Concern seeks to continually redefine the boundaries of its own knowledge, learn from the communities we work with and explore new programme tools and mechanisms. In short, we use innovation to design ever more effective programmes.

Olivia in her home near the Dandora dumpsite, Nairobi. The IDSUE research project aimed to develop a surveillance and early warning system for slow onset emergencies in cities like Nairobi. Photo: Abbie Trayler-Smith/Panos Pictures for Concern Worldwide.
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Concern as an innovator

Learning and innovation go hand in hand. The arrogance of success is to think that what you did yesterday will be sufficient for tomorrow - WC Pollard

In recent years, Concern has implemented a number of pioneering programmes to help address the chronic problems that the communities we work with face. Key to our innovations is investing time and resources in testing our methods and gathering detailed data to assess whether or not they work.

Our commitment to innovation has, in some cases, led to key breakthroughs for the entire sector – our innovation on Community-based Management of Acute Malnutriton (CMAM) led this method for the treatment of severe malnutrition to become standard practice across the world, endorsed by the WHO and UNICEF.

Here we focus on a selection of Concern's flagship innovations such as Community Resilience to Acute Malnutrition (CRAM), Indicator Development for Surveillance of Urban Emergencies (IDSUE) and projects under our Innovations for Maternal, Newborn & Child Health initiative such as the Chipatala Cha Pa Foni health phone service and the Maker Movement.


Highlights of Concern's innovations programmes.

Building community resilience with CRAM

The Community Resilience to Acute Malnutrition (CRAM) programme in eastern Chad was one of Concern’s pioneering projects to show ‘what works’ to improve the resilience of vulnerable people.

Through CRAM, we invested in an integrated set of activities to promote access to water and health services, and better hygiene, child care and agricultural practices. Crucially, we also carried out rigorous evaluation with our partner Tufts University to determine if the package had indeed made a difference. The programme achieved impressive results and protected children under-five in the target area from both acute malnutrition (wasting or extreme thinness) and chronic malnutrition (stunting or poor growth). Access to clean water and key hygiene practices also improved more broadly within the target communities, and an early warning system has been piloted to monitor the food and nutrition situation and raise the alarm early if and when humanitarian response is required.

Concern continues the same work in Chad and has expanded the approach to Sudan under the Building Resilience and Adaptation to Climate Extremes and Disasters (BRACED) programme – funded by DFID – and with continued funding from Irish Aid. Learning continues to emerge from this project, which Concern will continue to share.

How does CRAM work?

CRAM works in an integrated way across sectors to address the range of problems that combine to erode community resilience to shocks. In addition to rehabilitating or digging boreholes in each of the 35 project villages, Concern also set up mother support groups to promote life-saving practices such as breastfeeding infants, seeking timely care for sick children, hand washing and accessing ante-natal care. The programme also supported the tenuous government health system to deliver better services, including the treatment of severe acute malnutrition using the CMAM approach. A key innovation of this approach is bringing together humanitarian and longer term development programming.

Indicators for urban emergencies

More than half of the world's population is now living in urban areas and one third of these people are living in slums. As the world’s cities continue to grow at a rapid rate, Concern’s innovative Indicator Development for Surveillance of Urban Emergencies (IDSUE) programme in Kenya aims to provide robust data to help predict and avert urban food security crises.

IDSUE, an operational research that commenced in 2010 and ended in 2016, aimed to develop a surveillance and early warning system for slow onset urban emergencies.

IDSUE designed and rigorously tested a surveillance methodology and refined a set of core indicators – to be measured on a routine basis – and a set of context-specific thresholds for intervention, to be used in the Urban Early Warning, Early Action (UEWEA) mechanism. This system is aimed at responding to slow onset urban food security crises. The UEWEA project team is now working to ensure that the Kenyan government is equipped with both the systems and the information to take early action to slow onset urban crises by:

  • Establishing a coordinated urban early warning early action mechanism in the slums of Nairobi, comprising actions agreed with the Nairobi county government.

  • Routine surveillance in line with county coordination structures.

  • Monitoring of thresholds to trigger action with a coordinated multi-stakeholder response based on timely information.

Innovations for maternal, newborn and child health

The Chipatala Cha Pa Foni (health centre by phone) hotline in Malawi and the Maker Movement for low-cost medical devices in Kenya are two examples of the exciting projects born from our Innovations for Maternal, Newborn and Child Health initiative funded by the Bill & Melinda Gates Foundation.

“Chipatala cha pa foni” (free hot line) - a message urging Malawians who not close to a hospital or health centre to instead phone a hospital hotline to consult with a professional about health questions or concerns. Photo: Concern Worldwide.

Chipatala Cha Pa Foni is an mHealth innovation which we first introduced in 2011 in Malawi. The programme, piloted in partnership with our Concern office in Malawi, the Malawi Ministry of Health, and our implementing partner VillageReach, has proven so successful as a means of long-distance health advice and consultation that the Government of Malawi plans to expand it nationwide. Meanwhile, the Maker Movement forged partnerships between clinicians and biomedical engineers in Kenya to create low-cost, locally-designed medical device prototypes and spare parts to serve women and newborns. A key achievement includes the building, internally calibrating and securing clinical testing approval for the partnership’s first medical device – a suction machine.

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