JUNE 2009--Since the early 1990s, a few small-scale community programs in developing countries have been using integrated approaches that address population-health-environment (PHE) links in ecologically fragile areas. These projects have sought to increase access to family planning and health services, while simultaneously helping communities manage their natural resources.
In the latest issue of Focus, the Sierra Club's Roger-Mark De Souza provides some observations and recommendations based on his decade-long experience in the field. "PHE offers a step in the right direction—a flexible, innovative way for policies and programs to keep pace with today's rapidly changing world—and lays the foundation for empowering our children to manage these changes for generations to come," he says.
In two video interviews, De Souza argues that integrating PHE is particularly successful because it is an "empowering, logical extension of how people live their lives."
"When I see communities have a better understanding of how these issues interact and have an impact on their lives, they become very energized and enthusiastic. One woman said to me, 'I live my life in a way where all these things are integrated so the solutions and the approaches that you are talking about make sense to me.'"
Some Successful PHE Programs
Challenges to Scaling Up PHE
Despite these success stories, the field "is just beginning to develop scientific evidence to support the case for successful PHE impacts at scales beyond the community level," says De Souza.
"More researchers should compare operational results from integrated programs to sectoral interventions in control populations to quantify PHE's effectiveness, as demonstrated by recent research from the IPOPCORM program in the Philippines," he says. "Others should build on their efforts by systematically gathering data, incorporating such experiments into their programs, and seeking greater engagement with academics and technical experts."
"PHE advocates should use concrete indicators to prove to other NGOs and funders that the PHE concept is a good way to achieve development goals at scale," he argues. "The PHE monitoring and evaluation guide developed by MEASURE Evaluation offers a foundation for developing benchmarks, but more programs and policy activities need to use it to develop detailed, prospective monitoring and evaluation plans."