PHE Approaches

PHE approaches represent a variety of efforts to bring a holistic, integrated set of activities and services to bear in communities. The term refers to a flexible set of interventions or activities that communities, partner groups or nongovernmental organizations adopt in response to unmet community needs for improved health services, livelihoods and natural resource management/coastal resource management. PHE projects strive to simultaneously improve access to health services and assist communities to manage their natural resources in ways that improve their health and livelihoods and to conserve the critical ecosystems upon which they depend. Integrated activities often lead to greater benefits than result from single sector interventions. This section focuses on various aspects of PHE approaches tested and used during the past two decades.

BALANCED Newsletter: Population, Health, Environment and Livelihoods

2011 | University of Rhode Island Coastal Resources Center | 16

Balanced_v1i3.pdf

The Summer 2011 issue of the BALANCED Newsletter examines the link between PHE approaches and livelihoods. In recognition of the need and/or the "fit" for PHE projects to address a wider array of real life topics this issue of the BALANCED newsletter includes four articles that focus on the topic of PHE and livelihoods. The articles describe how livelihoods have been integrated into environmental conservation in Zambia, Ethiopia, and Madagascar.

2010 | BALANCED Project | 18

CRC (English)

This document from the USAID-supported BALANCED Project describes the purpose of the PHE Toolkit and the steps that the BALANCED Project took in order to organize existing PHE resources, develop the topic map to include key aspects of PHE approaches and establish the broad overarching framework for helping new and familiar audiences to use the PHE Toolkit in an efficient and user-friendly manner. At the same time, there are several guidance documents now on how to create a toolkit on the K4Health toolkit site, located at /toolkits.

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Community-based Coastal Management + Health/Family Planning

To Live with the Sea: Reproductive Health Care and Marine Conservation in Madagascar

2011 | The Woodrow Wilson International Center for Scholars | 12

This issue of FOCUS describes Blue Ventures' approach to combining reporductive health and family planning services with ongoing marine conservation efforts on the remote southwestern coast of Madagascar, home to the semi-nomadic seafaring Vezo ethnic group. Since Blue Ventures launched a family planning program in 2007, couples and women have been empwered to make their own reproductive health choices.

2010 | Environmental Conservation | 12

English

This article represents one of few peer-reviewed journal articles on the value added of PHE approaches. The article describes a quasi-experimental design used by the IPOPCORM project in the Philippines to test the hypothesis that there will be a significant improvement in both coastal resource management (CRM) and human reproductive health (RH) outcomes by delivering these services in an integrated manner as opposed to delivering either in isolation. The CRM, RH and integrated CRM+RH interventions were tested in three island municipalities of Palawan.

2010 | Institute of International Education | 14

Mayor Eutiquio Bernales’ efforts to integrate population, development and environment in the town of Ubay have made a significant impact on the quality of life for town residents. According to the Institute of International Education’s (IIE) Leadership Development for Mobilizing Reproductive Health Program, Bernales’ focus on integrated Population, Health and Environment (PHE) development solutions has established Ubay as a model “learning site” for new and emerging leaders in PHE.

No Date | PATH Foundation Philippines Inc. [PFPI] | pp. 2

t14_PFPI_ad-path_bohol.pdf

This two-page fact sheet provides an overview of Bohol, Philippines and explains why it is a priority marine conservation area. The document describes Path Foundation Philippines, Inc. (PFPI) work with communities and youth as part of the IPOPCORM project to slow population growth and decrease pressure on coastal resources, working with youth and addressing local issues such as food security.

2011 | University of Rhode Island Coastal Resources Center | 35

English

This study summarizes the results of a behavioral monitoring survey (BMS) conducted in Tanzania in June 2009. The study was co-sponsored by the “Building Actors and Leaders for Advancing Community Excellence in Development” (BALANCED) Project and the Sustainable Coastal Communities and Ecosystems (SUCCESS) Project. Both projects are funded by the U.S. Agency for International Development (USAID).

