Disseminating Urban Health Models for Scaling

Background:

There is a growing demand for use of scientific evidences and approaches in public health decision making. In a broader sense, an evidence-based approach refers to the application of the principle of scientific reasoning in development, implementation and evaluation of programmes and policies.
1 A key advantage of the approach is that it uses available evidences to make decisions and to address public health issues which are central to any effective public health programme. However, lack of resources and knowledge may hinder the use of evidence-based approach in making decisions while implementing any large-scale public health programme. It holds true especially for non-academic institutions in the public health domain where programme decisions are based on short term demands and anecdotal evidence.2 Many public health practitioners may not be well aware of the ways to incorporate scientific reasoning in to programme implementation. Sometimes, policy decisions may be made based on unsubstantiated facts and administrative causes rather than on evidence. In the given context, there is a critical need to promote evidence-based approach in public health. In view of this, at SNEHA (Society for Nutrition, Education and Health Action), we aim to consolidate our learning, create strong domain knowledge and translate it to build models of urban health intervention based on evidence.

Operatingprinciples

Research and Monitoring and Evaluation (M&E) are at the core of our programme implementation. M & E is a centralised domain of SNEHA with an independent framework of monitoring, assessment and reporting of programme outcome and impact. The role of the domain is to create evidence of models of urban health intervention that can be scaled and replicated through government and other NGOs, thus increasing the impact of the models. This is crucial to SNEHA’s mission of working in partnership with communities and health systems to build effective and replicable solutions, empowering women and their families in urban slums to improve their health. We leverage research techniques and engage in partnerships to generate evidence that can both improve service delivery through our interventions and inform public health policy and practice. While programme planning and implementation at SNEHA is fundamentally research driven, Research as a domain engages with a much wider scope of exploration and analysis. The entire endeavour in SNEHA is ably supported by use of technology in data collection, analysis and report generation.

Results/Impact

SNEHA is uniquely placed to carry-­‐out direct programme implementation and M&E/research – few NGOs straddle both areas. All our programmes have a well-­‐designed M & E framework and processes with research studies of both qualitative and quantitative nature weaved into it. Most of our programme evaluations and research findings are published in peer reviewed journals of repute. We have more than fifty research publications specific to our thematic areas of work. Our partnership with University College of London dates back over a decade where we have collaborated on several research projects including three randomized control trials.

Our Maternal and Newborn Health programme was developed in partnership with the government to generate evidence for a provider participatory model to strengthen referral systems for maternal and newborn health services in urban public health context and has been adopted and implemented in six adjacent municipal corporations of Mumbai. This translation of research into a policy decision has helped in streamlining high risk maternity referral and in improving maternal health of underprivileged urban populations.

We  aim  to  showcase  the  experience  and  insight  that  the  organisation  holds  into  building  evidence-­‐based urban health models with the wider audience. The dissemination event will have a thematic session on ‘Evidencebuilding’within the broad objective of ‘DisseminatingUrbanHealthModelsforScaling’. The session will stimulate a dialogue on evidence based public health practice, brainstorm on diffusion of implementation research findings to a large audience and how these findings can be used to influence public health policies.

¹ Lhachimi, S. K., Bala, M. M. & Vanagas, G. Editorial Evidence-Based Public Health tematic review titled ‘Exercise and BMI in Overweight and Obese Children and Adolescents: A Systematic Review and Trial Sequential Meta-Analysis’ utilizing a trial sequential. BiomedRes. Int.2016, (2016).

² Brownson, R. C., Gurney, J. G. & Land, G. H. Public Health: Public Health. Ind.Med.Gaz.35, 154 (1900).