The document summarizes a workshop on health partnerships held at the THET Annual Conference in London on October 25, 2017. It discusses several principles of effective partnerships, including addressing country needs, transparency, ownership, communication, and flexibility. It also highlights the importance of monitoring, evaluation, and learning from partnerships. The document then provides an example of the Mbarara Epilepsy Project, a partnership between Uganda and the UK that trains local health workers and village teams to diagnose, treat, and educate people with epilepsy in their communities. It discusses challenges faced and lessons learned from this collaborative model.

1. Health Partnerships:
Principles into Practice
Workshop
THET Annual Conference, London, 25th October 2017
Graeme Chisholm, Policy Manager, THET

2. co-development
equal partnership
reciprocal learning
mutual benefits
ownership
alignment
harmonisation
managing for results
mutual accountability
inclusive partnerships
capacity development

3.  Effectiveness: including the key principles for
effective voluntary engagement in global health;
 Organisational commitment: including the vital
role of UK employers and professional
associations;
 Support for volunteers: including preparation
and support for the whole volunteer journey;
 Health values and ethics: the importance of an
ethical approach and the values that motivate
volunteers;
 Monitoring, evaluation and learning: highlighting
the need to assess impact, improve effectiveness
and learn from best practice.

4.  Aid effectiveness principles undermined
 Poorly designed programmes are
unsustainable
 Impact undermined through lack of policy
coherence
From the Foreword
“This report is in part a tribute to the 7,000 health workers from across the
UK who have taken part in health partnership work. And in part, it is a call to
arms. We could be doing so much more and we could be gaining so much
more.” Professor Dame Sally C. Davies, Chief Medical Officer

6. Hallmarks example

7. Addressing country need
Firstly, ensuring that partnership objectives meet locally
identified needs was viewed as critical
“The biggest challenge was that the core aim for the project
was not set by us, but imposed on us by our UK partner and we
were somehow going to have to make it happen ... This came to
haunt us, especially when it came to evaluating the impact of
the project”
Low-/middle income country partner
“Most of the time links are institution to institution and the
benefit is to the institutions and individuals. It is not always the
interests of the MoH that is being met.”
Low-/middle income country partner
Partnerships in Practice

8. Transparency
“The lack of transparency in the way grant resources are used,
[leaves us feeling used]; that our UK partner may have benefited
more than us, even though it may not be so.”
Low-/middle-income country partner country Ministry of Health
Ownership
“ In some countries where health partnerships operate partners
based in the LMIC setting have expressed the view that they are
sometimes seen as ‘sub-contractors’ rather than equal partners.”
Low-/middle income country partner
Partnerships in Practice

9. Communication
Also, clear, regular and open communication was viewed as vital.
“Mutuality should encompass joint planning and
implementation; aiming to achieve together and address
challenges together; and being accountable and respectful of
each other.”
Low-/middle-income country partner
“Consistent communication from both sides is essential, as
ongoing feedback helps [us to] think of ways to improve the
partnership.”
Low-/middle income country partner
Partnerships in Practice

10. Breakout session
trust …

11. Flexible, Resourceful and Innovative
Tropical Health and Education Trust Conference
25th October 2017, London
Aaron Pritchard
Co-ordinator, Betsi-Quthing (Lesotho) Health Partnership
Principles of Partnership
Betsi-Quthing Health Partnership

12. Quthing (Lesotho)
• Area of 2,916 km2
• Approximate
population 118,107
people
• Languages Sesotho,
English, Xhosa
• Lots of mountains
and sheep!
North Wales
(BCU Health Board)
• Covers an area of
6,172 km2
• Approximate
population 687,937
people
• Bilingual population
especially rurally
• Lots of mountains
and sheep!

13. A public health approach enables
adaptability because you can see the
‘bigger picture’
This project is supported by the Tropical Health &
Education Trust (THET) as part of the Health
Partnership Scheme, which is funded by the UK
Department for International Development (DFID)

14. Assessing situational adaptability
Logistical capacity Communication
infrastructure
Environmental
considerations

15. Plan, plan and then; re-plan…
The capacity to be flexible relies on a degree of stability

16. ”It’s not so much the diploma
you carry, it’s more the kind of
human being you are…”
- Patricia Danzi, ICRC

17. With thanks to the Tropical Health & Education
Trust/Department for International
Development for funding our Rural Health
Project (2015-17)
Above all we would like to thank all our friends
and colleagues in Lesotho for their
partnership
Diolch – Kea Leboha – Thank you

18. Health Partnerships:
Principles into Action
Dalton Buzigye Frances St John

19. Uganda – some Facts
 Population of 39
million (WHO 2015 Report)
 Epilepsy is the
common brain disorder
 ¾ of its victims never
get treatment
 Sufferers excluded
from community
 Stigma worse than the
disease itself

20. Mbarara Epilepsy Project (MEP)
Why 5,000 Miles Away?
 Only ONE Regional Referral Hospital!
 Only ONE Neurologist!
 Only ONE Psychiatric Ward!
 Only ONE EEG Machine!
In South Western part of Uganda

21. MEP in Action – How we do it
Friendships with Shared Passion
Clear Vision and Objectives
Clear Communication Channels
Clear Roles and Accountability Lines
Tight Financial Controls

22. Effective and Sustainable - Principle
Partnerships explicitly recognise Barriers and
Challenges to Health Systems
Projects are based on Recognised Good
Clinical Practice and Health System
Health Partnerships operate in a way that
delivers high-quality projects that meet
“Targets” and achieve “Long Term Results”
Hallmarks focused on:

23. Why this POP and Hallmarks?
Work can continue after Project end and be
self-sustaining
Results continue to be seen after the Project
ends
Challenges have been a Conundrum
Project has had a Bottom-Up Community
approach - using the “TOT Model”

24. MEP in Action – Bottom up Approach
 Diagnose & Treat Epilepsy
 Train PHW’s and VHT’s
 Supervise PHW’s and VHT’s
 Treat minor/early cases
 Refer complex cases to TOT
 Educate the community
 Identify symptoms & refer
 Engage with the community
 Educate the community
Trained
Trainers
(9)
Primary Health
Workers (PHW’s)
(37)
Village Health Team
(88)

25. MEP in Action – Cascaded Training
Trained
Trainers
PHW’s VHT’s
Community
Referrals
Training and
Supervision
Training and
Supervision
Referrals
Mutual Support
Destigmatize
Educate Community
Destigmatize
Educate Community

26. MEP in Action – Dedicated Team

27. MEP in Action – Engage the Community
 Community Events
 Sensitization

28. MEP in Action – Engage the Community
 Services to the
Community
 Destigmatize
 Build Relationship
with the Community

29. MEP in Action - Collaboration
Focus Groups
 Knowledge Sharing
 Testimonies Feedback

30. MEP in Action – Engage Service Users
 Testimonies
 Expert Advice
 Feedback

31. MEP in Action – Health Centres
 Epilepsy now part of Health Checks
 Epilepsy
Handbook
 T-Shirts

32. MEP in Action - Outcomes

33. MEP in Action - Challenges Faced
Breaking the Stigma
Unreliable Medical Supplies
Staff movements/transfers
Managing the Expectation gaps
Lack of Resources (Personnel and Funding)

34. MEP in Action – Lessons Learnt
Need to be Flexible
Teamwork Works
Communication is Everything
Failing to plan is Planning to Fail

35. MEP in Action – Lessons Learnt
 Epilepsy in NOT Infectious
 Never stop Fundraising

36. MEP in Action - Appreciations
Thank You!