New report launched today: Join up, scale up – how integration can defeat disease and poverty.

Its all about integration…  

A new Tearfund policy report is launched today Join up, scale up – how integration can defeat disease and poverty’, written in collaboration with Action Against Hunger, Action for Global Health, End Water Poverty, PATH and WaterAid.  The report focuses on the benefits of taking an integrated approach to policies and programmes – with a particular focus on water and sanitation, primary healthcare and nutrition, of which significant improvements are needed to meet the MDGs.

Integration is increasingly being recognised across development fields as a more effective and sustainable solution to some of the challenges of poverty – through implementing programmes that more closely reflect how these areas overlap in people’s lives.

Former President of Cape Verdeand recently appointed Nutrition Advocate for West Africa, Antonio Monteiro rightly states “Combining and coordinating services makes common sense – and fiscal sense too, but most importantly it creates greater impact for those who most need these essential services.”

However up until now, little has been written about what this actually looks like in practice.

This report aims to address this gap by providing examples of a range of programmes including; education, urban agriculture, water and sanitation, nutrition, HIV/AIDS and maternal health, from across 17 countries.

 Nutritional gardens & water supply -Zimbabwe

One of the case studies features the work of Tearfund’s partner in Zimbabwe- Churches in Bulawayo (CiB). In response to rising food prices, high unemployment and lack of clean water, CiB, working closely with Bulawayo City Council and the local community implemented a combined nutritional garden and borehole rehabilitation programme, focused in high-density western suburbs. The City Council provided land for 20 communal gardens – each of about 2500 square meters that was divided into household plots. Each garden was close to a borehole that was rehabilitated during the project. 

The most vulnerable sectors of the population were chosen to be beneficiaries, including child headed households, widows, orphans and people living with HIV. They were able to grow vegetables and sell the excess and so the local community have been able to purchase fresh vegetables locally at an affordable price. In addition health assessments by the City Council health department indicate improved health. 983 families benefit from gardens and 20,000 people benefited from water supply. Some of the most vulnerable beneficiaries, including those with HIV report that they no longer feel stigmatised and have gained a new dignity in the community with their vegetable sales. Other residential areas are now asking if they can have similar projects.

Water and sanitation & reducing sexual violence – DRC

The report also mentions the work of Tearfund’s partner working in the Democratic Republic of Congo, ‘Programme de Promotion de Soins Santé Primaires’ (PPSSP). PPSSP takes an innovative approach to addressing the needs of women and children. Sexual violence is a common tragedy facing women and children, and recent estimates suggest 48 rapes occur each hour in DRC. Diseases, such as cholera, diarrhoea and nematode infections resulting from poor water, sanitation and hygiene are also commonplace in the area.

The links between sanitation and sexual violence become apparent when, due to lack of access to private latrines, women faced no choice but to walk outside of their village, often at night, to defecate – increasing their exposure to sexual violence. PPSSP have responded with an integrated and holistic approach. Adopting a CLTS approach, and working in schools and health clinics, maternal and child health in the area has improved, and the increase in household latrines have reduced the vulnerability of women. In addition, through establishing community protection committees, survivors of sexual violence are able to speak out, receive counselling and seek justice.

Report recommendations

Drawing from the evidence gathered, the report makes the following recommendations to international institutions, politicians, donors, and their NGO partners:

  • Commit high-level political leadership and financial resources to integrated approaches, where they can create greater impact.
  • Work with communities to design, implement, and evaluate integrated projects and programmes.
  • Incorporate experience and expertise across different sectors and stakeholders into development programmes.
  • Fund projects that demonstrate integrated approaches at the community level to learn what works, improve national plans, and inform scale-up strategies.
  • Provide flexible funding to partner countries in support of national priorities and integrated programmes.

 The report Join up, scale up – how integration can defeat disease and poverty is available for download here.


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