2011 | The BALANCED Project | 261

TOT_Manual_for_PHE_CBD_and_Adult.pdf

The manual was developed by BALANCED Project staff and conservation and rural development organizations in training individuals to integrate community-based family planning and health into PHE projects through the use of community-based distribution and peer education approaches. Field-tested in Tanzania, Zambia and Ethiopia, the guide uses a unique training approach where training participants “learn-by-doing”, such as leading certain segments of the training themselves.

2008 | Woodrow Wilson International Center for Scholars

Woodrow Wilson International Center for Scholars

Everyday more than 4,500 new residents are born in the Philippines. The rapidly rising population has overwhelmed the fisheries that have traditionally supported the population, bringing poverty and malnutrition to many coastal communities. The Integrated Population and Coastal Resource Management (IPOPCORM) initiative works to save these fisheries while improving the livelihoods of individuals that rely on them.

2008 | Springer Science + Business Media | pp. 19

Carr, 2008.pdf

This case study examines the link between marine resource management, and the universal contraceptive use as part of family planning among married couples in the lobster fishing village of Punta Allen, located in the Sian Ka’an Biosphere Reserve, Quintana Roo, Mexico. Several reasons appear to contribute to small desired and actual family sizes.

2005 | PATH Foundation Philippines Inc. [PFPI] | pp. 18

w05_Dagnes_gender-issues.pdf

This article provides a review of PHE efforts in the Philippines and explains how addressing gender issues has been an important factor in attaining project results. Sixty percent of Philippine’s population resides in the coastal zone. Women and men in coastal communities depend chiefly on the sea for subsistence. Coastal populations are young and expanding at rates that exceed regional and national averages. Conflicts among users of coastal resources are escalating.

2004 | PATH Foundation Philippines Inc. [PFPI] | pp. 15

w02_castro_Mainstreaming RH and ICM in local governance.pdf

The Philippines marine environment ranks among the top 25 “biodiversity hotspots” on the planet- an area of extreme species richness, biodiversity, and endemicity. The area faces an overwhelming increase in population growth that has strained resources in the past. These stressors necessitated an integrated intervention that takes into account population pressures when tackling conservation issues.

2003 | Population Reference Bureau [PRB]

20_Creel_RippleEffects_PRB_Pnadd169.pdf

2001 | Biodiversity Support Program's Global Exploration Series | pp. 61

World Wildlife Fund publications Part1 |

World Wildlife Fund publications Part2 |

World Wildlife Fund publications Part3 |

World Wildlife Fund publications Part4

This report summarizes a study of 31 health and conservation projects, documenting examples in which community-based health has been used as motivation to conserve biodiversity.

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Community-based Forest Management + Health/Family Planning

Coffee and Community: Combining Agribusiness and Health in Rwanda

2011 | The Woodrow Wilson International Center for Scholars | 12

This issue of FOCUS highlights the successes and lessons learned from the USAID-supported Sustaining Partnerships to Enhance Rural Development (SPREAD) Project in Rwanda. In the most densely populated country in Africa, coffee farmers are improving their livelihoods and the health of their families by combining community health education with agribusiness development by forming and strengthening cooperatives. Since 2006, this Population, Health and Environment project has increased farmer revenues and improved family health outcomes in the target communities.

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2011 | The BALANCED Project | 261

TOT_Manual_for_PHE_CBD_and_Adult.pdf

2010 | John Snow | 58

This report documents the process through which a Ugandan conservation organization,Conservation through Public Health (CTPH), successfully integrated interventions -traditionally seen as from different “domains” or “sectors”—for the dual purposes of i) reducing threats to mountain gorillas and their habitat and ii) improving the well-being of local communitiesdirectly dependent upon the health of the former (for ecotourism and natural resourceuse). John Snow Inc. (JSI), with the U.S.

2009 | The Woodrow Wilson International Center for Scholars | pp. 12

Woodrow Wilson International Center for Scholars

In the Khata areas of rural Nepal people who depend on forests are learning new ways to protect the source of their livelihoods. Farmers in the region have become stewards of the environment and advocates for integrating population-health-environment (PHE) programs into their community activities. Family planning and health issues have become an integral part of the community forestry program in Nepal. This document discuses the benefits of the PHE approach in the Terai Region of Nepal.

