Communities in and around the Lake Victoria Basin, in Kenya and Uganda, experience interconnected challenges. These challenges include 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 and engaged communities, Pathfinder International has been advancing an integrated population, health and environment (PHE) initiative called Health of People and Environment-Lake Victoria Basin (HoPE-LVB) since 2011.
The project applied the ExpandNet/World Health Organization (WHO) systematic scaling-up approach of Beginning with the End in Mind to ensure successful institutionalization and expansion of the project. This brief provides lessons to implementers and donors on how institutionalization emerged as a critical pathway towards scale-up and sustainability of integrated programming.