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The Implementing Best Practices
(IBP) Initiative
A partnership dedicated to improving reproductive health A partnership dedicated to improving reproductive health
10 years at a glance10 years at a glance
2000 2000 -- 20102010
Margaret Usher-Patel and Suzanne Reier, IBP Secretariat
Department of Reproductive Health and Research,
World Health Organization
On behalf of the IBP Consortium
2010 2010 -- 33 Consortium Members33 Consortium Members� CORE� East, Central, Southern African
(ECSA-HC)� ExpandNet� Family Care International� FIGO� Institute for Reproductive Health,
Georgetown University� International Council on
Management of Population Programs� Marie Stopes International� John Snow Inc. � Partners in Population &
Development � Population Council� Population Reference Bureau� Program for Appropriate Technology
in Health � Regional Centre for Quality of
Health Care, Makerere University, Uganda
� University Research Corp.� White Ribbon Alliance
* WHO/RHR* USAID * UNFPA * EngenderHealth* FHI * IPPF * IntraHealth* JHPIEGO* JHU* MSH * Pathfinder International* Public Health Institute
• Academy for Educational Development
•Bill and Melinda Gates Institute for Population andReproductive Health
• CARE• Centre for African Family
Studies, KenyaCentre for Development &Population Activities* Founding Members
VALUE ADDED•Expands the reach of individual members
•Complementary strengths
•Power in partnership
•Re-igniting interest and political will for reproductive health
•Reduces duplication of effort
•Harmonizes approaches
•Promotes cost-sharing
2010We have a vibrant and dynamic partnership
For over a decade we have shared acommon vision
• To establish strengthen and maintain networks committed to working at the global, regional and country levels to ensure that practical and cost-effective best practices are shared, utilized and scaled up in reproductive health programmes world wide.
For over a decade we have shared a
common commitment
• Reduce duplication of efforts, harmonize approaches
• Support synergies that accelerate the achievement of common goals
• Improve the documentation, introduction, adaptation, utilization and scaling-up of evidence-based and proven effective practices
• Support the Ministry of Health in networking and co-ordinating the implementation
• Foster innovation and creativity, support champions and advocacy,
• Strengthen leadership and the management of change
• Provide in-country support, mentorship and follow-up
• Improve access to and the use of information and create a culture of sharing and exchange of knowledge and experience to improve practice.
Where did we begin?
How can be listen and build on
the experience of people from
other organizations and
countries to improve practice
How can we
manage change
We know what to do
but are not addressing
the how
We must be practical
and realistic
How can re reduce
duplication
and
harmonize approaches?
We may work in
different agencies but
but we are addressing
similar problems
How can we network
with networks
to accelerate achieving
common goals
How do we engage
people in the learning
and change management
process
How can we share
and exchange ideas, knowledge,
experience with other
organization and
across countries?.
How can we work
with countries
and ensure effective
follow-up
How can the IBP be
thought provoking
systematic process
How are effectively are
guidelines, tools
and materials we produce
accessed and used?
How can define, document
and scale up
best practices?
How effective is the use
of information?
Effective management is the
missing link in improving
Reproductive health
How can we
build on experience?
How can we work
collaboratively towards
A common goal?
Review the literature
How do we share
And exchange
knowledge
more effectively?
In 1999 by asking "How can we" questions
Last quarter 1999
??????
• 8 International organizations agencies ask themselves:
• How effective is the use of theinformation we produce?
• How is it used and applied in practice?
• As partners we undertook an:
� Analysis of the evidence � Analysis of what is happening
in countries� Analysis of lessons learnt
The Birth of DAU Process(Disseminate, Adapt and Utilize Technical Guidelines
and Tools)
We said in 2000:
Information transfer requires:
• Innovation
• Access to and the sharing of information
• Building on existing levels of knowledge
• Sharing experience and self selecting information according to need
To create change in practice requires
• Effective collaboration
• Supporting a process that helps people to access the best available information to meet their needs when they need it
• A systematic and strategic approach
Adaptation and ApplicationAcceptance
Awareness
andAdvocacy
Adherence
Step 2.
Acceptance
• Reach consensus
• Develop country workplan and
strategy
• Revise policies and national guidelines
Step 4.
Adherence
• Define process indicators
• Use learner supported systems
• Monitor and evaluate
Step 3.Adaptation and Application
• Develop organizational
support
• Define performance goal and
analyze challenges.
• Support the infrastructure
and organization of the
service
Steps in the DAU Process conceptualized as
managing a river of change
Step 1.