2009 | United States Agency for International Development [USAID] | Nepal

Nepal_PHE_Report_October 2009.pdf

Since 1978, Nepal has implemented a community based model to address threats to deforestation, known as the Community Forest User Groups (CFUG). These groups have managed forest resources in a sustainable, democratic and socially inclusive manner, according to independent evaluations.

2008 | Conservation International | pp. 16

CICARE_Cambodia.pdf

From a range of interviews, observations, and desk reviews of documents this publication presents lessons learned from Conservation International (CI) and Cooperative for Assistance Relief Everywhere (CARE)’s health care and conservation initiative in the Cardamom Mountains Region of Cambodia. The primary focus is on elements of CI’s Population Health Environment (PHE) interventions involving reproductive health/family planning activities and conservation.

2008 | Conservation International | 36

t04_CI_healthyfamilieshealthyforests.pdf

Population, Health, and Environment(PHE) integrated projects are a part of this new generation. These projects not only aim to achieve goals in these fields, but to better understand the effects of these integrated approaches. Conservation International (CI) combined their extensive experience designing and implementing conservation projects, with the new understanding of the effects of integrated projects to create more valuable PHE projects. The idea in these projects was to reduce population pressures on biodiversity hotspots.

2006 | Environmental Change and Security Program

Woodrow Wilson International Center for Scholars

This Focus issue highlights Jane Goodall’s experience in chimpanzee conservation in Tanzania and the current PHE efforts of the Jane Goodall Institute (JGI) as part of the Congo Basin Forest Partnership, supported by the US State Department with matching funds from the European Union. The Lake Tanganyika Catchment Reforestation and Education (TACARE) project began in 1994 in 12 villages in Tanzania.

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Forests and Human Health

2006 | Center for International Forestry Research [CIFOR] | pp. 4

ForestsHumanHealth.pdf

This extensive report examines the state of human health in forests and the casual links between forests and human health. Focus is on human dependence on forests for food and their nutritional contributions and nutrition-related problems that affect forest peoples. Disease and other health problems, such as HIV/AIDS, malaria, Ebola, mercury poisoning and some 20 other tropical diseases are related to human and forest interactions.

2001 | Population Reference Bureau [PRB]

1_Nash_2001_HealthyPeopleForests_PRB_PNACR715.pdf

This Emerging Policy Issues in Population, Health and Environment brief examines how global deforestation impacts human and ecological health and identifies the underlying causes of deforestation and the role of human population growth. The brief highlights the four main essential causes of human induced deforestation, known as “people, poverty, plunder and policy.” Recommendations for policymakers include ensuring comprehensive consideration of the complex role of population dynamics, including population growth, density and migration.

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Family Planning + Environment

Jeanne Nyirakamana: Reaching Rural Rwandans with Integrated Health and Livelihood Messages

2011 | BALANCED Project | 2

Jeanne.Rawanda final.pdf

Mrs. Jeanne Nyirakamana serves as the Head of the Health Program in rural Rwanda advancing PHE efforts for the USAID-supported "Sustaining Partnerships to Enhance Rural Enterprise and Agribusiness Development" (SPREAD) Project. She and her outreach team help improve the lives of coffee farmers and cooperative members by providing them with health information and services related to family planning, maternal and child health, prevention of HIV/AIDS and water and sanitation. Read more about Jeanne's work in her PHE champion story.

2010 | Public Health Institute | 48

SPREAD_Health_Eval_Final.pdf

The overall goal of the SPREAD Project (2006-2011) is “to provide rural cooperatives and enterprises involved in high-value commodity chains with appropriate technical assistance and access to health-related services and information that will result in increased and sustained incomes and improved livelihoods.” Implemented by USAID and the Texas A&M University Norman Borlaug Institute of International Agriculture, SPREAD is a unique example of integrated programming within USAID, a “wraparound” project that receives funding across several technical areas in Health

2008 | World Wildlife Fund US | 86

This is the French version of WWF's Healthy People, Healthy Ecosystems programming manual.

