A Multi-Year Program Review

August 19, 2015

Although the key to significant change is often in the lessons of long-term implementation, we don’t see these multi-year studies as often as would be useful. Recently the Helping Babies Breathe (HBB) program released a five year report. As readers of this blog may know, I was fortunate to be part of this program’s evolution and wrote about its early days – partnership launch  and an early eight month review. It is encouraging to see the partnership continue in this direction – continued analysis and sharing of the lessons learned.

Some of the lessons shared in the five year review (and which may also apply in similar efforts) include:

  • Achieving impact is more than just training providers. Training does not automatically transfer to improvements in performance without institutional support and on-going skills use and strengthening.
  • The program has made a special effort to be country-led and country-owned, seeking the guidance and coordination of ministries of health. A side benefit to this approach has been a strengthening of parts of local health systems to support HBB. There is still a challenge of the program having significant donor funding and finding ways to integrate the costs more fully into national health system budgets.
  • Local context and integration with other local (in this case medical) facilities/programs – taking a holistic systems approach – is critical to effective long-term implementation.
  • Being clear about what is core to the program (for example ILCOR guidelines) as well as what ‘alternative formulas’ can be used by community providers in supervised home births, has led to wider usage and thus greater impact through more interventions that can save lives.
  • Tracking progress through varied countries and contexts can call for multiple and varied mechanisms to track progress.
  • Effective partnerships can help leverage each others assets, cash and in-kind contributions, influence, networks and program platforms.
  • You may have to modify your original mandate – either a narrowing or broadening of scope. In the case of HBB to better integrate into the newborn, child and maternal health focus of many health systems, the scope was broadened to Helping Babies Survive and Thrive.

The full report Helping Babies Breathe: Lessons learned guiding the way forward, can be downloaded here