Previously, our health work focused on HIV, supporting partners across Africa and Southeast Asia to promote safe sexual practices, access to critical services for people living with HIV, and tackling stigma and discrimination. This included partnering with faith networks such as INERELA to promote SAVE (Safer Practices, Access to treatment, Voluntary counselling and testing, Empowerment) as a holistic approach to HIV.
In 2011, we adopted an integrated community health programming approach, building on the past successes of our HIV work.
Our current approach incorporates a wider range of health issues, including: nutrition, malaria, maternal and child health (MCH), sexual reproductive health (SRH), and other integrated interventions that enable communities to not only be healthy, but to thrive and be resilient. To this end, our work has an increasing focus on governance, advocacy and shifting power relations.
We work in three areas, guided by a Community Health Framework:
- Health development approaches: ensuring that health programmes are technically sound and use appropriate methods and approaches, eg integrated health programming and health systems strengthening.
- Equitable social norms: ensuring that inequitable gender and social norms that violate the rights of individuals, reinforce exclusion of marginalised people and prevent them from accessing services are addressed, eg, stigma and discrimination, gender-based violence and female genital mutilation. This includes working with faith leaders to improve the health status of communities and to promote the adoption of beneficial practices.
- Equitable institutions: ensuring that institutions and health systems are accountable and responsive to citizens, that appropriate laws and policies are implemented and that there is an adequate, and equitable supply of resources to support appropriate health development approaches.
We support health work in ten countries that prioritise the right to essential services: Burundi, Ethiopia, Ghana, Kenya, Malawi, Myanmar, Nigeria, Sierra Leone,South Sudan, Zambia and the Central America region.
There is a health component in many emergency responses (notably in the Ebola response in Sierra Leone), which also builds on our community health framework and experience.
By attending training, we realised that health staff play an important role in promoting use of SRH services in the community. We learned to be welcoming and friendly when handling women. Now we have more women seeking skilled delivery in the facility than before and women appreciate our services more
- Pauline, Nurse in Kenya.
Our recent work has had some notable successes and reached millions of people around the world.
In Africa, our integrated PPA programmes in Kenya, Nigeria, Malawi, Ethiopia and Burundi have reached more than 5 million people with health education and access to essential HIV, malaria, MCH and family planning services.
In Myanmar, our work has contributed to an increase in the percentage of deliveries attended by skilled birth attendants in two target areas – from 15% to 33.9% and from 21% to 32.9% in 2015.
Our increasing work in health governance has seen the passing of anti-discrimination legislation for people living with HIV in 2015 in Nigeria and the increased engagement of citizens in demanding accountability, resource allocation and quality health services through work in Malawi, Kenya, Ghana and Nigeria.
We have increased our work on tackling inequitable social norms, through challenging gender-based violence, female genital mutilation and empowering women to increase their voice and participation in leadership and decision making. We have used SASA! (a community mobilisation intervention), Gender Empowerment and Development Organising Resource (GEADOR) circles and gender model families to reach people in Kenya, Nigeria and Sierra Leone.
Our programmes are also encouraging the involvement of men in MCH and family planning using the Men as Partners and Father-to-Father approaches in Malawi and Kenya. We are increasingly engaging faith leaders in family planning and SRH response in Ethiopia and Burundi.