Charter for International Health Partnerships in Wales
An evidence-based approach, searching out positive results that should be celebrated and an open culture willing to learn when things go wrong, are essential.
Use of the best possible evidence, through Evidence Based Practice, must be applied in international health partnerships. Where there is no available evidence from the region or a comparable region, research may need to take place to inform projects or interventions. Quality of care must not be compromised by a lack of evidence. Evidence and learning gained should be shared.
It is good practice to use the best available evidence when carrying out health interventions, something we commonly apply in Wales and which should be carried into our international health work. More information on the concept of Evidence Based Practice can be found on the WHO website.
Needs assessments can help to determine the requirements, and also expectations of the project. Where projects and partnerships involve developing country health systems, needs assessment must be led by the requirements of the partner country in order to provide a robust foundation for a new partnership or project. This is especially true where the country is low-income. Needs assessments must be carried out for each new project developed within a partnership. Asset Based Needs Assessment or Rapid Appraisal Methods should be considered.
Asset Based Needs Assessment
Information on the asset approach can be found at the Glasgow Centre for Population Health (GCPH). A summary of the approach can be seen here:
"Assets can be described as the collective resources which individuals and communities have at their disposal, which protect against negative health outcomes and promote health status. Although health assets are a part of every person, they are not necessarily used purposefully or mindfully. An asset based approach makes visible and values the skills, knowledge, connections and potential in a community. It promotes capacity, connectedness and social capital."
Asset based approaches emphasise the need to redress the balance between meeting needs and nurturing the strengths and resources of people and communities (GCPH 2011).
Rapid Appraisal Methods
Rapid Appraisal (RA) is an approach that draws on multiple evaluation methods and techniques to quickly, yet systematically, collect data when time in the field is limited. RA practices are also useful when there are budget constraints or limited availability of reliable secondary data. For example, time and budget limitations may preclude the option of using representative sample surveys.
Information on the use of this technique can be found at USAID.
Carrying out monitoring and evaluation must be integrated into each project and partnership. In developing country health systems the "Wales Africa Effectiveness Framework" can be used by Welsh organisations that are working with partners in any low income settings. It is a collaborative piece of work between Wales Africa Community Links, Wales International Development Hub, Network of International Development Organisations in Scotland (NIDOS) and Bond (formally known as the British Network for Overseas Development), and enables organisations to review their work against principles of good practice in international development, using practical benchmarks that are consistent across the UK. In other partnerships, monitoring and evaluation arrangements will be identified that follow recognised methodologies appropriate to the activities and acceptable to all parties.
All staff will be encouraged to understand the legitimacy of engaging in the international health agenda. This can be fulfilled in a number of ways, such as global citizenship training, investment in Fair Trade produce and collaborative working using online methods.
Global citizenship is the concept that implies an understanding of the increased interdependencies between different countries or citizens in a globalised world, where the person then acts more responsibly to take this into account. The global social determinants of health, health inequities and environmental sustainability recognises the importance of the link between the environment and human activity as impacting on health and well-being, which is fundamental to the principles of the global citizenship agenda.
Source: Barton, H. and Grant, M. (2006) A health map for the local human habitat. The Journal for the Royal Society for the Promotion of Health, 126 (6). pp. 252-253. ISSN 1466-4240 developed from the model by Dahlgren and Whitehead, 1991.
Wales has sustainable development and global responsibility at the heart of its policy and is leading the way for its international partnerships in the NHS. Forward thinking policy, such as the Well-Being of Future Generations Act (Wales) 2015, is enviable.
The Act has synergies with the Sustainable Development Goals (SDGs) (Figure 1) and is the Welsh response to implementing the Goals. In terms of the SDGs, there is recognition that education is required to ensure sustainable development is successful and this needs to be done at all levels and in all social contexts. Education and training to promote sustainable development and global citizenship' is one of Sustainable Development Goal’s targets, which all countries of the UN have committed to achieve by 2030. GC is part of the Education 2030 Agenda and Framework for Action initiated the United Nations Educational, Scientific and Cultural Organization (UNESCO) in 2015. Empowering learners to live responsible lives and to address complex global challenges means that education has to promote competencies like critical thinking, imagining future scenarios and making decisions in a collaborative way. This calls for new approaches to learning, the development of vibrant green economies and societies, and the emergence of “global citizenship”.