Synergies Among Components
Interventions within any of the three program components—Supply, Enabling Environment, and Demand—do not operate in isolation, as represented in the visual model below by the bridging arrows connecting these three areas. Investments in one component will have an impact on the other components, and activities that are well-coordinated and mutually reinforcing will yield optimal impact. The SEED Programming Model™ highlights three areas of synergy between the program components—quality client-provider interaction, systems strengthening, and the transformation of social norms.
Quality Client-Provider Interaction bridges Supply and Demand. A quality client-provider interaction is at the heart of quality services and is realized when a knowledgeable, empowered client interacts with a skilled, motivated service provider at an equipped and well-managed service site or during mobile/outreach activities. Investments in both the Supply and the Demand components contribute to a quality client-provider interaction. For example, supply-side investments in interpersonal communication, counseling training, and job aids/tools enable health providers to provide client-centered counseling that can positively influence clients’ knowledge of and demand for services. Tailored to clients’ needs, such counseling is effective in identifying and addressing knowledge gaps and misperceptions and helps clients identify their health needs, their intentions, and an appropriate course of action or treatment. Likewise, demand-side investments in effective SBCC interventions can heighten clients’ awareness of and knowledge about health issues and available services and can empower them to ask questions and to request their desired services or products during health consultations. These mutually reinforcing investments increase the likelihood that clients’ SRH needs will be met.
Systems Strengthening bridges Supply and Enabling Environment. To be sustainable, many supply-side interventions require systems strengthening. For example, initiatives to address gaps in provider competence and in essential equipment and supplies cannot be sustained without complementary investments in systems for supervision, commodity logistics, training, and the like. Systems strengthening may also entail consideration of new service delivery approaches, such as task shifting, task sharing, community-based or mobile outreach services, and the adoption of new technologies. Likewise, systems strengthening provides an opportunity to identify potential areas for integrating services, where improved linkages may both enhance efficiency and increase the accessibility and availability of services. Another important way to strengthen systems is to engage key stakeholders, particularly local communities, to ensure that they have meaningful and continuous input into resource allocation and program planning, design, implementation, and monitoring. This supports the principle that services should be accountable to the communities they serve, and that communities themselves have an interest in and ability to contribute to the establishment of quality, sustainable services.
Transformation of Social Norms bridges Demand and the Enabling Environment. A social norm is a value, belief, attitude, or behavior pattern to which most people in a particular community or culture adhere, and individuals are often expected by their community to conform to that social norm. Social norms significantly influence an individual’s SRH, in that they lay out expectations of behavior that may conflict with the behavior needed to safeguard one’s health and well-being. In such cases, a holistic program needs to undertake interventions that will work toward transforming those harmful social norms that inhibit individuals from ensuring their SRH and/or adopting positive health-seeking behavior. Engaging communities to discuss SRH issues requires, in part, an exploration of the sociocultural barriers to SRH, such as the expected roles of women, and concepts of masculinity. Undertaking demand-side interventions with a concurrent focus on fostering supportive social and gender norms not only increases an individual’s knowledge and awareness of SRH, but also his or her capacity to ensure this and seek care within a supportive environment.