乐鱼 体育

As is , , , , and  are inextricably linked in many parts of the world.

Efforts to address these issues, then, may be more effective if they take on more than one sector at a time. Such integrated development programs have been operating in countries like Madagascar and Uganda, where environmental issues collide with poverty and poor access to health services.  in both countries have been operating for years, serving isolated rural communities whose lives are entwined with threatened ecosystems.

As these PHE programs look to expand, however, challenges have arisen around replicability and funding.

Conservation and Family Planning in Uganda

Dr. Gladys Kalema-Zikusoka, founder and CEO of (CTPH) in Uganda, said they have had success promoting conservation alongside health and sanitation.

A veterinarian by training, Kalema-Zikusoka works with communities around  to teach people how to engage with local wildlife and use natural resources in a sustainable way. Uganda is one of three countries where  are found, and Bwindi is home to  of the approximately 880 mountain gorillas left in the world.

The gorillas鈥� survival may hinge on a better relationship with the people around them. Humans have been told they can鈥檛 enter the park, said Kalema-Zikusoka, speaking at the 乐鱼 体育 on October 14, but rapid population growth creates pressure to encroach on park lands and gorillas frequently cross the park鈥檚 border and into communities.

CTPH was initially focused only on gorillas, but after tracing cases of  back to contact with people, Kalema-Zikusoka decided they needed to work with human communities as well.

Integrating health and environment priorities was a matter of building on systems already in place, Kalema-Zikusoka said. The government created 鈥溾�� in 2001 as a way to reach rural communities, and 鈥渨e taught the existing VHTs to do conservation,鈥� she said.

 are trained to teach communities about constructive human-gorilla interactions as well as family planning, disease identification, nutrition, and hygiene practices. They improve water quality for humans, gorillas, and livestock, and provide health education to prevent the spread of disease.

The success of CTPH has helped bring family planning in particular to the national stage, she said. Uganda held its first  in July 2014, during which the president  family planning as 鈥済ood for the children鈥or the family welfare, and for the country.鈥�

The biggest challenge to PHE is communicating effectively with donors from different sectors, Kalema-Zikusoka said. 鈥淭hings are always changing on the ground鈥t鈥檚 a very dynamic sector. Conservation is very dynamic, public health is very dynamic, community development [is dynamic]. So it鈥檚 good that we have to keep educating the donors.鈥�

Lack of sustainable funding can be a major setback, especially for those PHE programs that rely heavily on volunteers to spread the word about interactions between sectors. 鈥淥nce the funding ended,鈥� she said of one program near Bwindi, 鈥渢hen the volunteers were a bit demotivated because we couldn鈥檛 meet with them regularly鈥nd then they eventually stopped doing the work.鈥�

PHE programs that include income-generating activities tend to be more sustainable, she observed, since community members become more involved in the project. She mentioned a project funded by USAID鈥檚  that gave community members goats and cows; once the project鈥檚 funding ran out, village health and conservation team members continued their PHE activities because they saw continued benefits, including income generation.

Building a Network in Madagascar

, a London-based NGO, has been working on PHE programs in Madagascar for seven years. 鈥淧eople don鈥檛 live their lives in siloes,鈥� said Caroline Savitzky, a community health program coordinator. 鈥淧HE addresses health, it addresses conservation, and livelihoods all together.鈥�

Madagascar is known for being a biodiversity hotspot 鈥� 80 percent of its flora and fauna are found nowhere else in the world, Savitzky said. But population growth is rapid () and communities depend heavily on local natural resources, especially fish, for their livelihoods. High levels of poverty (), food insecurity, and poor access to basic health services strains households even further.

Blue Ventures works to provide viable alternative livelihoods to fishing through , and  about sustainable management of natural resources. But when they first arrived they also found a tremendous unmet need for contraceptives, said Savitzky. Since they started offering family planning through rural clinics in southwest Madagascar, the contraceptive prevalence rate for women in the area has increased five-fold, from just 10 percent to 55 percent, well above the national average.

鈥淎 lot of organizations are hesitant to go outside of their comfort zone,鈥� Savitzky said, 鈥渟o conservation organizations are hesitant to start doing health work and they might think that it鈥檚 going to look like mission drift if they do this.鈥�

But collaborating with others can help organizations break out of single-sector approaches, she said. 鈥淲e鈥檙e looking at how partnerships can create more comfort in this as well as looking at ways that we can communicate PHE so that it鈥檚 clearly understood as an effective approach, rather than mission drift.鈥�

We don鈥檛 see Blue Ventures as becoming this huge organization implementing PHE projects all over the place, but rather we see ourselves as being in a position to support other organizations, both large and small, that want to implement these models.

In the last year, Blue Ventures  between , a global sexual and reproductive health organization, and the , to better integrate health and conservation efforts in northeast Madagascar. They also , whose inaugural meeting was attended by representatives from 35 different health and environmental organizations.

Blue Ventures has also experimented with innovative ways to raise funds, said Savitzky, including eco-tourism expeditions to  and , which not only help fund PHE activities but give people an opportunity to contribute to their research.

Linking to Resilience

One avenue to expand PHE programs may be to look at ways it aligns with other multi-sectoral development efforts. Resilience is something nearly every development agency is, said ECSP鈥檚 Roger-Mark De Souza, and programs that help communities 鈥溾�� after shocks and stresses share many of the same tenets as PHE.

After Cyclone Haruna struck Madagascar in 2013, for example, Blue Ventures , distributing water sanitation kits, mosquito nets, and health care to villages that were 200 kilometers from the nearest city. Their close relationship with communities allowed Blue Ventures to respond faster and more effectively than an outside organization would have been able to, said Laura Robson in a .

De Souza heard similar testimony from a woman in Ethiopia participating in a PHE program. 鈥淲hen I asked Birhane about her experience working on PHE, she said to me that it really helped build her resilience as an individual and helped build her community鈥檚 resilience,鈥� he said. 鈥淪he spoke about having a sense of trust within the community, that the community that she lived in was able to mobilize itself, that she was able to access reproductive health and family planning services that led to her empowerment.鈥�

Linking PHE with resilience could strengthen both efforts, as development organizations look to other models of holistic development to  and PHE programs look for ways to expand, said De Souza.

鈥淭he environment is right for scaling up PHE,鈥� said Kalema-Zikusoka. As PHE programs work to reach more people, there鈥檚 an opportunity to learn from, build on, and achieve even more co-benefits from integrated development.

Event Resources:

Sources: African Wildlife Foundation, Applied Knowledge Services, Center for Global Development, GSDRC, Health Policy Project, International Institute for Environment and Development, Population Reference Bureau, Proceedings of the National Academy of Sciences of the United States of America, Republic of Uganda Ministry of Health, United Nations Department of Economic and Social Affairs, UNESCO, U.S. Centers for Disease Control and Prevention, World Food Program.

Drafted by Heather Randall, edited by Schuyler Null.