Success Factors
A number of useful concepts grew in the 1990s in relation to effective community-based programs. The concept of success factors helped sort out complex interactions: when numerous possibilities exist, understanding the successful pathway to effectiveness is more important than trying to disentangle what did not work. Focusing on successful programs helps simplify complexity and identify success factors, only some of which are programmatic (directly under the influence of the intervention itself); others are contextual.
The importance of context, within which programs are initiated and run, thus emerged as crucial, and priority factors were proposed from studies of community-based programs in Asia (Gillespie, Mason, and Martorell 1996, 67; Jonsson 1997). Sanders (1999) described similar concepts under the headings of community participation and political will. This distinction and interplay between context and program factors is helpful in identifying required supporting policies to improve the context to make programs work. Details are in the later section titled "Contextual Factors."
An overall framework (figure 56.2) for causal links to child survival and nutrition, put forward by the United Nations Children's Fund (UNICEF 1990), gave a basis for a common language—even if the details might be questioned—revolving around food, health, and care as proximal causes to be addressed through programs. Improving these factors attacks hunger, disease, and neglect, which are the converse of food, health, and care. Basic causes are, like context, open to influence through policy decisions and acting through directly influencing food, health, and care and by modifying the effect of programs. Here malnutrition is seen as the outcome of processes in society, and direct interventions are seen as both shortcutting the needed basic improvements in living conditions and being dependent on these improvements in the long run for sustainability.
[Figure
56.2]
