In June of 2010 I wrote about the launch of the Helping Babies Breathe Global Development Alliance and then provided some updated information here in November and on the Global Scale-up wiki. It has now been eight months since the original launch and another face-to-face partners meeting was held. A few days prior to the meeting, an expanded alliance for Saving Lives at Birth was announced by U.S. Secretary of State Hillary Clinton, citing some of the major partners in the Helping Babies Breathe program. This provided our discussions with additional energy and momentum. Still challenges to implementation of course remain. Some of the major process issues discussed at this most recent meeting included:
How fast to move?
The original plan was to have the partnership focus on scale-up, evaluation and feedback in approximately 10 countries. This number fairly quickly grew to 20 and then over 30. Even with numerous new volunteers (often well versed in the program’s content) how effectively can a program be implemented in different locations, while still keeping a focus on sharing implementation and evaluation lessons? There is a trade-off between tapping into the momentum and enthusiasm, and taking the time to develop mechanisms for sharing information that will improve the program. For example, for HBB, through the initial field roll-out it was discovered that some of the equipment could be adapted in ways that would make it easier to maintain cleanliness, an important health component. With a faster roll-out, the existing equipment would need to be sent as is; with a slower roll-out there would be time for the equipment to be re-tooled, tested and be ready for use. Additionally there would be more time for translations, and logistics such as equipment clearing customs or local procurement.
What should be core?
This question is closely linked to the speed of roll-out. The more different locations, the larger the increase in possible permutations in how the program is implemented. The partnership needs to decide what is core to keep the fidelity of the program, which becomes clearer as the roll-out proceeds. If the roll-out is slower, this information can be fed back into a ‘global’ discussion. If the roll-out is moving very quickly there is less time to have this exchange of information and more adjustments are made de facto which can lead to programs getting ‘off track’ in potentially negative ways.
Coordinating information flow
The more organizations that come into a partnership or alliance, the more challenging communication becomes, at the same time that is becoming increasingly important. In the focus on program implementation it can be easy to neglect the time it takes to create and use effective communication processes and mechanisms.
Several factors have helped the HBB Global Development Alliance to deal with these challenges including: (1) The commitment among key stakeholders to create communication mechanisms and allocate time to use them; (2) Designating key people to be ‘in charge’ of facilitating this communication and (3) Scheduling regular ‘check in’ calls and meetings. This experience as well as previous ones have underscored to me the critical importance of communication systems – creating them and nurturing them through a commitment of time.