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IR 3 - IMPROVING HEALTH THROUGH INTEGRATION HIGHLIGHTS
HCP often integrates several health issues (or SOs) under one program to improve overall health. HCP also integrates multiple domains in its approach, such as addressing the environment in which healthier behaviors are sought. In Year 3, 13 HCP programs addressed more than one health strategic objective. One of the best examples of this is Jordan 's "Our Health, Our Responsibility" program, which now focuses on chronic diseases and healthy lifestyle issues, in addition to family planning, reproductive health, child survival, and maternal health. The program's Web portal will be one of the first Arabic-language sites to address this wide range of health issues.
HCP also successfully integrated communication into new program areas, such as Ethiopia 's Champion Communities program, which combined health with education. The following provides specific program details by country, SO, and IR.
Multiple Strategic Objectives (SOs)
CHL worked in Year 3 to deliver a unified package of health messages anchored in the idea of the "Healthy Family." The project was designed to cut across all the vertical health areas, such as family planning and reproductive health, maternal/child health, infectious disease (including HIV/AIDS), practices in support of health reform, and healthy lifestyles. The conceptual framework recognized that the household is the primary producer of health, and therefore the main actor in adapting healthy behaviors and demanding health information and services. The goal of the program was to enhance the continued practice of healthy behaviors within the family and, by extension, to improve the health status of the wider community. CHL will operationalize the family focus of the program through a Life Stage approach, which segments the family and the population at large according to the age- or stage-appropriate needs of each member. Indonesia: KuIS designed, implemented, and evaluated a provincial-based hygiene improvement campaign that promoted correct and consistent behaviors related to washing hands with soap. The campaign was developed with USAID's Development Assistance Program (DAP) partners, KuIS local coalitions, key partners, and local government leaders. All were involved in the design of the materials, which were then incorporated into their child health, maternal health, and hygiene improvement programs within the districts where the campaign was launched. Jordan - An Advanced Media and Internet Strategy Reaches Jordanians of All Ages: As a middle income country with improving infectious and maternal and child health status, Jordan is now focusing on chronic diseases. HCP is helping with a cross-cutting approach branded "Our Health, Our Responsibility" that addresses health issues across traditional health-sector divides, and fosters behavior change communication on many interrelated health issues under one umbrella. Those health issues include non-communicable disease (the healthy lifestyle issues such as smoking, physical fitness, etc), reproductive health and family planning, and maternal health and child survival. In addition, the Jordan Health Web Portal will be the first of its kind in Arabic, and will address health issues across SOs, such as reproductive health, child survival, chronic disease prevention, and healthy lifestyle issues. HCP, along with the technical advisory group, developed a compendium of health messages that cover the spectrum of health issues most important to Jordanians. The compendium is used in the program and among counterparts to shape communication messages and priorities. Zambia - Integrating FP and HIV Health Communication Activities (Core): This core-funded activity was the first qualitative research on integration at the community level that sought to understand how complex social, cultural, and individual decision-making dynamics interact to affect a woman's (or couple's) decision to practice family planning in the context of HIV. This in-depth study, fielded in Zambia, provided a rare opportunity to better understand how integration is filtered through the community lens, what aspects of it are working, and what needs to be strengthened in addressing health communication needs. Through this work, HCP improved understanding of FP/HIV interaction at the community level as it affects decision-making, as well as strengthened the capacity of the University of Zambia to conduct this type of analysis.
Bangladesh: The Bangladesh ARH program addressed multiple health topics: family planning, maternal mortality, child survival, and HIV/AIDS prevention. Ethiopia: The Family Health Card, Essential Health Trunk, and Champion Communities programs all address HIV/AIDS, child survival, and population. India: The radio programs covered multiple topics: HIV/AIDS, reproductive health, family planning, child health, and maternal health.