Awareness and Advocacy
• Assess needs
• Involve key stakeholders
• Introduce new and emerging
ideas
2000 – 2001 DAU Partnership formedDAU vision:
• To work with countries to create networks and an enabling environment that supports the development of practical strategies to bring evidence-based best practice into wider programmatic use.
Partners started develop interactive training tools:
• Mini Universities, Technology Café, Tool kits, Advocacy kits, Posters
• Facilitator training manual for performance improvement
• Leadership and management of change
• Preparation of DAU papers
• Framework for follow-up
The DAU Principles
Principles:
•Collaborative and inclusive
•Multi-disciplinary
•Practical and realistic
•Responsive to local conditions
•Manages existing and new information
•Evidence-based
•Creative in finding solutions to problems
•Results orientated
DAU launched in China:
2000 and 2001
2000:• Invitation by the State Family
Planning Commission (SFC) to support the updating of family planning technicalinstructions
• Revised and published 2001
2001• Support the introduction of the performance
improvement process to provincial managers to introduce thefamily planning guidelines.
• SFC organises follow-up
Nepal Launch 2000
DAU process
Acknowledge contributions and attributes of partners
Network to support learning and creativeprogrammes that adapt and apply best practices
Build partnerships
Support shared learning
Create local ownership
Build on what exists
Foster creative thinking
Develops managerial and technical skills
Lead and supports a process of change
What happened next?Countries were active
• Nepal participants formed the DAU Club and worked with the
MOH to update family planning guidelines
• Published within one year
• Participants from Uttaranchal State India also
formed the DAU Club
• Their goal was to improve the quality and uptake
of vasectomy services.
• Within one year they reported increasing services
and the training centre serving as a model to train
in which to train others
What happened next?Partners reviewed the feedback received
• It is a great process but countries must decide on their own
information needs
• New technical guidelines do not solve the
operational and managerial problems
• DAU – too linear, top down and only focused on
international guidelines
• There is a need to learn from local rather than international
experience
2002Feedback was a catalyst for re-thinking our strategy and
launching the:
Implementing Best Practice (IBP) Initiative
To effectively exchange and transfer knowledge, information,
expertise, and experience in order to improve practice
Our challenge
Overcome the gap intransfer and application
of knowledge
Improve practice and
health
Unlock and share our knowledge and experience
IBP Initiative launched in Egypt: 2002 Egypt, India, Jordan, Lebanon, Pakistan, Palestine, Turkey and Yemen.
• Country teams from Egypt and Jordan formed before the meeting, with
local funding and support
• Information needs assessment undertaken and agenda
tailored to meet local information and managerial
priorities.
• More emphasis on leadership, the management
of change, and how to use the performance
improvement process.
• A more structured follow-up programme supported
by an IBP partner already working in the country
Country action: Country action:
MMobilize networks of reproductive health professionals
and advocates not necessarily working with each otherbut all working in the field of reproductive health
Partners
Agencies
Institutes
NGOs
Donors
Projects
IBP
Country steering
committee
Consortium
• Create Communities of action• Identify common areas of performance• Locally grow activities to meet local
needs
Leadership
of MoH
Partners support the formulation and
implementation of collaborative strategies
Jordan, 2002 Jordan, 2002
• Network formed under the leadership of MOH
As a partnership: As a partnership: • Developed one national family
planning guideline
As individuals: As individuals: • Developed different levels
of training curricula
Collectively• 2004 Launched a national
strategy to improve family planning
Partners support the use of proven effective managerial,
training and performance improvement models
Egypt, 2002:
Network formed under the leadership of MOH and MSH
"Cairo Club"
The partnership was a catalyst for action
In 2003,, the districts of Aswan, the districts of Aswan, DarawDaraw
and and KomKom OmboOmbo increased the increased the
number of new family planning visits number of new family planning visits
by 36%, 68% and 20%,by 36%, 68% and 20%, respectively
Partners support the use of proven effective managerial,
training and performance improvement models
Egypt, 2002: Egypt, 2002:
Network formed under the leadership of MOH and MSH
"Cairo Club"
The work continues under the leadership of the MOH
In 2005, Aswan Governorate focused on scaling up effective practice to reduce maternal mortality rate
In 2007 - They succeeded. The maternal mortality
rate fell from 85.0 per 100,000 live births to 35.5 per 100,000.
Process shared with Afghanistan
2003: Partnership formalized as IBP Consortium
PHI supports "Group Jazz" to help partners review our strategy:
• Undertake an extensive review of our to work
• Develop our brand promise
• Reformulate our vision, goals objectives and strategy of the IBP Work Plan
• Senior fellow from PHI supported byUSAID joins IBP Secretariat
• Partners continue to work in task teams
• Partners start to analyse the principles of knowledge management
2003IBP Initiative launched in 4 States in India
Uttar Pradesh, Uttaranchal, Jharkhand, and Andhra Pradesh.
