Valuing the Girl-Child to Better Meet her Health and Well Being Needs

1. Valuing the Girl-Child to Better Meet her Health and Well Being Needs Dr Ruth Yeoman, Research Fellow, University of Oxford

2. Valuing the Girl-Child to Better Meet her Health and Well Being Needs The Problem: • India Context - High levels of anaemia in adolescent girls, resulting from poor nutrition, limited community understanding and inadequate public health services. • Need to deliver new services to more than 90 communities by end 2018 • Requirement to demonstrate impact of new model across measures of malnutrition, infant and maternal mortality, incidence of future disability. How the project could respond: • Generating scalable community-level change by learning from participatory interventions in rich action contexts. • Connecting deep local change to ecosystem responses in institutions, policy making and national frameworks. • Embedding sustainable local, regional and national innovations in public health, nutrition and social/cultural practices

3. A Thinking, Feeling and Acting Model for Deep Local Change

4. Aspects of the Model for ChangeSystems approach, expansive learning and values-oriented • A systems approach to expanding and enriching our knowledge of the Girl-Child using: • Ethical values (moral) • Health and well-being data (reasoning) • Emotional sensitivity (feeling) • Developing and using this knowledge with an ‘expert group’ of local community members and specialists. • Focus on a pilot with a small cohort of communities (acting) • Use participatory methods, such as Change Laboratories, photovoice, theatre, to generate the collaborative knowledge and shared expertise needed for cultural adaptation, innovation and change. • Securing strategic cover by connecting, through expanding circles of concern, to regional and national stakeholders through workshops • Perhaps supported by a Policy Making Delphi conversation • Action-oriented • Provides replicable learning for other communities.

5. The Expert Group in Expanding Circles of Concern National level/strategic cover Policy makers Government National institutions International stakeholders Private sector partners Expert Group Girls/boys Parents/carers Teachers Community elders Govt health workers Others in the system Local/Regional Institutions NGOs Public Health Organisations Education/schools Others?

6. QuestionsTensions/Challenges/Paradoxes Some indicative questions – very general at the moment: • ‘The System’ – what does the system look like? What is the history of the system? (successes/failures/memory/legacy). How does it need to be redesigned? Are there any system leaders/orchestrators? • Cultural norms and assumptions – What cultural norms impede an expanded and enriched understanding of the Girl-Child? • Power – where does power lie? How does it need to be redistributed? • Who are the local, regional and national stakeholders? What technical, social and material resources do they have? What is the level of trust? What do the relationships look like? • Are there any communities which are particularly ready for change? That is – they feel a sense of urgency, are committed to doing something, are ready to learn and work with each other (locally and at other levels). • What are the general capabilities of ‘the system’ to orchestrate change?

7. Dr Ruth Yeoman, BSc, MBA, PhD Centre for Mutual and Employee-owned Business Kellogg College, University of Oxford. ruth.yeoman@kellogg.ox.ac.uk