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


Exploring the Impact of SALT

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.

The Assam Project: a treasure trove of learning

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!



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“.

HealthRise India Transition Grant – End-line Evaluation Report

October 2020

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“.

“In addition, this assessment suggests that the higher the number of population reached by the ACP, the more cost-effective the results are, as does not only the ACP reduce HIV risk behaviours resulting in HIV infections averted, but also improves individual capability resulting in increased quality of life among individuals.”

Research Report, Using capability index to determine a value for money of the AIDS Competence Process in Thailand.

Health Intervention and Technology Assessment Program (HITAP)

Asian Development Bank (ADB)

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.

The WHO-UNICEF evaluation of AIDS Competence in Papua New Guinea


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


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

June 2005



  • 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

The Constellation 2022 Reporthttps://the-constellation.org/the-constellation-report-2022-english/

Link & Learn, the ‘L’ of SALT with Listen, is the basis of the ability of any human, any human group, to live its full potential. The experiences shared [in the report] show that, whether it is between people with a common goal, between outsiders and a group, between groups that oppose each other, Link & Learn offers a ‘a platform for growth’, opens the field of possibilities for beneficial actions for all.

Connecting and learning with SALT is about breaking down barriers by focusing on commonalities and being energised by the strengths of the people involved: an essential starting point for action.

Le rapport 2022 en françaishttps://the-constellation.org/the-constellation-report-2022-french/

Kaza, S. K., Gupta, P., Vaidya, R., Nooyi, S. C., Chaudhury N. (2022). Effect of COVID-19 lockdown on lifestyle habits and self-care practices of diabetic and hypertensive patients in rural Shimla and Udaipur – Findings from the HealthRise India program. Indian Journal of Public Health, 66(4), 466-472. https://www.ijph.in/article.asp?issn=0019-557X;year=2022;volume=66;issue=4;spage=466;epage=472;aulast=Kaza


Conclusion: Participants exposed to support, appreciate, learn, and transfer-community life competence process (SALT-CLCP) intervention maintained metabolic control during the COVID-19 pandemic with improved behavioral and self-care practices. Community-based interventions such as SALT-CLCP method bring ownership and empower community in achieving the better health outcomes.”

The Constellation 2021 Reporthttps://the-constellation.org/the-constellation-report-2021-english/

“This year for The Constellation was very much about growing from a challenge to new opportunities and perspectives.

That is true for our organisation. Also, during the Virtual Global Learning Festival (V-GLF), we heard many expressions and examples from people and groups going through the same. I guess that is what looking at life with SALT as attitude offers us.

We propose to dive deeper into this in the annual report as a beautiful testimony.”

Marlou de Rouw, The Constellation Board and Voting Assembly Member.

Le rapport 2021 en françaishttps://the-constellation.org/the-constellation-report-2021-french/

The Constellation 2020 Reporthttps://the-constellation.org/the-constellation-report-2020-english/

“2020. Covid-19 put the world upside down. The ‘normal’ in the lives of organisations, communities, neighbourhoods, families, and individuals was challenged. Also, for The Constellation, its teams, its partners and its members. This annual report makes a tour around the world and the account makes us hopeful.”

Le rapport 2020 en françaishttps://the-constellation.org/the-constellation-report-2020-french/

Ramaiah International Centre for Public Health Innovations (RICPHI). HealthRise India Transition Grant Endine Evaluation Report. October 2020. https://drive.google.com/drive/folders/1eFcna7ldyEN2k5YXuNsw4k_n7fAJsD2k

“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 Constellation 2019 Report.

“It is with great pleasure that I welcome you to the pages of our annual report of The Constellation.
You will find many beautiful stories, hopes, successes and also many questions, new and old.
More than ever, during this past year, we have questioned our identity, our role and of course our actions.
More than ever, I see the merits of a dialogue based on our humanity and on openness to others in order to confront, in particular, identity retrenchment and mistrust.
More than ever, our dream is relevant; and it is exciting to see that the path towards it is becoming richer and richer as the years go by.”

Continue reading Luc Barriere-Constantin’s introduction and the report here: https://www.communitylifecompetence.org/uploads/6/3/7/1/63712543/constellation_report_2019_en.pdf

“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”.

“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?”

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”.

  • AIDS Competence – Jean-Louis Lamboray (December 2007), ‘AIDS: let us learn from those who progress’.
  • Thierry Goorden (October 2007), ‘Médecin itinérant‘ [Itinerant Doctor], Journal des Médecins, No. 1868.

Participatory Action Research


“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.”

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.

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.

Reflections on the SALT approach

Join the journey, learn the walk
and contribute to building a better world

Become a partner and build resilience in your own organization or community
Become a change maker in your own community
Help communities to be autonomous