We create significant impact
On some of today’s most pressing social challenges
“The utility of the project to instil and sustain behavioural changes is striking and unprecedented. While this effect cannot be measured in numbers, it becomes visible when young girls take the floor in front of the whole community or when fathers take their children to the vaccination appointments.”
Michael Steffens, Outcome Harvesting Assam Project
The Constellation worked in Assam between March 2017 and June 2019. It worked in Shimla and Udaipur between April 2019 and June 2020. These projects helped The Constellation to understand how to evaluate of the impact of its work. This note discusses how we can use that understanding to evaluate our work in the future.
Three years of supporting facilitators and communities in Assam, India, has provided us with huge opportunities for learning. The result is well worth waiting for!
EVALUATIONS OF THE IMPACT AND RESULTS OF OUR WORK IN THE FIELDS
“The SALT-CLCP methodology is unique and different from the traditional community-based interventions in that it stimulates community members to identify resources within the community rather than importing solutions from outside to address its own problems, including health. This methodology does not provide any messages as part of intervention; rather, it provides an opportunity for the participants to identify their strengths and take decisions according to their perceived needs. The study findings do show a strong association between SALT-CLCP methodology and health behaviour among patients which may be instrumental in improving metabolic control of their disease conditions. It can be concluded that the SALT-CLCP methodology has potential to shift NCD care management from health care facility led model to community led model by empowering the community. The SALT-CLCP methodology also has a role in improving the capacity of the FLHWs in providing NCD care at the community level“.
“The SALT Approach was appropriate for the objective of changing attitudes and behaviors toward vaccination acceptance” (…) “a longer time frame could assure that changes would be adopted long-term and that the new attitudes would transfer to nearby communities not directly engaged in the project”. *
* Extract of CDC, Report on the Global Immunization Division Research Program 2011–2013 “Using the SALT Approach to Increase Acceptance of Polio Vaccination Among Religious Communities in Katanga Province, Democratic Republic of Congo“.
“The Malaria Competence process is very likely to foster a strong sense of community ownership. The self-assessment process led to a surge in community-led initiatives to create greater community awareness around malaria. It can be used for monitoring and evaluation, particularly when the assessments are documented and repeated on a regular basis. The National Malaria Control Programme in The Gambia believes that the Malaria Competence approach is instrumental in building sustainable community responses to malaria control.”
The Roll Back Malaria/PATH evaluation of Malaria Competence in 9 African countries
“The AIDS Competence Process is an effective approach in combating HIV/AIDS through local empowerment and should be continued and expanded. It meets local needs and its consistent support resulted in sustained local actions. For its low-cost but often labor intensive input of resources, the output has been substantial – awareness, empowerment, plans and actions regarding both HIV/AIDS and related social and other issues.”
“Between 83% and 87% [of AIDS Competence Process users] are satisfied and confident that the program achieves impact within communities, based on the experiential outcomes that they see or perceive within their communities.“
“Cost-effectiveness—efficiency varies from US$ 0.10 to US$ 2.00 per person reached (>1 Million). Costs/reach may become negligible as AIDS Competence Programme methods and knowledge spread in communities. Costs per Satisfied User likely to spread the process currently vary between US$ 1.00 to US$ 4.50.“
UNAIDS evaluation of AIDS Competence
PUBLICATIONS – BOOKS
- “Four principles of Community-Based Primary Health Care, Support, Appreciate, Learn/Listen, Transfer (SALT)“
Marlou de Rouw, Alice Kuan, Philip Forth, Rituu B. Nanda and Luc Barrière-Constantin (2020). Chapter 6 in Achieving Health for All, Primary Health Care in Action. Edited by David Bishai PhD, MD, MPH, and Meike Schleiff, MSPH, DrPH.
- Read The Constellation chapter.
Book for sale here
- “What Makes Us Human, the story of a shared dream“
Jean-Louis Lamboray (2016), Balboa Press.
“You can read it all in one breath, but then you feel the need to go back to it again to have a longer taste of those situations, attitudes, words that make a person contemplate different possibilities that allow for a life change.” Maria José Vazquez.
For sale here
- “Sida : La bataille peut être gagnée“ [AIDS: There is another way], Jean-Louis Lamboray and Jean Legastelois (2004), Les Editions de l’Atelier.
“He conveys a powerful message that is so simple that it transcends all ideological debates: “It’s the people that matter.” This lesson is both an inspiration and a powerful message about development theory.” Joseph Decostas
For sale here
English translation here
Learning from SALT-CLCP experience
Ramaiah International Centre for Public Health Innovations (RICPHI). HealthRise India Transition Grant Endine Evaluation Report. October 2020.
