International Health Links Funding Scheme (IHLFS)

1. International Health Links Funding Scheme (IHLFS)

2. About the International Health Links Funding Scheme Application process Project planning and the application form Lunch Advice and questions on individual proposals and plans Agenda

3. Long term partnerships between UK health institutions and counterparts in developing countries Aim to improve health services in developing countries through reciprocal transfer of skills and knowledge between partners Health Links

4. Objectives of the IHLFS • Improving health care in developing countries by sharing skills and knowledge • Building capacity of developing country health services • Through: • Providing grants and support to Links between institutions in developing countries and UK • Supporting development of new Links and the strengthening and expansion of existing Links

5. 3 years (2009-2011) Funded by UK DfID and UK Department of Health Jointly managed by THET and British Council £1.25 million each year for Health Links Different sized grants (project and start-up) The Scheme

6. Up to £15,000 a year, for 1 or 2 years Existing Links Could be used for needs assessments or projects Applications for funding for two years considered in this round only Project Grants: 2010

7. Up to £3000 Establishment of new and young links Link must be less than 2 years old Either partner can apply Applications for small grants considered any time until allocated funds for each year have been spent Examples of funded grants: To undertake a needs assessment To develop an activity plan and memorandum of understanding Start-up Grants

8. Africa: eligible countries • Sierra Leone • Nigeria • Tanzania • Uganda • Zambia • All grants • Ethiopia • Ghana • Kenya • Rwanda • Malawi • Mozambique • Start-up grants only • Democratic Republic of Congo • Sudan • Zimbabwe

9. Asia: eligible countries • All grants • Bangladesh • Nepal • Pakistan • Start up grants only • Afghanistan • Cambodia • India • Vietnam • Yemen

10. Developing country hospitals, training institutions, professional associations and UK counterparts Institutions committed to improving services for those living in poverty If you are unsure about your eligibility please contact HealthLinks@britishcouncil.org Eligibility

11. Benefit people living in poverty Developed and agreed by all Link partners Focused on capacity building Not duplicating existing development activities Consistent with the strategic plans of the developing country partner institution Aligned with national or district health plans / priorities Informed by evidence based health and development practices Show a commitment to share learning with IHLFS Funding Criteria

12. Read the guidance notes Discuss and plan with Link partner/s Complete the application form Complete the budget Get signed letters of institutional commitment from both Link partners Deadline 5pm 31st May 2010 Application Process

13. British Council team check eligibility Peer review Independent Selection Panel make final decision Applicants told of results beginning of August 2010 Formal Grant Agreement Selection process

14. Why do a needs assessment? Understand context Prioritise need Identify problem and appropriate solutions Establish a baseline from which to measure change Identifying Needs

15. What is the specific problem this project aims to address? How does this project address these needs? Is this the best way to address this problem? What are the key health issues in the area where you will be working? What National and local policies and plans are in place to address these needs and issues? How does your project fit in? Questions to consider

16. Tswana University was founded in 1999 next to the St Mary’s referral hospital to provide courses leading to a Bachelors of Med and Surgery. In 2004 a MMed was established. Initially 2 lecturers ran both undergrad and postgrad courses. The first 2 MMed students graduated in 2006 and since then a further 9 have graduated. There are another 7 trainees who will graduate over the next 3 years. All but 1 of the graduates are currently working as lecturers in Tswana. The presence of these doctors working and teaching hospitals and universities has made an enormous difference to standards of clinical practice and resulted in specialist departments being set up.

17. Historically NCDs had low priority in the health agenda of developing countries. With improved management of infectious diseases, NCDs will become increasingly important. Poorly controlled hypertension is a risk factor for vascular events, cardiac and renal disease. Cerebrovascular disease and ischaemic heart disease are not the 6th and 7th leading causes of death in Tswana (WHO). The hypertension clinic at St Mary’ssees 50 patients/week. Most patients are poorly controlled due to failure of clinicians to treat to target, poor drug availability and lack of patient education. Hypertension is particularly common in diabetic patients in whom it increases risk of complications (UKPDS). Over 1000 patients attend the diabetic clinic at St Mary’s. 52% of diabetic patients attending the clinic have raised BP, despite receiving antihypertensive meds. 34/35 diabetic patients with stroke had poorly controlled hypertension. Treatment regimes are old-fashioned, the main treatment being methyldopa, only 9% are prescribed ACEIs, primarily due to drug availability (Tswana Med J) Attempts to improve BP control and achieve internationally recognised BP targets have proved unsuccessful.

18. Your description of need should directly relate to the goal of your project Focus on illustrating the localised need – the level at which your project activities will have an impact Use facts to back up your claims not just for the sake of having stats. Things to remember when writing about needs

19. Relevant details about each Link partner Strengths Experience of running projects and managing funds Link activities to date Success stories or lessons learnt How they’re informing this plan Project Partners

20. Anybody who will benefit from your project: Direct Beneficiaries Eg Health workers receiving training Indirect Beneficiaries Patients and their families Beneficiaries

21. Anyone who: Could have power or influence over the project Should be involved in the project E.g. Hospital management, district and national health departments, the community, health worker unions, other non-profits working in the hospital/area Stakeholders

22. “If you don’t know where you are going, any road will take you there” Alice in Wonderland Project plan

23. A summary of the key factors in a project A tool to work towards consensus with stakeholders Helps organise your thinking Check the logic of the project Monitoring progress Evaluating achievements Uses of project plans

24. The longer term change to which the project will contribute Likely to be focused on changes in people’s health E.g. Reduced maternal mortality Goal

25. “To build the capacity of the psychiatric hospital through training and support” How could this goal be improved? What to avoid: Goals

