Greater Than the Sum of Its Parts: Quantifying the Integration of Population, Health, and Environment in Development

This post is a synthesis by the authors of “Integrated management of coastal resources and human health yields added value: a comparative study in Palawan (Philippines),” recently published in Environmental Conservation.

It makes intrinsic sense that integrated approaches working across development sectors are a good thing – especially when it comes to the complex issues facing people in developing countries and the environment in which they live. After all, integration avoids overlap and redundancies, and adds value to results on the ground. Yet, quantifying the benefit of integration has been difficult and to date, little on this topic has been published in the peer-reviewed literature.


Not anymore. Our article, “Integrated management of coastal resources and human health yields added value: a comparative study in Palawan (Philippines),” recently published in the journal Environmental Conservation, breaks new ground. Rigorous time-series data and regression analysis document evidence of different disciplines working together to produce synergies not obtainable by any one of the disciplines alone.



The article presents quasi-experimental research recently conducted in the Philippines that tested the hypothesis that a specific model of integration – one in which family planning information, advocacy, and service delivery were integrated with coastal resources management – yields better results than single-sector models that provide only family planning or coastal resources management services.



The study collected data from three island municipalities in the Palawan region of the Philippines, where the residents are dependent on coastal resources for their livelihoods. The integrated model was implemented in one municipality, while the single-sector models (one coastal resource management program and one reproductive health management program) were conducted in two separate municipalities.



The results of the study provide strong evidence that the integrated model outperformed the single-sector models in terms of improvements in coral reef and mangrove health; individual family planning and reproductive health practices; and community-level indicators of food security and vulnerability to poverty. Young adults – especially young men – at the integrated site were more likely to use family planning and delay early sex than at the sites where only family planning and reproductive health interventions were provided.



Coral reef health – as measured by a composite condition index – and mangrove health increased significantly at the integrated site, compared to the site where only coastal resource management interventions were provided. Data from the integrated site also showed a significant decline in the number of full-time fishers, as well as fewer people who knew someone that used cyanide or dynamite to fish – both factors that amplify a community’s vulnerability to food insecurity. Finally, the proportion of young people with income below the poverty threshold decreased by a significant margin in areas where the integrated population and coastal resources management (IPOPCORM) model was applied.



Let’s hope this research is just the beginning of a more thoughtful and effective approach to meeting multiple development goals in a lasting manner
Educational activities at the integrated site focused on illuminating the intrinsic relationship between fast-growing coastal communities in the Philippines and the diminishing health of the coral reefs and fisheries that they depend on for food and livelihoods. Community change agents, often fishermen and their families, talked to their neighbors and fellow fishers about the importance of planning and spacing families and establishing and respecting marine reserves to protect the supplies of food from the sea. They referred those interested in family planning to community-based social marketers of contraceptives or the nearest health center for other services.



These same community members also participated in activities to sustainably manage their coastal resources: working with local government officials to establish marine reserves, replant mangroves, serve as community fish wardens to patrol those reserves, test out alternative livelihoods such as seaweed farming, and start small businesses to diversify their income and reduce fishing pressure.



Development professionals should pay close attention to the conclusions of this study. In environmentally significant areas where human population growth is high, it will be difficult to sustain conservation gains without parallel efforts to address demographic factors and inequities in the distribution of health and family planning services. Integrating responses to population, health, and environment (PHE) issues provides an opportunity to address multiple stresses on communities and their environments and, as this study demonstrates, adds value in such a way that significantly improves community resilience and other outcomes.



This research allows those of us who believe strongly in integrating population, health, and environment programming to point to quantitative proof that the approach works. We now need to expand PHE programming to reach more people in other parts of the world where communities face a similar nexus of challenges. New initiatives have started taking the lessons from this research, applying them to new contexts in Africa and Asia, and scaling them up to reach many more in the Philippines.



Let’s hope this research is just the beginning of a more thoughtful and effective approach to meeting multiple development goals in a lasting manner in the places that need it most.

Leona D’Agnes is the technical director of IPOPCORM, Joan Castro is the executive vice president of PATH Foundation Philippines Inc, and Heather D’Agnes is the Population, Health, Environment Technical Advisor in the U.S. Agency for International Development’s (USAID) Office of Population and Reproductive Health.



Sources: BALANCED, Link TV, PATH Foundation Philippines Inc., World Wildlife Foundation.



Image Credit: Philippines village (adapted) and municipalities map courtesy of PATH Foundation Philippines Inc.