Multiple Strategic Objectives (SOs)
TA for capacity building, planning, and implementation, as well as direct support for activities designed to strengthen and promote the "Ask-Consult" private sector marketing association. CHL works with local subcontractors to implement integrated marketing communication campaigns promoting the full range of related health products and services available through the affiliate network of "Ask-Consult" private pharmacies and doctors. Bangladesh: The ARH program worked at the individual, community and national levels, and the Bangladesh HIV activities worked at the national and district level, and NGO service delivery points. Ethiopia: The Family Health Card linked parents and health workers, addressing both individual behavior and health service delivery. Nepal: The FF program addressed the various domains that would affect marginalized population's access to and demand for FP services, that is, the regional domain (with local language broadcasting over FM stations), the clinic domain, and the community domain in the areas for intensive Literacy and Radio listeners groups. Indonesia: KuIS was the pioneer to lead the Handwashing with Soap Campaign in two provinces: Banten and North Sumatra (USAID's focus areas in Indonesia ). This campaign was KuIS's flagship program that began in January 2005, and addressed the policy and community domains. In Banten, the campaign took place in three to four districts partnering with Laz Harfa, an association of Muslim organizations. Laz Harfa concentrated on community development and fundraising, while in North Sumatra, KuIS partnered with members of KuIS in North Sumatra in four to five districts. The campaign was focused at the community level through community-based hand washing promotion activities and will be supported by mass media, mainly radio. The community mobilization activities are the driving force behind the program. KuIS will implement the activities in partnership with local coalitions, the DAP partners, and other organizations, where ever possible by integrating the campaign messages and materials into their on going programs and working with micro-credit network, working with religious organizations, local journalists, etc. As partner programs are considered ongoing, the hand washing messages and materials will not be new "stand alone" programs but will be fully integrated into their existing activities. Funding for this program ended in June 2005 and KuIS was actively seeking support from other donors and the private sector to continue a program that has the potential to become a national campaign in Indonesia. KuIS was originally established to influence policy makers, foreign based groups, the civil society and the private corporate sector, and the local leaders especially at the districts to appreciate the importance of investing in public health.
Multiple Strategic Objectives (SOs) Jordan: HCP assisted the MOH in designing and developing materials for the "Prolong Your Life" smoke-free airport initiative at Queen Alia Airport in Amman. HCP also assisted the MOH with materials development for a dental health campaign. BCC interventions designed in collaboration with the Ministry of Education include an Arab Schools Sports Tournament where youth health messages will be disseminated. Egypt: CHL will work to increase demand for health services and adoption of healthy behaviors, specifically in the areas of family planning and reproductive health, maternal and child health. New health areas being addressed by CHL are tuberculosis, under the private sector "Ask Consult" program, and healthy lifestyles (smoking, etc.) Nepal: The flexible funds activities include a literacy component linked to the health communication radio program and listeners groups, and reaching marginalized populations, such as low caste and religious minorities and the poorest of the poor. Ethiopia: The Champion Communities program integrates communication into both health and education. Partners on the program include ESHE (JSI), Pathfinder, World Learning, and the regional boards of health and education in SNNPR. Bangladesh: The Adolescent Reproductive Health package is now being adopted and implemented in selected madrasas (religious schools). SO4: HIV/AIDS Madagascar: HIV/AIDS prevention has been integrated into the national scouting program's "Ankoay" program. Zambia: In Zambia, the HEART model is being implemented in the education sector, having won support with many schools and teachers. |
HCP had eight programs that worked across domains in Year 3. Indonesia 's KuIS is a cross-cutting coalition that includes local media, community groups, and the private sector. KuIS led a Handwashing with Soap campaign this year in two provinces with partners from a variety of domains. 
MOH Directorates Join Forces for Newlywed Event: In Egypt, the Newlywed event demonstrated the effectiveness of CHL's cross-cutting approach: messages targeted at Newlyweds came from all MOHP directorates (FP/RH, HM/HC, IDSR, FFH) and had relevance for other life stages. 
Zambia: The Zambia program addresses reproductive health, child survival, infectious disease, and HIV/AIDS in its community capacity building through the Community Action Cycle. 
Egypt: One of the primary objectives of the CHL program is to develop institutional, technical, and financial leadership and systems to implement health communication programs in the policy, service, and community sectors. CHL's support to the Public sector State Information Service Center (SISC) and Ministry of Health and Population (MOHP) is mainly in the form of focused technical assistance (TA) in planning and implementation of activities approved under the MOHP and SIS. The MOHP has a lead role in defining strategic priorities across health areas and target audience groups, and the SIS has the major role of implementing programs addressing messages to cross-cutting population groups by Life Stage, covering the spectrum of health priorities. In addition, SIS continues to support service marketing for the public sector as well as other specific health messages. CHL also provides TA to specific health communication activities funded by the MOHP, in areas of FP/RH, MCH, health reform, and infectious disease. CHL support to the NGO/CDA sector takes the form of technical assistance in capacity building, planning, and implementation. In addition, CHL provides direct support for the production and dissemination of materials not covered through the public sector, as well as for community-based NGO/CDA activities. Save the Children, a CHL partner with an extensive community network in Egypt, including local offices in El Minya, is the key player in coordinating and implementing CHL activities at the governorate level. CHL support to the Private/Commercial sector program includes