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Family Planning Action Session Guide

No Date | Save the Children | pp. 25

t33_SaveChildren_FP_session_guide_intro.pdf

It was noticed by Save the Children (STC), that in the Philippines, many communities’ family planning (FP) needs were underserved. To combat this lack of assistance the PESCO-DEV project created a FP session to educate couples in the reproductive age (15-49 years old). This action session guide is intended to supply family planning information where it is most needed, targeting families that rely on fishing as a livelihood.

No Date | Woodrow Wilson International Center for Scholars

WWC Naturellement.pdf

Madagascar has one of the world’s most valued ecosystems, but one of the most threatened. Madagascar is also among the world’s poorest countries: of 17 million Malagasy people, 13 million live on less than 1$ a day. This poverty costs the people and the country. It drives farmers to practice slash and burn techniques that destroy one third of the forest each year, and is the cause of the loss of 90% of Madagascar’s forests.

2011 | Pathfinder International | 8

Since the beginning of 2011, Pathfinder International has been working together with The Nature Conservancy and the Frankfurt Zoological Society to design a project that reduces pressures on the diverse and fragile Greater Mahale Ecosystem in western Tanzania by Lake Tanganyika. As a health partner invited in

2011 | The BALANCED Project | 2

Pascal.PHE_.Champion final.pdf

Mr. Pascal Gakwaya Kalisa has produced coffee in the densely-populated country of Rwanda for the past nine years. He also helps promote improved health practices among the coffee farmer cooperatives and community members in one of the world's most densly-popuated countries. Read more about his efforts as a PHE champion.

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2011 | The BALANCED Project | 261

TOT_Manual_for_PHE_CBD_and_Adult.pdf

2010 | PATH Outlook Newsletter | 8

This issue of Outlook examines the relationships between family planning and the environment, including key lessons learned from integrated or linked family planning and conservation interventions. The author targets family planning practitioners who are seeking new ways of reframing a fundamental issue - how family planning and the environment relate within the context of well-being and promoting social equity.

2008 | United Nation Population Fund [UNFPA]

FamPlanningEnviro_StabilizingPop.pdf

About half the earth’s biological production capacity has already been diverted to human use. Life-supporting ecosystems are affected everywhere by the planet’s 6.7 billion people, which is projected to reach at least 9.2 billion by 2050. This document, by the UNFPA, explores the links between population and environmental quality. It recognizes how complex and varied the links may be, and that slowing the rate of population growth may give countries time to take measures to meet people’s needs, while protecting the environment through various means.

2008 | World Wildlife Fund [WWF] | pp. 99

World Wildlife Fund community action document

The integration of population, health, and the environment in development projects can have many benefits. This manual describes the what, why, and how of Population, Health, and Environment (PHE) projects.

1999 | Population Action International | pp. 60

Population Action

This document is a follow up to Plan and Conserve, which inventoried 42 community-based population and environment projects. Forging the Links contains 15 additional project profiles as well as an assessment of the evidence and evaluation of CBPE approaches. The conclusions show that most evidence is anecdotal but that there are several reasons to continue linking family planning and conservation.

1998 | Population Action International | pp. 112

Population Action

Plan and Conserve profiles 42 projects that PAI was able to document that combined family planning and reproductive health services with natural resource conservation to improve access to family planning services. Project profiles span the globe including Asia, Africa, Latin America and the Middle East, and include NGOs such as World Neighbors, CARE and CEMOPLAF in Guatemala and Ecuador.

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Health + Environment

Jeanne Nyirakamana: Reaching Rural Rwandans with Integrated Health and Livelihood Messages

2011 | BALANCED Project | 2

Jeanne.Rawanda final.pdf

2011 | Conservation International | 4

latrines case study.pdf

In honor of World Water Day in March 2011, Conservation International (CI) produced this success story which looks at the legacy of the USAID-supported "Healthy Families, Healthy Forests Project," implemented by CI Madagascar from 2002-2008.

