(January 2014) Population, health, and environment initiatives (PHE) can be more effective than single-sector efforts in improving people’s lives, demonstrates a new PRB ENGAGE presentation. PHE is an integrated approach to solving challenges in vulnerable and remote communities through improving access to health services (especially family planning and reproductive health), while also helping households improve livelihoods, manage natural resources, and conserve the critical ecosystems on which they depend.

The ENGAGE presentation, Population, Health, and Environment Working Together, was created to increase support for the PHE approach. The story begins with Rukia, who lives in a small agricultural village in Tanzania—but she really could be any woman or “every woman” in a struggling rural community. Rukia's community is burdened by unsustainable fishing, poor agricultural production, and lack of land due to the neighboring Saadani National Park. These challenges are compounded by a growing number of families grappling with dwindling resources. And after a day’s labor running the household and collecting the food and water needed for daily life, women like Rukia have little time or the means to devote to health services for themselves or for their children.

According to Jason Bremner, program director for PHE at PRB, “Many organizations, in response to these complex and interrelated challenges, have developed innovative ways of working with communities to simultaneously discuss health and environment issues in community meetings, combine service delivery, and develop integrated behavior change communications and messaging.”   

The presentation explains how the PHE approach works to improve health, livelihoods, food security, and natural resources worldwide; highlights success stories over the past several years from select projects around the world; and encourages discussion about the need for increased investment in such projects. The presentation explores the impact of several global projects. One example is Blue Ventures, a conservation organization that integrated health services into their existing marine conservation activities in southwestern Madagascar. The result: Contraceptive use increased from only 10 percent prior to intervention to 55 percent by 2013. Their conservation impacts also increased.

But the PHE approach of integrating conservation and health does not only improve women’s health. Men’s involvement in family planning and reproductive health increases as well. In Ethiopia, through the Guraghe People’s Self-Help Development Organization, husbands in the PHE project were four times more likely to support use of family planning than husbands in the reproductive-health-only program. The PHE project integrated discussions of reproductive health into meetings with men to discuss agriculture and reforestation. Women also benefited from the integrated intervention—they were almost four times more likely to earn an income than the women in the reproductive-health-only program.

Rukia's community has absorbed the messages from the USAID-funded Pwani project. Rukia, now empowered by her knowledge of the mutually reinforcing relationship between population, health, livelihoods, food security, and environment, has become a PHE peer educator and educates other community members about these connections.

The PHE approach is one about working together—addressing the needs of local communities, and partnering with them to achieve their goals. For more PHE success stories and explanation of the PHE initiative, view the entire presentation. For a glimpse into the complex and interrelated challenges faced by many families and communities around the world, and concise highlights of how the PHE approach can address these challenges, view the ENGAGE Snapshot video. 

“We’ve created this presentation as a communication tool for advocates and practitioners. We hope that people will use this presentation to reach out to new organizations, new donors, and new communities to engage their support and involvement in PHE efforts. I look forward to hearing about the many ways that both the long presentation and the related ENGAGE snapshot are used,” said Bremner.

Population, Health, and Environment Working Together premiered at the opening of the International Population, Health, and Environment Conference, funded by the David and Lucille Packard Foundation, USAID’s Office of Population and Reproductive Health, and USAID’s East Africa Regional Office. The conference was held in Addis Ababa, Ethiopia, in November 2013.