• MoH supports local partner steering committee that work incollaboration with IBP partners
• States visited to foster commitment and teams selected from each State
• Information needs assessment undertaken
• Focus on:� Information sharing and exchange
� Applying performance improvementframework
� Leadership and the management of change
� Mentorship and follow-up� Interactive learning and engagement
• 250 Participants
IBP India Launch: 12 months later
Supported by the Steering Committee, MOH
and WHO/Country Office
under discussionLocal plans to cascade IBP Process to mid-
level managers
undertakenLocal initiatives to use best practice materials
and disseminate/introduce to local staff
maintainedMentorship and follow-up programme
implementedPlanned activities
maintained IBP State teams meet at regular intervals
maintainedMOH support
ActionActivity
India – Follow-up
Uttah Pradesh
• Challenge: To increase access to family planning services.
• Problem: Poor housing and conditions for Auxiliary nurse midwives (ANM) in rural areas so no one will go there.
• Action: Collective advocacy with health and finance ministries
• Result 1: Within three months rental subsidy for ANMs increased by 150Rupees: Housing and working conditions included in next 5 year health plan.
• Result 2: As part of the roll out of the RCH II strategy planning meetings local teams a information transfer and exchange with mid level managers.
India – Follow-up
Jharkhand
• Jharkand Secretary of Health forms Jarkhand Health Society (JHS) with local NGOs for joint planning and action
• They develop a plan to link with grass root agencies to improve
maternal health and access to essential obstetric care in rural areas
• Campaign days planned and implemented
• JHS and IBP support knowledge exchange and performance improvement workshop for district managers
• Follow up by partners
• JHS exists today.
IBP Launch Africa: 320 Participants
Entebbe, Uganda, November 2004More than just a meeting – a beginning of a journey
• Planned by a steering committee representing five countries, Ethiopia, Kenya, Tanzania, Uganda, Zambia
• Countries teams selected and local funding and support leveraged
• Information needs assessment and priorities assessment
• Grounded on sharing of knowledge
and experience
• Strengthening leadership
through the management of change
and performance improvement
• Partnership, collaboration and innovation
• Maintaining momentum through follow-.up
Africa LaunchAfrica Launch –– one year laterone year laterSupportive followSupportive follow--up to share progress and up to share progress and
acknowledge successacknowledge successKenya
Ethiopia
Uganda
Tanzania
Zambia
Local initiatives
Creation of an advocacy plan and development of training materials to support the implementation of family planning programmes
Strategies to support the integration of family planning with VCT and PMTCT have been initiated
Supporting the repositioning of family planning, focusing on advocacy and integration with other services
Team expanding and focusing on coordinating reproductive health efforts
Partners supporting the updating and dissemination of FP/STI guidelines
Examples of individuals leading the implementation of innovative practices
CountryCountry ActionAction
IBP Africa Launch: Ethiopia follow-up
Ethiopia: 2004
• Led by IBP partners and MOH local IBP Steering Committee formed 35 members
• Plan to incorporate family planning into VCT and PMTCTthroughout the country
• Strategy launched in 7 regions of the country focusing onlessons learned and best practices.
• Country has many local best practices not documented andscaled up.
Ethiopia 2006• IBP partners support the identification, documentation and scaling up local
best practices in 4 regions
Ethiopia 2008• Documenting Reproductive Health Practice in Ethiopia published by MOH
and partners
Follow-up continues
IBP Africa Launch: Kenya follow-up
Increase uptake of family planning
April April 20042004
May May 20042004
Launch of the IBP
initiative
June June 20042004
June June 20042004
Oct Oct 20062006
Development of
performance goal
Formation of country
team Dissemination of results
Development of country action
plan
18 months implementation period
Dec Dec 20052005
Kenya:Co-ordinated effort increases family planning
uptake by District
0
10000
20000
30000
40000
50000
60000
70000
Malindi Homabay Meru
South
Nakuru Nyeri Kisii Bungoma
Jan-June '05
July-Dec '05
Total # of FP users
Kenya team continues2007 - 2010
Kenya team
• Addresses issue of commodity security and
successfully advocate for national budget line
• Introduces fostering change and scaling up of
effective practices to increase family planning
• Compiles a compendium of reproductive health
best practices
Countries Countries
of of
general general
focus focus
N=105N=105
Countries Countries
of of
intensified intensified
focus focus
N=42N=42
Countries Countries
ofof
inin--depth depth
focus focus
N=12N=12
IBP Partners support the WHO/UNFPA Strategic IBP Partners support the WHO/UNFPA Strategic
Partnership Partnership programmeprogramme to disseminate evidenceto disseminate evidence--based based
guidelines to countries through regional meetings and guidelines to countries through regional meetings and
country support.country support.