2010 | World Conservation Society | 75

The Wildlife Conservation Society organized a December, 2009 forum to explore the question, “Can health be economically quantified as an ecosystem service, correlated with ecosystem intactness and if so, under what circumstances?” To provide for a richer discussion, WCS compiled an illustrative (not exhaustive) set of annotated readings exploring five dimensions of this question.

2008 | World Wildlife Fund US | 86

This is the French version of WWF's Healthy People, Healthy Ecosystems programming manual.

2011 | Pathfinder International | 8

2011 | The BALANCED Project | 2

Pascal.PHE_.Champion final.pdf

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2011 | The BALANCED Project | 261

TOT_Manual_for_PHE_CBD_and_Adult.pdf

2010 | International Union for Conservation of Nature ESARO | 62

http://iucn_hivaids and environment

The connections between HIV/AIDS and the environment are complex, multifactoral, bi-directional, and involve indirect as well as direct pathways. Recognizing the lack of a comprehensive examination of these relationships, the authors undertook a broad review of published literature regarding the potential links between HIV/AIDS and the environment. In assessing the literature, the authors identified a number of topics linking HIV/AIDS and the environment.

2008 | SCOPE Series | pp. 5

URI_BioEcosystemServices.pdf

In this world the maintenance of biodiversity and ecosystem services in critical to human health and welfare. The climate change wild card adds insecurity as to what biotic resources may be needed for human adaptation to food supply disruptions, ecosystem alterations, shifting disease patterns, and other health threats. This document has explored the effects of biodiversity on four major determinants of human health and well-being: ecosystem services, constraints of infectious disease, medicinal resources, and quality of life.

2007 | World Wildlife Fund [WWF]

World Wildlife Fund community action

AIDs affects 39.5 million people worldwide, and nearly two-thirds live in Sub-Saharan Africa. This fact sheet observes the links between HIV/AIDS and rural livelihoods, and impacts on conservation and natural resources. Specifically noted are the impacts on the conservation organizations, their staff in biodiversity areas, and funding. Also discussed is community resource management, how to reduce the impacts of HIV/AIDS amongst the community and on the natural resources, and scaling up responses to HIV/AIDS.

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Forests and Human Health

2006 | Center for International Forestry Research [CIFOR] | pp. 4

ForestsHumanHealth.pdf

2005 | World Health Organization [WHO] | pp. 41

AvianFluEcoHealth.pdf

There had been growing concern over a highly pathogenic strain of avian influenza, HPAI H5N1 that could spark the next influenza pandemic as traditional public health measures had limited success. Not taken into consideration however, was the necessity to redress ecological imbalances that had given rise to the threat in the first place. This gap calls for adopting an ecohealth perpective-one that focuses on the upstream causes of emerging diseases, with are at root questions of ecosystem degradation and ecological imbalance.

2005 | Conservation International | pp.12

6_EdmondRPD_ConservationLearning_CI_PNADE663.pdf

The purpose of this paper is to present the experience of Conservation International (CI) in working with partners in the Population Environment (PE) program and lessons learned from those experiences. The "Meeting Population and Conservation Needs in the Selva Lacandona" project partnerships are examined in this case study of CI’s PE program in Chiapas, Mexico, which was funded by the Davis and LucillePackard Foundation. Additional lessons learned from other types of partnerships in other PE programs are also included.

2002 | Population Reference Bureau [PRB]

w20_yinger_FramewkIdentGendrIndic.pdf

This paper addresses the rationale for including gender in Population, Health, and Nutrition Programs. It define gender and several aspects of gender in ways that make it easier to incorporate in programs, and suggests a framework for identifying and addressing gender-related constraints to achieving program objectives, using a detailed set of illustrative examples. The authors address a number of obstacles that project designers are likely to encounter, and offer indicators that have proven useful in monitoring of changes as a result of addressing gender issues.

1995 | University of California | pp. 44

Change_Epidemiology.pdf

Although improvements in human health represent a crucial aspect of development worldwide, many trends associated with development and global change appear to be reducing health security. In this article, we define the human epidemiological environment and describe key biophysical, economic, sociocultural, and political factors that shape it.

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