The 7 Steps to an International Partnership
made in Heaven
Prof Tony Ryan, UCC, Cork
1. Projects past and Present
2. What have we learned?
3. The 7 Steps
1. Omdurman Maternity Hospital, Sudan
est. 1957
• 26,000 deliveries per annum
• 2002: Return of UK-trained obstetricians.
• Reorganization of obstetrical services.
• Partnership with CUMH (2002-10).
• Logbook (1956-2007).
– Evaluate & compare all 60
years of data.
Cork Omdurman Partnership Project
Returned
Obstetricians
2002
•
•
•
•
•
•
24hr consultant cover
with handover
MgSO4 for PET
Prophylactic antibiotics
Thromboprophylaxis
Improved anaesthesia
Antenatal care
Partnership with CUMH
2002-11
•
•
•
•
€165,000 Irish Aid
€1.5 million equipment
Enhanced training &
education
Support &
encouragement
OMH
800
725
700
600
500
400
(22)
200
300
266
200
(7)
36
100
2002
Year
2007
Ireland: 1/100,000
OMH: 36/100,000
2007
2005
2003
2001
1999
1997
1995
1993
1991
1989
1987
1985
1983
1981
1979
1977
1975
1974
1972
0
1970
Maternal deaths per 100,000 live
births
Maternal Mortality Ratio
(# actual deaths)
Stillbirths Down
Neonatal Deaths Unchanged
50
per 1000
40
(Ireland)
30
30
Stillbirth Rate
(6)
Neonatal
Mortality Rate
(4)
24
20
16
10
2002
0
Year
19
Irish Health Awards Winner
2011
2. Helping Babies Breath
The Problem
The intervention: Helping Babies Breath
98% of newborn deaths occur in
resource poor countries
Every year four million newborns die
during their first month of life,
50% dying during delivery and the first
24 hours of life.
Study design:
Pre-Post HBB
The Principle
HBB:every
The infant
Golden
Minuteat
At birth,
deserves,
least, an initial evaluation and a
trial of basic resuscitation efforts
by a trained individual
80 Conclusions
Midwives
Completed 2013
The Aim
To reduce neonatal mortality by
teaching HBB to Village Midwives
in Sudan
Current Study
Sponsorer Irish Aid
Conclusion
3. CORK - CHACAS JOURNEY
Peru vs Ireland
INDICATOR
PERU
IRELAND
30 million
4.5 million
Infant Mortality Rate
19
4
Neonatal Mortality Rate
11
2
% of < 5y underweight
6
-
% of < 5y with stunting
24
-
Maternal mortality ratio
98
3
% of population below
international poverty
line (1.25 U$/day)
8
0
Population
Preventing High Altitude Renal
Disease in the Peruvian Andes
Dr. Jackelina Pando-Kelly
Dept of Paediatrics
UCC
SCREENING PROGRAM FOR RENAL
DISEASE IN CHILDREN IN THE
PERUVIAN ANDES
Operation Mato Grosso in
Chagas
• 1970 - Italian volunteers settled in the
Peruvian Andes
• 1994 -“Mama Ashu “ Hospital in Chacas –
11,000 ft
The Highest Pub on Earth
Paddy Flaherty’s
in Perū
Future Peruvian Projects
Inaugural UCC Medical Student Electives
2012
The 7 steps to a Global Partnership
made in Heaven
1. Find a Partner
2. Recognize the importance of Context
3. Get to Know Your Stakeholders
4. Decide your Objectives
5. Use an Outcome Logic Model
6. Design, Develop, Deliver
7. Look for the Stickiness factor in your Project?
Step 1
1. Find a Global Partner
–
–
–
–
The Law of the Few: the 80/20 principle
Find a Connector
Who are the Influencers?
Who do people turn to when they want to
find out about something?
Step 2. Context is important
1. Opportunities arise because of Real World Events
2. Epidemics are sensitive to the conditions and
circumstances of the times in which they occur.
Human behavior is sensitive to and strongly influenced by
its environment.
3. Persuasiveness is an important skill
Step 3
2.
Get to Know Your Stakeholders?
– What assumptions are you making
about them?
– What do they Want?
– What do they Need?
– It’s not just about you!
Step 4
Decide your Objectives
– Make a Contract
– What Resources can you bring?
– What Activities need to be done?
Step 5
Use an Outcomes Logic Model
1.
2.
3.
4.
5.
Inputs
Activities
Outputs
Outcomes
Impact
short to medium
term
Long term
Outcomes
In order to
accomplish our
set of activities,
we will need the
following:
In order to
address our
problem or asset,
we will conduct
the following
activities:
We expect
that once
completed or
under way
these activities
will produce
the following
evidence of
service
delivery
We expect that if
completed or
ongoing these
activities will lead to
the following
changes in 1-3 then
4-6 years
We expect that if
completed these
activities will lead
to the following
changes in 7-10
years
Step 6
Step 7
Find the Stickiness Factor
The specific content of a message that
renders its impact memorable.
Sesame Street: Enhanced effective Educational
retention in tandem with Entertainment.
