CoastalResources Center

PATH FoundationPhilippines, Inc.

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Reaching the Hardly Reached with Integrated Approaches

The BALANCED Project

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Rukia in Tanzania

Rukia lives around Saadani National Park in Tanzania

Most of the arable land is in the Park and cannot be cultivated.

Growing population pressure, destructive farming and fishing practices and drought have left Rukia and her community food insecure.

Growth rate range from 4 to 6 % ; CPR is 26%.

Nearest health care clinic is from 5 to 10 kilometers away.

Rukia cooking on one of her fuel-efficient stoves

Mr. Gezahegh in Oromia Ethiopia

Mr. Gezahegh used to eke out a living as a farmer.

But he learned sustainable agricultural practices from a conservation group and has better yields.

Yet, low agricultural productivity, drought, land degradation and growing population pressure still threaten livelihoods and health of farmers.

TFR in Oromia is 6.2; CPR is a mere 13.6 %. (2nd most populous in Africa)

Distance to a local health posts is about 13 kilometers (over 7 miles).

Population, health and Environment

PHE approaches simultaneously improve communities’ access to family planning and reproductive health (FP/RH) services, while improving natural resources management in ways that improve livelihoods and conserve the critical ecosystems upon which humans depend (Pielemeier 2007).

Why Integrate

FP is essential to assure sustainability of conservation gains and in climate change mitigation and adaptation

NRM/CRM provides a context for better understanding of the need to limit family size

Integration makes sense and cents

Integrated approaches can generate higher impact than sectoral approaches

Working with conservation groups helps governments/programs reach the “hardly reached” with health and FP interventions

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How to Integrate

Develop conceptual framework to show linkages

Develop goals and objectives which articulate the integration

Develop integrated IEC messages

Develop a community-based distribution and peer education system

If youth are a target group, train youth peer educator

Advocate for PHE with your stakeholders, especially to include funds for integrated activities in local government development plans

PHE in Tanzania – since 2009

PEs - Sellers of cooking stoves, SACCOS members, store owners give FP, health (watsan and HIV) and environment messages

Community-based distribution of FP methods thru CBDs and ADDOs (who are also PEs and Saccos members)

Increased referrals to health centers

Over 800 new users

Reduced distance to FP services from 7.8 kilometers to less than 1 Km

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PEs – Watershed management groups, women’s coop members give FP and environment messages

Community-based distribution through stores - trained to distribute FP methods (through special permission from MOH)

Over 200 new users

Reduced distance to FP services from 8 km to 50 m to 3 km

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PHE in Ethiopia – just starting

PHE in the Philippines – since 2007

PEs – Couples, youth, fisherfolk, community organizations, etc give FP and environment messages

Community-based distribution through stores - trained to give FP information and methods

Over 8,000 new users

Reduced distance to FP services from 8 km to 50 m to 3 km

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Call to Action

If there are conservation or rural development organizations in your region, consider partnering with them to expand access to family planning

Go to www.k4health_PHE Tookit for more tools Go to www.balanced.crc.uri.edu

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