2005: 22 IBP Partners revisit the IBP strategy• Incorporate knowledge sharing, exchange and improved access to and
the use of information
• Away from international best practice to locally identified and
documented best practices
• Towards processes that strengthen leadership, management of change
and performance improvement
• Collaborative efforts to support country specific activities, identification,
documentation and scaling –up of local best practices
• Engaging collectively in advocacy and action
• Towards defining best practice and more proactive promotion of the IBP
Initiative and process.
IBP Partners define best practice
• A process, procedure, tool or principle that is based on
scientific evidence and/or programmatic experience and
has improved the quality of health programmes.
• For our purposes, a best practice is identified as "best" at
this moment in time in a particular situation. It refers to
evidence based practices or proven effective practices
and considers lessons learned to help the adaptation of
the best practice to other settings.
IBP partners redefine our "Mission"
• Support countries to fulfil their
reproductive health agendas by
strengthening international, regional and
country co-operation to share experiences
aimed at improving the introduction,
adaptation, utilization and scaling-up of
best practices in reproductive health.
IBP Partners redefine our IBP Strategy
Overview of activities at the global level
How-to guides – developed by partners and shared with other
organizations:
A set of guides to support the planning and organizing of IBP’s interactive
methodologies.• How to
– Plan and Organize a Mini-University.
– Plan and Organize an Information Exchange Bazaar.
– Plan and Organize a Poster Session.
– Plan and Organize a Technology Café.
– Plan, Organize, Manage, Launch and Facilitate Virtual Knowledge Networks and Discussion Forums.
– Management and Performance Improvement training:
• Implementing Best Practices Facilitator Manual.
• Implementing Best Practices Participant Manual and Worksheets.
• Best Practice Tool Kits – CD Roms
Guide to Fostering ChangeGuide to Fostering Change• What is it? A tool to link RH best practices with proven
practices for successful change.
• Who developed it? The international interagency IBP/MAQ Fostering Change Task Group supported by USAID and WHO
• For whom? People in a position to foster and support change at the district, regional and country level (e.g., MOH, Reproductive Health Task Group, NGOs, etc)
• Based on what? Best practices for managing and leading change and collective experience and lessons learned.
• How is it being used? Countries use the structure to improve priority issues, countries using guide with partners, virtual programme
Collectively and Deliberately FOSTER CHANGE
IBP partners promote sexual and reproductive health for persons with
disabilities• WHO/UNFPA Guidance note
• An estimated 10% of the world’s
population live with a disability.
Persons with disabilities have the
same sexual and reproductive
health (SRH) needs as other people.
Yet they often face barriers to
information and services.
• This guidance note addresses issues of SRH programming for persons with disabilities
Overview of recent regional activities
• IBP partnership, supports Repositioning Family Planning Conference, held in Ghana, 2005,
• IBP partnership supports the Extending Service Delivery Project (ESD).
• The ESD project embraces the principles and purposes of the IBP Initiative
• In Africa ESD activities have been undertaken
• Angola, Burundi, Democratic Republic of the Congo, Ethiopia, Guinea, Kenya, Nigeria, Southern Sudan and Tanzania.
• In Asia and the Near East, the ESD project has worked in• Egypt, India, Indonesia, Jordan, Nepal, Pakistan and Yemen.
• The IBP partnership has supported each launch meeting, and the IBP secretariat has followed Afghanistan and Jordan
Overview of recent regional activities
2009: WHO Eastern Mediterranean Regional Office (EMRO)
and IBP Partners convene Fostering Change Workshop to
Scale up Family Planning for 18 countries from the region
IBP meeting on Family Planning
2010 IBP partners conducted a more intensive Fostering
Change training programme for representatives from eight
high-priority countries in Rabat, Afghanistan, Djbouti, Iraq,
Morocco, Pakistan, Somalia, Sudan and Yemen.
Overview of recent regional activities
• 2009: Fostering Change training and support for "Money Well Spent" project - East, Central and Southern Africa (ESCA)- Health Community:
• The subjects of their plans are:
• ECSA-HC: Strengthening financial sustainability through resource mobilization
• Kenya: Preventing postpartum haemorrhage in provincial hospitals
• Tanzania: Infection control in maternity wards
• Swaziland: Referral system through midwives for high-risk deliveries
• Uganda: Contraceptive security in tandem with family planning outreach camps
• Zimbabwe: Youth-friendly family planning services in nursing schools.