26. “To build the capacity of the psychiatric hospital through training and support” Vague: build the capacity to do what? Not focused on health or service outcomes: What difference will it make? No need to say that it is “through training and support” as those are the activities What to avoid: Goals

27. “To develop a fully integrated eye department and surgical training centre for the region as a unique ophthalmic facility dedicated to the provision of surgical skills training in sub-specialities, continuing medical education and treatment of all eye disease, including refractive error, thus raising the standard of eye care, increasing the number of properly trained eye care personnel and their productivity which in turn will significant help in reducing avoidable blindness and visual impairment in this region.” How could this goal be improved? What to avoid: Goals

28. “To develop a fully integrated eye department and surgical training centre for the region as a unique ophthalmic facility dedicated to the provision of surgical skills training in sub-specialities, continuing medical education and treatment of all eye disease, including refractive error, thus raising the standard of eye care, increasing the number of properly trained eye care personnel and their productivity which in turn will significant help in reducing avoidable blindness and visual impairment in this region.” Too long Some are outcomes Instead: “Reduced avoidable blindness and visual impairment.” Or… “Improved standards of eye care in the region.” What to avoid: Goals

29. The changes that result from the outputs Usually changes in practice / behaviour by members of the target group E.g. Increased number of referrals by MCH Assistants of high risk pregnancies to clinics Outcomes

30. Staff trained in intensive care unit Mental health promotion activities To initiate training in surgery and train the trainers basic surgical training course while also developing plans for training in one other sub-speciality course What to avoid: outcomes

31. Staff trained in intensive care unit Mental health promotion activities To initiate training in surgery and train the trainers basic surgical training course while also developing plans for training in one other sub-speciality course Output not outcome What will be the result of that training? What to avoid: outcomes

32. Staff trained in intensive care unit Mental health promotion activities To initiate training in surgery and train the trainers basic surgical training course while also developing plans for training in one other sub-speciality course Activity not outcome What will be the result of that activity? What to avoid: outcomes

33. Staff trained in intensive care unit Mental health promotion activities To initiate training in surgery and train the trainers basic surgical training course while also developing plans for training in one other sub-speciality course Activity not outcome Output: “training of trainers basic surgical course undertaken by 6 surgeons” Outcomes: “more training courses to have been run”, and “improved surgical skills” What to avoid: outcomes

34. The tangible, direct results of the project E.g. MCH Assistants trained in antenatal care Outputs

35. What you are going to do (includes timeframes, content, follow-up) E.g. Run three training workshops for MCH Assistants Activities

36. Check the logic

37. Indicators are signs of change or progress that can be measured Specific Measurable Achievable Relevant Time bound Indicators Who has seen the wind? Neither I nor you. But when the leaves hang trembling, The wind is passing through. Who has seen the wind? Neither you nor I. But when the trees bow down their heads, The wind is passing by. Christina Rossetti

38. “To achieve the project outcomes and outputs” “To achieve the development of improved radiology services” “Develop and deliver good quality education and training packages for the multi-professional workforce” What to avoid: Indicators

39. “To achieve the project outcomes and outputs” “To achieve the development of improved radiology services” “Develop and deliver good quality education and training packages for the multi-professional workforce” An indicator should indicate how you will know that you have achieved your outcomes and outputs. E.g. How will you know that radiology services have improved? What to avoid: Indicators

40. Monitoring: What have we done? Are we on track? Flag up any problems Measure project outputs Evaluation: So what difference have we made? Evaluate the outcomes Evaluate the process What is M&E?

41. For accountability to your stakeholders To learn and improve To celebrate successes Think about evaluation questions: What have been the results / changes of our intervention? (expected or unexpected, positive or negative) How effective are links? Monitoring, evaluation and learning

42. “Evaluation of effect and efficacy will be conducted during month 18 and a report on impact made available.” What’s missing? What to avoid: evaluation plans

43. Plans: Who will do what and when? Baselines Include your M&E plans in the timeline and budget M&E plans

44. “Evaluation of effect and efficacy will be conducted during month 18 and a report on impact made available.” What’s missing? What will be evaluated and how? Methods / tools How monitoring, evaluation and learning will be integrated into the project; will nothing happen before 18 months? How will impact be assessed? Is it feasible to assess impact within the timescale of the project? What to avoid: evaluation plans

45. Work with stakeholders to identify meaningful indicators Incorporate M&E activities into existing systems: audit, log books, hospital records etc Build capacity in health management information systems where needed Knowledge, attitudes and practice in the long-term: How you will find out what difference training has made and whether skills are implemented? More than just measuring indicators: What works? (or doesn’t) Why? In what context? Build review and learning into project activities throughout M&E tips

46. Who communicate with? Community, Ministry of Health, other Links, health care staff Why? Collectively analyse findings and identify future actions Increase engagement in the project Health promotion Advocacy How will you communicate? Reports, internet, radio, publications, community meetings, face to face meetings When and who? Dissemination of progress, results and learning

47. Lasting change after the grant money has been spent: What and how will Link activities continue? What activities will need resources to continue? What will be the lasting benefits? Is there a risk of the need increasing again? How will the project build a platform for future Link activities? Sustainability

48. Internal Risks Project design Partnership High staff turnover External risks Things you have limited control over Political instability Natural disasters How will you manage the risks? Risks

49. Budget

50. Website: www.britishcouncil.org/learning-healthlinks E-mail: healthlinks@britishcouncil.org The International Health Links Manual, Health Links Monitoring and Evaluation Toolkit and other THET guidance, available from http://www.thet.org.uk Your local British Council country office may also be able to help Further information