(April 2009) For more than a decade, the Population Reference Bureau has nurtured national and international coalitions that address population, maternal and child health, global health priorities, and the environment. These alliances between individuals or organizations, each cooperating in joint action for a common cause, can play a key role in focusing attention on important issues and advocating for policy change. According to Rhonda Smith, associate vice president of International Programs at PRB, “Building coalitions and fostering unity among key actors is critical to moving issues higher on the national agenda.” PRB has learned that sharing the successes and challenges of coalitions in similar contexts can motivate and instigate new coalitions. This article captures the experiences from a newly formed but rapidly advancing coalition focused on population, health, and environment (PHE) issues in Ethiopia, with the hope that their experience will be valuable to similar nascent groups in sub-Saharan Africa and beyond.

A Clear Need To Link Population, Health, and Environment Trends

Population growth, stresses on natural resources, loss of biodiversity, and poverty present obstacles to development, but these challenges are interrelated. To be addressed, organizations, donors, and governments need a holistic approach that incorporates various programs and sectors, facilitates communication across sectors, and breaks down barriers to integrated work. This is the lesson of the launch of Ethiopia’s PRB-supported Consortium for Integration of Population, Health, and Environment (CIPHE), a network of over 60 nongovernmental organizations, international donors, academic institutions, media outlets, and government ministries that seeks to enhance understanding of linkages between population, health, and the environment and promote integration for sustainable development.

The vicious cycle of poverty and underdevelopment in Ethiopia leads to an unsustainable use of natural resources. The effects are connected: Population growth puts pressure on farm land in short supply, leading to deforestation. Deforestation degrades watersheds and creates a shortage of wood for fuel, further degrading the environment since animal waste and crop residues must be used as fuel rather than left as fertilizer in fields. Soil erosion is estimated to affect large parts of the country and forest cover has gone down from 14,165,000 hectares in 1990 to 13,000,000 hectares in 2005, an annual decline of 1 percent.1

These problems point to the need for linked, multisector approaches across different programs that support livelihoods and communities. PHE integration is essential since the benefits affect individuals, families, communities, and their environments in a synergistic manner. National and international commitments already make this clear; both the Ethiopia Plan of Action for Sustainable Development to End Poverty and the Millennium Development Goals promote an integrated approach to development.

Building the Coalition and CIPHE Activities

CIPHE was initially conceptualized at a conference co-sponsored by PRB and LEM in Ethiopia in November 2007. An ad-hoc committee of volunteers from seven organizations worked to build the consortium, and designated Negash Teklu as the full-time coordinator. Teklu and the committee members visited 90 prospective organizations and 10 donor organizations, making the case for cross-sector integration and the benefits of a network. The process was not always easy. Many organizations that focus on a single issue felt that PHE integration was potentially marginalizing and could threaten their missions. The committee realized they had to make clear that a PHE approach is not a new development model, but an integration of existing sectors. CIPHE would support the existing work of organizations while facilitating communication, coordination, and collaboration among institutions from different sectors, with the very real possibility of further project success. They promoted integration as a means of strengthening the work of each sector. As a result, all organizations were willing to support the effort.

After months of hard work, CIPHE was formally established in May 2008 with over 50 participants committing “to see a prosperous and healthy society in a sustainably managed environment.” Girma Wolde Giorgis, the president of Ethiopia, pledged his dedication and expressed admiration at the speed of the consortium’s establishment and the diversity of its membership.

Field visits have given member organizations the chance to learn from other integrated approaches. In October 2008, 14 members visited western Ethiopia, one of the few forested areas of the country, to see how new PHE projects are implemented and how they integrate historically single-sector programs in biologically threatened areas.

Training sessions on integrated project design and monitoring and evaluation systems for multisector projects were held in November 2008. CIPHE members gained a better understanding of how to effectively design and evaluate integrated projects. The increased capacity for monitoring and evaluation will provide CIPHE with success stories and lessons from PHE projects in Ethiopia that can be communicated to decisionmakers in Ethiopia and interested practitioners and partners worldwide. The challenge now is to scale up these capacity-building efforts to all members of the network.

Lessons for Creating Multisector Networks

What were the key reasons for the consortium’s growth and development? According to Negash Teklu, “First, there was the objective reality that the integrated approach would be a real injection into the development of the country…The second point is that many organizations were trying to answer the development questions of society in their separate ways…but when you see the results, the value added is when they are integrated…The role of the ad-hoc committee, their commitment including the coordinator, the role of member organizations…government, research institutions, was high and it contributed to attract and influence many organizations…including the president of the country, who is our patron.”

PRB has learned a great deal through working in East Africa. First, coalition building depends on identifying motivated and influential champions who are committed to particular issues and willing to work collaboratively with diverse organizations to address these issues. Second, once a small group of champions is identified, large scale events, though resource intensive, can bring together a critical mass of individuals and institutions to begin a larger coalition. Third, coalitions require constant communication between members, including periodic face-to-face meetings. Virtual networks can function in some settings, but periodic meetings are more efficient at ensuring commitment in the beginning stages. Fourth, coalitions need to have clearly defined objectives and activities that will benefit all members. Finally, while coalitions can survive solely on volunteer involvement, the coordinator needs to be responsible for the work, either through existing funding or by solidifying funding specifically for the position.

Looking Toward the Future

The work of CIPHE has just begun. Over the coming year, there are plans to map biodiversity hot spots in relation to population and socioeconomic indicators, adapt PHE project design and monitoring and evaluation manuals and translate them into local languages, engage the consortium in evidence-based advocacy, facilitate shared research across disciplines, and ensure communication among members.

The challenges in health, environment, and population are not unique to Ethiopia. CIPHE is committed to working with other East African organizations that collectively make up an East Africa PHE Network, and with African and international partners to integrate approaches toward sustainable development. As Negash Teklu says, “we recognize that overcoming the complex PHE problems of Ethiopia and the globe depends on the solidarity and the partnership of a global community of PHE champions.”

The lessons of CIPHE’s formation and growth highlight the need for the cross-sectoral integration and policy communication that PRB supports through local and international networks—building the capacity of women journalists, training local NGO staff on policy communication strategies, or building networks of policy advocates for reproductive health and family planning programs. “Coalitions serve as vehicles for stakeholders to come together, identify their priorities, and strategize about a common approach for getting policymakers to pay attention to their concerns,” says Jay Gribble, vice president of International Programs at PRB. “Our work with CIPHE and other PHE networks encourages NGOs, researchers, practitioners, and others to advocate more effectively for changes that improve people’s lives, livelihoods, and health.” 

Eric Zuehlke is an editor at the Population Reference Bureau. Jason Bremner is program director, Population, Health, and Environment, at the Population Reference Bureau.


  1. Food and Agriculture Organization, Global Forest Resources Assessment 2005, accessed online at www.fao.org/forestry/fra2005/en/, on April 27, 2009.