The 7 steps
1. Find a Partner
–
–
–
Find a Connector
The Law of the Few: 80/20 Principle
Who are the influencers? Who do people turn to?
2. The importance of Context: Epidemics
3. Get to Know Your Stakeholders?
–
–
What do they Want?
What do they Need?
4. Decide your Objectives
–
–
–
Make a Contract
What Resources can you bring?
What Activities need to be done?
5. Use an Outcomes logic Model
–
How are you going to measure success
6. Design, Develop, Deliver
7. Look for the Stickiness factor in your project
The 3 Steps to an
Partnership Heaven
“Now there are Three Steps To Partnership Heaven
Just listen and you will plainly see
And as life travels on
And things do go wrong
Just follow steps one, two and three
Step one - you find Global Partners to love
Step two - They fall in love with you
Step three - You work together and hold them tightly
Yeah! that sure seems like heaven to me”
Thank you
The 7 steps
1. Find a Partner
2. Context is important
3. Get to Know Your Stakeholders?
4. Decide your Objectives
5. Use an Outcome Logic Model
6. Design, Develop, Deliver
7. What is the the Stickiness factor for your project?
Step 4
Find the Influencers
Milgram distributed letters to 160 students in Nebraska, with instructions that
they be sent to a stockbroker in Boston (not personally known to them) by
passing the letters to anyone else that they believed to be socially closer to the
target. The study found that it took an average of six links to deliver each letter.
Of particular interest to Gladwell was the finding that just three friends of the
stockbroker provided the final link for half of the letters that arrived
successfully.[17] This gave rise to Gladwell's theory that certain types of people
are key to the dissemination of information.
Step 4
Find the Tipping Point
The tipping point is that magic moment when an idea, trend, or social behavior
crosses a threshold, tips, and spreads like wildfire.
Just as a single sick person can start an epidemic of the flu, so too can a small
but precisely targeted push cause a fashion trend, the popularity of a new
product, or a drop in the crime rate.
Step 4
Find the Tipping Point
The Law of the Few", or, as Gladwell states, "The success of any kind of
social epidemic is heavily dependent on the involvement of people with a
particular and rare set of social gifts."[3] According to Gladwell,
economists call this the "80/20 Principle, which is the idea that in any
situation roughly 80 percent of the 'work' will be done by 20 percent of the
participants.
Step 4
Find the Tipping Point
Connectors, are the people who "link us up with the world ... people with a
special gift for bringing the world together."[5] They are "a handful of people
with a truly extraordinary knack [... for] making friends and acquaintances".[6]
He characterizes these individuals as having social networks of over one
hundred people.
Step 4
Find the Tipping Point
Mavens are "information specialists", or "people we rely upon to connect us
with new information."[4] They accumulate knowledge, especially about the
marketplace, and know how to share it with others. Gladwell cites Mark Alpert
as a prototypical Maven who is "almost pathologically helpful", further adding,
"he can't help himself".[8] In this vein, Alpert himself concedes, "A Maven is
someone who wants to solve other people's problems, generally by solving his
own".[8] According to Gladwell, Mavens start "word-of-mouth epidemics"[9] due
to their knowledge, social skills, and ability to communicate. As Gladwell states,
"Mavens are really information brokers, sharing and trading what they
know".[10]
Step 4
Find the Tipping Point
Salesmen are "persuaders", charismatic people with powerful negotiation skills.
They tend to have an indefinable trait that goes beyond what they say, which
makes others want to agree with them. Gladwell's examples include California
businessman Tom Gau and news anchor Peter Jennings, and he cites several
studies about the persuasive implications of non-verbal cues, including a
headphone nod study (conducted by Gary Wells of the University of Alberta and
Richard Petty of the University of Missouri) and William Condon's cultural
microrhythms study.
Step 4
Find the Tipping Point
Real world events
The Power of Context: Human behavior is sensitive to and strongly
influenced by its environment. As Gladwell says, "Epidemics are sensitive
to the conditions and circumstances of the times and places in which
they occur."[11] For example, "zero tolerance" efforts to combat minor
crimes such as fare-beating and vandalism on the New York subway led
to a decline in more violent crimes city-wide. Gladwell describes the
bystander effect, and explains how Dunbar's number plays into the
tipping point, using Rebecca Wells' novel Divine Secrets of the Ya-Ya
Sisterhood, evangelist John Wesley, and the high-tech firm W. L. Gore
and Associates. Gladwell also discusses what he dubs the rule of 150,
which states that the optimal number of individuals in a society that
someone can have real social relationships with is 150.[12]
Changing minds
• In his latest book, Harvard psychologist Howard Gardner offers
insights into the phenomenon of changing minds. Why is it so
mysterious? How do people become set in a certain way of
thinking? And what does it take to change a perspective? As he did
in previous books about intelligence, creativity, and leadership,
Gardner challenges traditional thinking. He draws on decades of
cognitive research to show mind change not as a sudden “epiphany”
but as a gradual process that can be actively and powerfully
influenced. He identifies seven levers that aid or thwart the process
of mind change and provides an original framework that shows how
individuals can align these levers to bring about significant changes
in perspective and behavior.