Trust Networks In Action: Examples of Trust Networks

I have talked with the Temple of Understanding about the interfaith community in the United States and the possibility of developing humanization campaigns (using Jonas Salk's words to connote a 21st Century corollary to 20th Century immunization campaigns) to avoid social conflict and war. Marshia may also want to bring in some of the ToU discourse regarding the use of gaming with youth to help them understand and engage Trust Networks with the benefit of seeing how environments of trust are built and are susceptible to being destroyed in simulation.

Timothy John Downs a, Heidi Jane Larson b
a
Environmental Science and Policy Graduate Program, Department of International Development, Community and Environment (IDCE)and
George Perkins Marsh Research Institute, Clark University, 950 Main Street, Worcester, MA 01610,USA
b
Harvard Center for Population and Development Studies, 9 Bow Street, Cambridge, MA 02138, USA

Abstract

Biomedical interventions promise achievement of health-related Millennium Development Goals provided social-, capacity-
and knowledge-based constraints to scaling up and reaching marginalized people at risk are addressed, and balance between
prevention and treatment is struck. We argue for a new approach: multi-stakeholder capacity building and learning for
empowerment: MuSCLE. MuSCLE is used as a way to frame three systemic weaknesses in traditional health science and
policy approaches: (1)a lack of engagement with people at risk to build a collective understanding of the contexts of health
problems, including social drivers; (2) a lack of multi-criteria evaluation of alternative interventions; (3) a lack of attention
paid to integrated capacity building. The MuSCLE framework responds in three ways: (1) participatory assessment of the
ecological, socio-cultural, economic and political contexts of health, identifying priorities using risk and vulnerability science,
and modeling drivers; (2) selection among intervention alternatives that makes ecological, socio-cultural, economic and political
tradeoffs transparent; (3) integrated capacity building for sustainable and adaptive interventions. Literature and field lessons
support the argument, and guidelines are set down. A MuSCLE approach argues for a transformation in health science and
policy in order to achieve Millennium Development Goals for health.

Keywords: Poverty; Risk; Vulnerability; Capacity building

doi:10.1016/j.healthpol.2007.02.008

T.J.Downs,H.J.Larson/HealthPolicy83(2007)144–161

Contents
1. Introduction.................................................... 145
2. Social learning framework................................................. 146
2.1. Communication for social change.................................. 146
2.2. Participatory methods.................................................... 147
2.3. Proposed learning cycle................................................. 148
3. Systems understanding..................................................... 149
3.1. Health as a dynamic system........................................... 149
3.2. Prioritizing health problems........................................... 152
4. Selecting among interventions ......................................... 153
5. Building capacity............................................................... 154
6. Overall approach: implementation.....................................156
6.1. Risks and obstacles....................................................... 157
7. Conclusion....................................................................... 158
Acknowledgments .................................................. 159
References.................................................159