• As of March 2010 all teams had work underway.
Example of country action: Coordination, collaboration, cooperation and strategic thinking to accelerate reaching common reproductive health goals
• Integration of PMTC/VCT/FP – Kenya, Tanzania
• Documentation, sharing and scaling up of local effective practices –
Ethiopia, Benin, Kenya
• Link with other interventions and support to countries to adapt and apply
WHO guidelines (SPP/Africa – Nigeria, Zambia, Indonesia, Benin)
• Analysis of community based services and partner exchange
(Mali, Madagascar, Cameroun, Ghana, Ethiopia)
• Scaling up the Extending Contraceptive Choice, Zambia
• Scaling up Post Abortion Care in six countries in Francophone Africa
Virtual Fostering Change ProgrammeBlended learning that combines e-learning, virtual networking
and knowledge sharing to support implementation of plans
Participants maintain a high level of interest and engagement
for over 1year
• Supporting country follow-up to workshop on scaling up best practices in post-abortion:
– Teams from Burkina Faso, Guinea, Mali, Niger, Rwanda, Senegal and Togo
• Supporting follow-up to ESD Conference in Bangkok, 2007– Teams from Afghanistan and Yemen and two from Jordan—that had
attended
International Conference on Family Planning: Research and Best Practices
Kampala, 2009• IBP partners organized the third day of activities focused on taking
Knowledge to Action in collaboration with The Bill and Melinda
Gates Institute for Population and Reproductive
Health at the Johns Hopkins Bloomberg
School of Public Health
• IBP partners synthesize the knowledge shared
into:
– 5 key challenges, 3 key managerial processes
and 5 key actions that will support
the effective scaling up of family planning
What is the IBP Knowledge Gateway?
• An electronic communication platform that connects people around the world through virtual knowledge networks and
online discussions
• Research and developed
by WHO/RHR/WHO/ITT and a number
of IBP partners 2002 – 2004
• Launched 2004 with 300 users
• Now the most popular electronic communication platform in the health and development sector, with a total membership of >200.000 from 200 countries/territories
What does the IBP Knowledge Gateway do?
• All correspondence and documents are archived in a community's workspace
• Ability brand and customize the appearance of online communities
• Capacity to reach 200 countries and territories
• Real time and virtual support to establish and maintain communities
• Functions on a cost-sharing basis
How can the IBP Knowledge Gateway be used?
• Small working groups– Preparing for a meeting– Review of documents– Sharing materials and tools
• Follow-up of conferences and workshops
• Large virtual community related to your work– Sub-communities on specific topic areas
• Virtual online global discussion forums
IBP Knowledge Gateway has many names and uses
The IBP partners supports other organizations and agencies toestablish, launch and manage their own customized branded virtual knowledge networks and discussion forums
http://hpv-vaccines.net/
http://knowledge-gateway.org
2002 2004 2006 2008 2010
Research and
development
IBP KG/RH launched:
300 users
Platform adopted by WHO
as corporate tool
Departments in WHO
launch their own
knowledge networks
(e.g. GANM)
IBP KG/RH: 5000 users
105 countries
96 communities
Others outside WHO
customize and brand the
IBP/KG for their
knowledge networks e.g.
• World Dental Federation
• UNHCR
• UN Staff College
IBP KG/RH: 12,053 users
390+ communities
7 global discussion forums
Total Membership:
200,000+ users
Organizations and
agencies own their own communities, e.g.
• Dgroups (100,000+
members)
• E-Portuguese
• HUG
• IDS
• HIFA 2015
IBP KG/RH:
18,200+ users
490 communities
15 global discussion
forums
Growth and Development of the IBP Knowledge Gateway
Line represents growth of the IBP Knowledge Gateway for Reproductive Health (IBP KG/RH)
Benefits of participating in virtual knowledge networks
• Network and communicate with other inter-disciplinary and multidisciplinary professionals worldwide
• Learn from and encourage each other
• Learn about resource materials and tools, promising and effective practices used by other organizations and countries
• Provides a platform to contribute your voice, your opinion, your knowledge and experience to policy and practice dialogue
• Share problems and challenges
• Share your knowledge with someone who is not connected
IBP Consortium: Our value added A shared vision for improved reproductive
health• Expand the reach of each individual member
• Comparative strengths that complement and support each other
� Power in partnership – coordinated effort, more than just the sum of the individual agencies
� Re-igniting interest in, and political will for, reproductive health
� Reduce duplication of effort to improve value for money
� Harmonize approaches to accelerate change
� WHO and partners stand behind and support the use of evidence-based practices
