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Key Questions to Consider:

  • What would success look like, and how will we know it?
  • How will we monitor wha​t we are doing?
  • How will we evaluate whether what we are doing is successful?
  • Did we reach our goal(s), and, if not, how will improve our efforts?​

Core Activities:

  • Establish a monitoring system that provides reliable population-based data (e.g., standardised measures of mortality and morbidity) for:
    • NCDs and modifiable risk factors and behaviours
    • Incidence and prevalence of communicable diseases
    • SDGs (e.g., rates of infant mortality)
    • Social determinants of health (e.g., levels of income inequality)
  • Measure process and output indicators to permit accurate monitoring of actions taken (e.g., measures of implementation, new or modified programmes/policies/practices)
  • Evaluate the impact of interventions on outcomes (e.g., incidence and prevalence risk behaviours and related diseases)
  • Use the results, including differential effects with different populations, to guide improvements and resource allocation


Field Note: The Healthy School Program in South Africa

Map image of South Africa In South Africa, inequalities in economics and health stem from a history of racial and gender discrimination. Since the end of apartheid in 1994, schools were target settings for addressing racial and ethnic divides by offering a healthy place that fosters learning. The primary target of intervention is a primary school that is situated in a semi-rural town about 50 kilometres outside of Cape Town. This community has a high level of ​unemployment, commercial sex work in teens, substance abuse, and gang activities. The value of education was suggested as a 'social vaccine' to prevent the spread of HIV. The Teacher Support System (TSS) was a program that identified policies to address teaching, learning and the school environment. A Health Promoting School (HPS) is one that engages health and education officials, educators, pupils, parents, and community leaders in efforts to promote health, a healthy environment, school health education, school health services, and school-community outreach projects. HPS links between the education, health, and the community sectors.

The HPS documented evidence of impact of learning and health outcomes before and after the HPS program was implemented into the school curriculum. The nurse and principal as well as other staff were key program implementers and evaluators in addressing various aspects of development and growth. The nurse documented health-related visits, the principle documented instances of violence, and teachers documented students' performances within class. The evaluation utilised a quas​i-experimental approach with comparison schools. The target school reported better performances in the intervention for most outcomes (e.g., increased self-esteem in learners, increased positive relationships, and increased involvement of learners, teachers, and parents). There was also a new established vegetable garden within the school. Documentation of program components, new collaborations built, and program impacts highlighted improvements and gaps to be addressed. The development of formal evaluation structures and guidance is important to operationalise, manage the process, set goals, organise teams, evaluate progress, and improve practice.

[SOURCE: WHO (South Africa), WHO African Regional Office, Health Promoting Schools]


Resources to Help You Evaluate:

Resources from the World Health Organisation:

​​​Resources from the Community Tool Box (CTB):

CTB Toolkit:

CTB Troubleshooting Guide(s) for Solving Common Problems:


Other Related CTB Readings:




Key Questions to Consider:

  • How will we institutionalise what works?
  • ​​How will we ​assure that resources will be available for long enough to achieve the intended goals and objectives?

Core Activities:

  • Institutionalise effective programmes and policies to reduce NCDs, control disease, attain the SDGs, and address social determinants of health
  • Develop mechanisms for sustainable health financing in order to promote health for all, including maintaining programmes/policies to reduce health inequities


Field Note: Addressing Social Determinants of Health through Intersectoral Collaboration: Fish Farming Project in South Imenti Constituency in Meru County, Kenya

Map image of KenyaThe Government of Kenya is committed to sustainable development as demonstrated in the Poverty Reduction Strategy and the Economic Recovery Strategy for Wealth and ​Employment Creation. Among the numerous intersectoral programmes introduced was the fisheries development programme. This program consisted of construction of fishponds in 140 constituencies in Kenya. The main aim of introducing fish farming (aquaculture) was to improve nutrition and create over 120,000 employment and income opportunities. This project focuses on fish farming in Imenti South Constituency and explores the extent to which fish farming has had an impact on nutrition, food security, employment, and household income. Data was collected before and after project implementation in the Imenti South constituency, located in the Eastern part of Kenya. Fishery officers worked with the community to maximise participation and assure collaboration in the planning and implementation phases.

The Economic Stimulus Program (ESP) aims to jump-start the economy towards long-term growth and development by protecting the livelihood of poor populations and creating jobs for the youth. Some of the ESP activities include: expansion of irrigation-based agriculture, construction of fresh produce markets and fishponds. A series of trainings were held in collaboration with the ministry of health. In 2004, aquaculture was able to make an important contribution to poverty alleviation, food security, and social wellbeing. Fish provides a good source of protein and essential micronutrients, thus plays an important role in the prevention of many diseases. In addition, fish farming reduces fishing pressures on oceans, lakes, and rivers.

Participants reported fish farming created an increase of 56.1% employment opportunities and boosted household income by 43.9%. Sixty-six percent of participants felt that field visits by the extension fishery officers provided continuous technical know-how skills. Of all participants, 56.4% were trained on marketing skills, which increased fish sales. Knowledge and technical skills were essential in assuring good pond management and sustainability of fish farming activities on the constituency. ESP's farming initiative contributed to the health of mothers and children and to the sustainability of food security within Kenya. This program will be sustained through ongoing training of fish farmers as well as technical support from fishery officers.​

[SOURCE: WHO (Kenya), WHO African Regional Office]

Resources to Help You Sustain the Effort:

Resources from the World Health Organisation:

​​​Resources from the Community Tool Box (CTB):

CTB Toolkits:

CTB Troubleshooting Guide for Solving Common Problems:

Other Related CTB Readings:


AUTHORS/CITATION: WHO-AFRO Online Supports for Intersectoral Action for Health and Equity. 2015. World Health Organization Collaborating Centre for Community Health and Development at the University of Kansas http://communityhealth.ku.edu/ (Stephen Fawcett, Ithar Hassaballa) & the World Health Organization's Regional Office for Africa in Brazzaville, Congo—Health Promotion Cluster (Davison Munodawafa, Peter Phori).