Communities in and around the Lake Victoria Basin experience a number of interconnected challenges, including dependence on diminishing natural resources, pervasive poverty, food insecurity, poor sexual and reproductive health outcomes, and inaccessible health services. At the same time, the ecosystem itself faces substantial degradation. To address these intertwined
challenges and foster healthy, engaged communities, Pathfinder International is currently advancing an integrated population, health, and environment (PHE) initiative called Health of People and Environment–Lake Victoria Basin (HoPE–LVB) in partnership with several environmental and health sector partners in Uganda, Kenya, and the US. Funded primarily by the David and Lucile Packard Foundation, and the John D. and Catherine T. MacArthur Foundation, with technical support from the USAID-funded Evidence to Action project, the HoPE-LVB project is implemented in a combination of island, lakeshore, and inland sites in Uganda and Kenya.
Applying ExpandNet’s systematic scaling-up approach of “beginning with the end in mind,” advocacy has been an important component for the HoPE-LVB project to ensure successful institutionalization and expansion. With this approach, the HoPE-LVB team has been able to foster innovative policies and guideline changes to accommodate integrated multi-sectoral programming in a predominantly vertically organized system. It is our mission to ensure sustainable capacity not only in project communities, but also nationally and internationally. The HoPE-LVB team is working closely with member governments of the East African Community, through the Lake Victoria Basin Commission, to ensure that the project’s advocacy efforts yield lasting changes. The HoPE-LVB experience differentiates itself from other PHE efforts around the world, which did not necessarily have this explicit focus. This brief discusses the project’s experience with advocacy and offers lessons for other implementers on how to lay the groundwork to sustain integrated PHE projects at the sub-national level.