Weaving trust through the know-do gap

Much of the discussion in this weeks readings resonated with the frustrations that arose for me during my summer practicum observing and documenting progress toward the achievement of the Millennium Development Goals (MDGs) in Northern Nicaragua. Working under an initiative that integrated every buzzword of the hour was a fascinating experience and I came to realize just how far buzzwords really make it beyond air-conditioned offices in capital cities. Intersectoral participatory work is complex and if trust can be cultivated while carefully treading around a “Christian, Socialist, and Solidarity!” government, it’s cherished.

During my short time there I found that proposals for intervention were drowning in evidence with each of the latest and greatest international declarations from social determinants of health, to health in all policies, to the most cost effective water purification strategies. With the crunch of funding deadlines and lack of time and financial resources to properly execute intersectoral work that truly valued local actor’s voices however, much of this evidence could not be put to good use. The call to action for “approaches that employ the principles of community-based participatory research and team science that take stakeholder and local perspectives and treat all collaborators as valued “experts” on their domains of interest” (Glasgow et al, p. 649) was acknowledged, but failed in practice.

My primary focus for this work was MDG 7, Target 10: Halve, by 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation. In order to build off of these shortcomings I witnessed during my time in the field I’d like to explore this issue further in the context of the course. If domestic water quality management is the most cost effective water treatment strategy, how can that awareness be put into action in the community? How can trust built between intersectoral actors be fostered and taken advantage of to create sustainable change? Effective solutions for collaboratively translating the growing body evidence surrounding water security worldwide into sustainable changes are needed. Moving past buzzwords and into evaluating implementation strategies, I think a focus not only on effective interventions but on building effective long-term relationships across sectors in the effort to promote evidence-based practice will be a key to the on-going improvements of health outcomes.

References

Glasgow RE, Green LW, Taylor MV, Strange KC. (2012). Evidence integration triangle for aligning science with policy and practice. American Journal of Preventive Medicine, 42(6), 646-654.

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