Forging Effective Partnerships
By PRONTO’s Executive Director, Jason Sterne
In 2015, world leaders adopted the United Nations’ 2030 Agenda for Sustainable Development, an important framework for promoting prosperity while also protecting the planet. Over the next fifteen years, the global community will pursue 17 specific goals ranging from improving education and ending poverty to developing clean energy and tackling climate change.
Underpinning the first 16 goals on the list is Sustainable Development Goal 17: Revitalize the global partnership for sustainable development. Transforming our planet will require partnerships at the global, national, regional and local level. Collaboration among organizations with shared vision and goals will help focus more resources on the people and the communities they serve.
In 2009, PRONTO launched its first pilot program in Mexico in partnership with the Instituto Nacional de Salud Pública, to improve the quality of care during birth. Mexico, like many low- and middle- income countries, was struggling to further reduce its maternal morality rate, even though it had succeeded in increasing facility-based delivery. More than 90% of births occurred in hospitals and were attended by physicians. An analysis of these maternal deaths led to the conclusion that women were appropriately making the choice to seek care, arriving at a facility, but then not receiving the care needed in case of an emergency. This was a surprising result, given the fact that facilities were documented as having adequate staffing, supplies and infrastructure. Provider teams were, quite simply, failing to do the right thing at the right time. A targeted training strategy was needed to improve quality. So PRONTO collaborated to develop a customized modular program, with two days of initial training, plus a one-day follow-up training three months later focusing on the major killers in Mexico. The results were positive: a relative 44 percent decrease in perinatal mortality; a 21 percent decrease in caesarean sections; and a 62 percent institutional systems goal achievement.
As PRONTO’s footprint grew to rural northern Guatemala and Western Kenya, one thing became clear, while there can be value in standardization, a one-size-fits-all approach isn’t always the best one. We found training is more effective and has an increased likelihood to be sustained if it is tailored to reflect the context, culture and health systems in the setting where it is implemented. To be successful in this model, we realized the power and necessity of building strong partnerships with local teams and collaborating to develop a comprehensive targeted solution.
These early lessons from our global projects helped to frame our approach to PRONTO’s largest project to date in Bihar, India, with our local partners CARE India and the state government of Bihar. With a population of over 108 million, Bihar struggles with limited-resources and poor quality of care during birth. To address these challenges, PRONTO has plugged into a scale-up intervention by integrating on-site obstetric and neonatal simulation and team training into a mobile nurse mentorship model in 320 primary health clinics and 56 hospitals across the state. This train-the-trainer model was a new frontier for PRONTO. To ensure fidelity to PRONTO’s core elements and replicability at scale, it required thoughtful development of curricular materials, new monitoring and measurement systems, and a robust mentor feedback mechanism. It was a daunting task to undertake, but creating a program that addressed Bihar’s specific needs would make a better program that had a higher chance to be sustained and ultimately save more lives.
PRONTO International’s mission is to implement training strategies that help health care provider teams make better, coordinated decisions during the critical moments of an obstetric emergency that can the save life of a mother and baby. But tightly woven throughout this are collaboration, adaptability and innovation. Through our work, we’ve seen the value of multi-stakeholder partnerships that mobilize and share knowledge, expertise, technology and resources. Forging these relationships also improves transparency and accountability, which in the end leads to better results. Partners can also help an organization like ours demonstrate more value to potential donors, who often look for the ability to scale and provide sustainable programs that can ultimately strengthen the health system. Finding organizations that share the same vision is essential to forging effective partnerships.
The right partners can complement an innovation to make a solution.