Session 5

Selecting PHE Interventions

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Session Objective

From a conceptual model, identify:

• The intervention(s) that addresses the interdependencies between population, health and environment factors at a local site

2

Intervention Type

1. Single sector – impacts a sectoral objective

– Example: Measles vaccination that impacts child survival

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Intervention Type

2. Value Added – adds value in one sector as a result of work targeted at another sector

– Example: Improved cooking stove (ICS) to conserve trees/forests also yields social benefit (time-saving), economic benefit (fuel-saving) and health benefit (ARI-prevention) for humans

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2. Value added (2nd example)

Moringa Tree (Moringa oleifera )

• Perennial softwood native to sub-Himalaya• Fast-growing, drought resistant, thrives in poor soil• Targeted as agro-forestry intervention (alley-

cropping)• Also adds value for:

Human health (leaves/seeds are edible and highly nutritious)Animal husbandry (food/fodder)Livelihood (seeds processed into cooking oil)Climate adaptation (trees make good wind breakers)Environmental health (seeds used for H2O purification)

Alternative energy (biogas production)5

Intervention Type3. Linked - two or more sectoral

interventions that are conceptually linked, operationally coordinated and generate results that go beyond the expected sectoral impacts

– Example: An environmental hygiene intervention (organic waste management) linked to an agricultural intervention (composting) impacts sanitation in the homestead (expected), crop production (expected) and the nutrition status of children in the homestead (unexpected) 6

IPOPCORM InterventionsObjective (short-term outcome)

1. Reproductive health outcomes improved in coastal communities

2. Community capacitated to implement CRM strategies including alternative livelihood

3. Public/policymakers’ awareness and support for PHE increased

List of Interventions

• Habitat enhancement • Community based

distribution (CBD) of contraceptives

• Protected area management

• Environmentally friendly enterprise development (EED)

• Coastal clean-up campaign

• Adolescent sexual and reproductive health IEC

• Micro-credit for EED

Objective (short-term outcome)

1. Reproductive health outcomes improved in coastal communities

2. Community capacitated to implement CRM strategies including alternative livelihood

3. Public/policymakers’ awareness and support for PHE increased

List of Interventions

• Habitat enhancement • Community based

distribution (CBD) of contraceptives

• Protected area management

• Environmentally friendly enterprise development (EED)

• Coastal clean-up campaign

• Adolescent sexual and reproductive health IEC

• Micro-credit for EED

Which of the above is avalue-added intervention?

CBD – targeted at the health sector but also adds value to CRM as it creates alternative livelihood opportunities

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Interventions Work at Different Levels

IndividualDelivered to one person at a time; seek to modify knowledge, attitudes, beliefs, and self-efficacy

GroupDesigned to influence individual behavior but delivered in a group setting and reinforced by peer pressure and support from other group members

CommunitySeek to change attitudes, norms, and values of an entire community or target population

Structural Aim at modifying the social, economic, and political structures and systems; may affect legislation, media & the market place

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IPOPCORM Interventions – Work at Several Levels?

InterventionIndividua

lGroup

Community

Structural

Policy advocacy

Peer education about FP/RH

CBD of contraceptives

Youth ecology camp

Participatory coastal resource assessment & mapping

Establish fish sanctuary

Passage of local ordinance banning use of cyanide in fishing

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“Evidence-based” InterventionsWhat & Why?

• Set of activities or procedures that has been validated through experimental studies or rigorous evaluation

• Enhances the effectiveness of your PHE project and chance of success

• Enables members of the leadership team to build on the experience of others

See Participant Manual: List of Evidence-based PHE Interventions

Can you suggest other examples of evidence-based interventions related to environmental

outcomes?10

TASK – Select InterventionsStep One: Review your Conceptual Model, hierarchy

of Objectives and Results Chains and identify a critical factor (desired outcome) for each sector

Step Two: Using the list of Evidence-Based Interventions, select those that match your desired outcomes (create your own, if necessary)

Step Three: For each intervention, identify Level & Type

Step Four: Input your selection into the WorksheetTime: 50 minutes

1 Worksheet for each Objective1 Value-Added Intervention per Objective

OBJECTIVE ResultsChain Factor

INTERVENTION

Level of Interventio

n

Type ofIntervention

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Intervention Selection WorksheetExamples

OBJECTIVE

ResultChain Factor(desired outcome)

INTERVENTION Level ofInterventio

n

Type of Intervention

RH outcomes improved

Access to family planning information and products increased

CBD system and social marketing scheme for contraceptives

Structural Value added(FP, Livelihood)

Referral mechanism for clients who want sterilization

Individual Single sector

Acceptance and use of FP improved

Peer education for married women of reproductive age

Individual Single-sector

Street drama encouraging people to plan their families and to protect their coastal resources to improve food security from the sea

Community Linked(RH-CRM = food security)

Unintended pregnancy among youth reduced

Safer sex education for teens engaged in unprotected sex

Individual Value added(FP, Health)

Interactive board game with IEC messages encouraging youth to become stewards of their sexuality and the environment

Group Value added(RH, Environment)

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OBJECTIVE

ResultChain Factor

INTERVENTION Level Type

CB-CRM capacity developed

Critical habitats protected by community

Participatory coastal resource

assessment (PCRA)

Group Value Added(CRM, Governance)

Marine tenurial agreement Structural Single sector

MPA managementCommittee and Plan

Group Value Added(CRM, Governance)

Establishment of MPA (i.e., fish sanctuary, mangrove reserve)

Community

Single sector

Illegal fishing stopped with community involvement

Surveillance (patrolling) of MPA

Community

Single sector

Enforcement effort by deputized fish wardens

Group Single sector

Behavior change communication targeted to illegal fishers

Individual Single sector

Fishing effort reduced

Environment-friendly enterprise development (EED)

Group Value Added(CRM, Economic)

Micro-credit facility for EED Individual Value Added(CRM, Economic)

CRM gains sustained

Integrate FP into CRM agendas and village development plans

Structural Linked(CRM-RH-EED)

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