices of the population residing along the Nepal-Bihar border, and a coordinated prevention and strategy has been developed based on the findings. “Kala-azar Week,” a communication campaign focusing on behavior change messages, which include rallies, exhibition, and radio messages targeting the border population, has also been conducted in 11 kala-azar affected border districts. Regular meetings are also planned to identify roles and responsibilities and reach an agreement upon a plan to sustain cross-border collaboration.

For more information, please contact Gene Brantly at [email protected].

COLLABORATING WITH PAHO IN HYGIENE PROMOTION

In collaboration with PAHO, ministries of health and PVO and NGO partners, USAID is implementing a hygiene behavior change activity in two countries——Peru and Nicaragua. The objective of this activity is to improve behaviors that studies have shown to have an impact on diarrheal disease incidence.

Hygiene promotion focuses on promoting three hygiene practices——handwashing, safe excreta disposal, and safe water (treatment, storage and use within the home). The methodology used is based on a C-IMCI module developed by EHP and successfully implemented in the Dominican Republic (DR).

Under this collaboration, EHP is providing technical assistance and training of NGOs in the design, implementation and evaluation of a hygiene behavior change activity involving community participation. One highlight of the activity is the involvement of a core group of Dominicans who had been trained in the pilot activity in the DR, and who contributed to the skills and capacity building of participating NGOs in Nicaragua and Peru.

The first four phases of the activity have been completed. The activities focused on conducting formative research related to behaviors to be promoted, development of the hygiene behavior change strategy, preparation and production of materials, training of community hygiene promoters and implementation of the hygiene promotion activities. The last two phases will focus on monitoring and supervision and a final survey to measure behavior change.

For more information, please contact John Gavin: [email protected]

ASSESSING THE EARLY WARNING AND REPORTING SYSTEM IN NEPAL

EHP carried out a three-week assessment of the Early Warning and Reporting System (EWARS) in Nepal. EWARS is a hospital-based sentinel surveillance system tracking six priority diseases in Nepal: three vaccine-preventable diseases (polio, measles, and neonatal tetanus) and three vector-borne diseases (malaria, kala-azar and Japanese encephalitis).

The objective of EWARS is to track, monitor and report disease trends related to the six priority diseases. The information flow in EWARS, starting from the communities, the health posts and centers, and the district public health office, goes to the hospital-based sentinel sites and ultimately reaches the national/policy level via the Vector-borne Disease Research and Training Center (VBDRTC). The sentinel sites send reports to the VBDRTC immediately, in the case of an outbreak, and weekly on a regular basis. VBDRTC serves as the focal point for receiving and analyzing information and sending it to the national level, so that timely information is provided to policy-level decision-makers in case of an outbreak to facilitate early response activities.

USAID through EHP assisted EWARS in the development of reporting and investigation forms, outbreak reporting forms and guidelines; training in surveillance and response; distribution of epidemiological surveillance kits; and resource back-up.

The report on the assessment findings and recommendations is now available from EHP (see New EHP Publications below).

PUBLIC-PRIVATE PARTNERSHIP FOR HANDWASHING WITH SOAP INITIATIVE

UNICEF/Nepal in collaboration with USAID, the World Bank, local government ministries, and private partners is launching a Public-Private Partnership (PPP) to promote a handwashing with soap initiative. The initiative is modeled after a successful USAID-led PPP process launched in five Central American countries in the late 1990s that produced 50% increases in handwashing with soap among mothers and reduced diarrheal diseases in children under-five.

The objective of the Nepal initiative is to reduce diarrhea incidences in children under-five through a coordinated communication campaign promoting proper handwashing with soap. The initiative is based on the concept that private firms and public organizations would find it mutually beneficial to work in partnership to achieve complementary profits and benefits in promoting handwashing with soap to prevent diarrhea. For example, one of the key goals of the initiative is expansion into new markets, particularly in low income rural areas. Thus, the soap industry stands to gain by selling more soap in newer markets, while the public agencies move toward the desired objective of improved handwashing practices and a reduction in diarrheal diseases.

As part of USAID’s support to the Nepal initiative, EHP worked with a marketing and communication consulting firm to develop a series of planning tools that were used in the preparation of the first phase of the initiative. These tools can be used and/or adapted by public or private sector organizations interested in initiating a PPP. A report, “Planning Tools for the Nepal Public Private Partnership for Handwashing Initiative,” is now available from EHP (see New EHP Publications below). For more information on PPP initiatives, also visit www.globalhandwashing.org

EHP END-OF-PROJECT EVENT

USAID and EHP will be hosting “Advancing Environmental Health for Disease Prevention: Past Experiences and Future Priorities” on Tuesday, June 1, 2004, 1:30-3:30 pm, at the 31^st Annual GHC Conference, Omni Shoreham Hotel, Washington, D.C., Congressional Rooms A & B.

At the event, USAID and EHP staff will share lessons learned from five years of EHP experience (1999-2004) and discuss future directions in environmental health programming. Highlights include:

Application of the Hygiene Improvement Framework (HIF) for diarrheal disease prevention——integration of the HIF into child health and primary health care programs
Strengthening national malaria prevention and control programs
Linking population-health-environment
Improving health for the urban poor

Conference registration not required for attendance

Stay tuned.

For more information about the 31^st Annual GHC Conference, go to http://www.globalhealth.org/view_top.php3?id=223.

NEW EHP PUBLICATIONS

Activity Report 123. Cairo Healthy Neighborhood Program: Situation Analysis with Literature Review and Stakeholder Meetings

The participatory situation analysis and stakeholder meeting process has proven to be an effective approach to catalyze actions aimed at improving the health of children and families in certain poor urban neighborhoods in Egypt. This report presents the background, methodology and results of the situation analysis and stakeholder meetings along with a literature review of existing studies on child health in urban slums in the ANE Region.

A 1 MB PDF version of this activity report is available at:

http://www.ehproject.org/PDF/Activity_Reports/AR%20123%20Egypt.pdf