In the implementation of its programs and activities as well as the development of the training programs it offers, ACI emphasizes a socio-ecological approach to health considering the various determinants of health in designing the strategies, programs and projects to be implemented to respond to changes and meet challenges.  

Processes of change such as these can not be  initiated from the outside ;  the process of social tranformation can only be engaged from within each social micro locale which is why a participatory approach is essential.
The eco systemic approach to health working at a micro-level but with a global perspective can allow us to identify the determinants of health in relation to :
the physical environment, consequences of climate change (cycles of drought, flooding, water borne diseases, etc), the quality of housing, problems of universal access to clean water and hygiene
the socio-cultural and political environment ; socio-cultural norms, stigma and discrimination, exclusion, family and social destructuration, change in social and sexual practices, living conditions, illiteracy…
the economic environment; drought and agricultural empoverishment leading to internal and external migration, precarity in semi urban zones, economic activities requiring mobility and population shifts ; weak economic development zones abandoned by  actors and politicians, areas of conflict deserted by economic actors and causing  strong mobility (Casamance), mining and industrial zones that create crowded living conditions, sexually transmitted infections including HIV, and unnwanted pregnancies.….

The socio-ecological approach targets the environmental determinants of health requiring an inter-sectorial community, political and social vision. This approach encourages the design of integrated programs including questions of health (agricultural development, literacy, education, income generating development activities in urban areas, envronmental hygiene…)