“The study findings do show a strong association between SALT-CLCP methodology and health behaviour among patients which may be instrumental in improving metabolic control of their disease conditions. It can be concluded that the SALT-CLCP methodology has potential to shift NCD care management from health care facility led model to community led model by empowering the community. The SALT-CLCP methodology also has a role in improving the capacity of the FLHWs in providing NCD care at the community level.”
Impacts of the Stimulate, Appreciate, Learn and Transfer Community engagement approach to increase immunisation coverage in Assam, India.
“Qualitative data demonstrated that the CLCP/SALT intervention helped in improving awareness and utilization of services to some extent, and had additional benefits outside the context of immunization”.
- Rituu B. Nanda (2019), ‘Experience capitalization: Collective planning from the ground up‘, Experience capitalization from theory to practice: Trying out a new approach, Experience Capitalization Series 11. Wageningen: CTA: 30-32.
“As a result of engaging and listening to the people on the ground, our plan has completely changed”.
- On creating communities of practitioners – Rituu B. Nanda (March 2015), ‘Stories from The Constellation‘, AI Practitioner, Vol. 15, No. 2, 2013: p.25.
“How do you create, maintain, and transform “common unities” among practitioners, inspired by Appreciative Inquiry and strengths-focused approaches?”
- Malaria Competence – David Kpevai and Joseph Senesie (February 2010) unpublished, ‘Malaria Competence in Imperi, Sierra Leone‘.
All four villages revealed that: “To date, no infant, child and maternal deaths were recorded since April 2009 after the facilitation of the Malaria Competence Approach. There is improved sanitation in the villages as youths are mobilized to carry out brushing around the villages”.
- Malaria Competence – The Constellation and Roll Back Malaria – Philip Forth & Jean Legastelois, (October-November 2008), ‘The ‘Competence approach’ in the battle against malaria in Togo and the Gambia‘.
- AIDS Competence in Indonesia – Rebeka Sultana (December 2009), ‘Speaking of a journey, The inside story of AIDS Competence
in Indonesia‘, published by UNFPA Indonesia.
- AIDS Competence & Malaria Competence – Gaston Schmitz and Philip Forth (November 2009), ‘Believing in the human capacity to respond to HIV and malaria: sharing experiences on a human level for global impact‘, Knowledge Management for Development Journal.
- AIDS Competence – Jean-Louis Lamboray (December 2007), ‘AIDS: let us learn from those who progress‘.
- AIDS Competence – Jean Legastelois (May 2007), ‘In Democratic Republic of Congo Local communities meet the challenge‘, published in La Croix in French.
- Thierry Goorden (October 2007), ‘Médecin itinérant‘ [Itinerant Doctor], Journal des Médecins, No. 1868.
Participatory Action Research
- Pauline Oosterhoff & Rituu B. Nanda (2020), ‘Participatory action research on alcoholism and bonded labour in times of prohibition in India, Educational Action Research, DOI: 10.1080/09650792.2020.1813184.
“Men reluctantly agreed that to realise the vision of the village they wanted, something needed to be done about the drinking. Women agreed that slapping men might feel good but was unlikely to motivate them or to result in a happier family or community life.”
- Pauline Oosterhoff & Danny Burns (2020), ‘Systemic Participatory Action Research and Learning within Large-Scale Operational Programs to Eradicate Bonded Labor in India‘, International Review of Qualitative Research, DOI: 10.1177/1940844720933235.
This publication mentions SALT as an approach giving action researchers “more confidence” and dream building “helped the group to find a purpose.
Using SALT in Evaluation
- Dr Rajib Nandi, Rituu B. Nanda and Shiny Saha (2018), ‘Sense of ownership as capacity building: Experience of using SALT amongst domestic workers for systematic self assessment‘, New Directions for Evaluations: Visibility, Voice and Value, ISBN: 9789351249221, Author: Brahmachari, Aniruddha, Ghosh, Samik.
- Rajib Nandi, Rituu B. Nanda and Tanisha Jugran (March 2015), ‘Evaluation from inside out: The experience of using local knowledge and practices to evaluate a program for adolescent girls in India through the lens of gender and equity‘, Evaluation Journal of Australasia, Vol. 15, No. 1, p.38-47.
The story and mission of The Constellation and SALT-CLCP
- Jean-Louis Lamboray (October 2017), ‘La source de SALT‘ [The source of SALT], interviewed in French by Patricia Spletinckx, The New Workers, episode No.45.
- Jean-Louis Lamboray (May 2016), ‘Il faut changer notre regard sur l’autre‘ [We have to change our outlook], Le Mauricien.
- Jean-Louis Lamboray (December 2006), ‘L’appropriation locale, vaccin social‘ [Local ownership, a social vaccine], interview by Laurence Dardenne, La Libre Belgique.
Reflections on the SALT approach
- Birgitta Schomaker (May 2016), ‘A deeper level of humanity: My Introduction to The Constellation‘, AI Practitioner.com, International Journal of Appreciative Inquiry.