Mapping

Environmental Analysis

In addition to understanding stakeholders, you also need to assess the existing structures and availability of resources for integration.

Environment Analysis Elements and Questions to Ask

Existence of national-level strategies, policy documents or action plans for SBCC integration. Has integration been prioritized and formalized in the form of national-level documents?
Extent to which relevant health and development programs are already integrated. Have any existing strategies or policies on integration been implemented in practice? What topics have been integrated? What lessons, including specific challenges or success factors, can be learned from this experience?
Existence of national-level SBCC coordinating bodies. Is there a MOH Health Promotion Unit or equivalent structure currently coordinating SBCC? Do vertical programs within the MOH, such as the National Malaria Control Program or Reproductive and Child Health Section, have their own staff dedicated to SBCC outside of the Health Promotion Unit? Have any SBCC task forces or working groups been formed that span across different sections within the MOH? What is the SBCC technical capacity of these groups? How active and well-resourced are these coordinating bodies? Can any of the existing coordinating bodies serve as the coordinating mechanism for the integration effort, or is a new coordination mechanism needed?
Human resources for SBCC at decentralized levels. Are there point people responsible for SBCC in place at sub-national levels (e.g., Regional or District Health Promotion Coordinators or Community Health Focal Persons)? What is the SBCC capacity of these individuals? Is health promotion their only responsibility, or are they in charge of other areas as well (e.g., family planning coordinator)? If they are simultaneously coordinating other areas, how might that help or hinder their focus on SBCC and integration?
Extent to which the relevant services are available and integrated. Which services are available at which level of health facility? Are some services integrated? How are they integrated, and how well is it working? Is this standard practice in all of the health facilities? Are there plans to scale-up this type of integration?
Health providers’ ability to accommodate the number of topics expected to be included. What cadres of health providers are implicated in the integration? Is it realistic to expect health providers to take on the number of health topics included in your program? What additional training will be required in order to achieve this?
Presence and roles of community health workers (CHWs). Is there a formal, institutionalized CHW cadre at the national level, or do different programs (either MOH units or donor-funded projects) recruit and train their own CHWs in different health areas? How extensive and decentralized is the network of CHWs? What qualifications are required to become a CHW? What health topics are included in the CHW training? How are these topics integrated, if at all? What methodologies are used in the training (e.g., didactic lectures or participatory approaches), and what types of activities are CHWs expected to carry out at the community level? Does their training have an SBCC component? Can the CHWs accommodate the number of health topics expected to be included? Who supervises the CHWs? How are CHWs compensated or incentivized?
Existing referral mechanisms. How are clients currently referred from the community level to the health facility, to different services within the same health facility and between health facilities? Are there standardized referral systems, or do different programs, projects and/or health areas have their own mechanisms?
Existing media that could be adapted to accommodate integrated SBCC. If the new initiative will have a mass media component, investigate whether there are any existing radio or television programs, magazines, newspaper sections, websites or social media sites focused on health or development. What do they currently address, and how? Could any existing hotlines or short message service (SMS) platforms be utilized for integrated SBCC? Could any of the available media channels be easily added to or adapted to include additional topics?

Worksheet

Take the following points into consideration and complete Worksheet 4: Environmental Analysis in order to round out your knowledge of all the existing gaps and opportunities.

Resource

See How to Conduct a Situation Analysis for more information on environmental analyses for SBCC programs in general.

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