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Foundations, Associations, and
  Networks; “Oh My!”' – Health
  System Strengthening, a Haiti
                   Experience
                Carl C. Stecker, RN, MPH, EdD
         Head of Program Quality Support Unit
               Catholic Relief Services – Haiti

               Breakout Session 3 (10:30a-12:00p)
                         CCIH Annual Conference
                                    10 June 2012
Objectives

• Personal background
• Historical context Haiti
• AIDSRelief and HSS
• Foundations, Networks, Associations
• Experience in CAR with ASSOMESCA
• Réseau des Institutions Chrétiennes de
  Santé d'Haïti(RICSH)
• Discussion questions
Haiti Hospital Network Partners
St. Francois after the Earthquake
Public Health
The New St. Francois de Sales
Health System Strengthening

1) Good health services which deliver effective, safe, high
   quality health interventions
2) Well-performing health workforce
3) Well-functioning health information system
4) Equitable access to essential medical products, vaccines
   and technologies
5) Health systems financing
6) Effective leadership and governance (policy frameworks,
   regulation, system design and accountability)
Strengths of FBO HIV/AIDS work

 5 reasons FBOs important in HIV AIDS Response:
   Extensive networks and reach: rooted in local structures and
    in virtually present in every community in the world.
   Experience/capacity: meeting the needs of individuals,
    families and communities infected and affected by HIV since
    beginning of the pandemic.
   Leadership and credibility: faith leaders often have the most
    integrity and therefore seen as most credible members of
    their community.
   Spiritual mandate: FBOs and local communities faith provide
    compassionate and holistic services to those who are
    affected by HIV/AIDS—addressing the physical, spiritual, and
    emotional well-being of the individual and the community.
   Sustainability: FBOs have proven sustainability of their work
    through centuries of continuous presence in human
    communities. FBOs are in a position to make sustained
    efforts to address the erosion of communities’ traditional
    sources of care and support, resulting from the impact of the
    AIDS pandemic.
• Dindiki ba dinkƐkƐ
Definitions?

• Foundation: external support for one
  institution or health system
• Network: informal grouping of related
  partners for specific short-term strategic
  benefit
• Association: formalized network with
  letters of incorporation, constitution and
  bylaws
Fondations

• Historical ties
• started by returning/ retired missionaries,
• Objective to keep the place open (fiscal,
  fiduciary, financial sustainability),
• capacity building of national staff by periodic
  medical mission trips and internships,
• often specifically paired to one organization
  overseas,
• collection/distribution in-kind pharmaceuticals
  and supplies
CRUDEM – Sacré-Cœur de Milot

CRUDEM (Center for the Rural Development
 of Milot) / Hôpital Sacré Coeur
  – provide accessible health care to the poor
  – train and nurture a competent Haitian
    medical staff, supplemented and
    supported by volunteer specialists
  – practice Christian compassion and
    respect for the inherent dignity of every
    individual
St. Boniface Haiti Fondation

• St. Boniface Haiti Foundation
  – committed to helping those in need when
    no one else can. We work side-by-side
    with the people of Haiti to break the cycle
    of poverty and alleviate suffering through
    health care, education and community
    development. We work with compassion,
    respect and love for the people and
    communities we serve.
Networks

• Local level between several institutions
• Short term collaboration on specific activities
  (e.g. visiting laboratory technical assistance)
• Sharing of information (campaigns, subsidies,
  grant opportunities, visiting specialist/ clinic)
• Short term meeting needs (borrow/ lend
  supplies, pharmaceuticals, …)
• Beginning some joint representation national
  and international
Association
• Local level between multiple institutions
• Short term and long term collaboration on specific activities
  (e.g. joint procurement and supply chain)
• Recognized by national MOH  joint representation and
  voice  strong partnership with MOH while able to remain
  true to historical mission and vision.
• National subsidies and international grant opportunities
• Joint support/benefit for health education institutions (med
  school, nursing school,
• Sharing of staff (e.g. single institution cannon afford fulltime
  FTE of laboratory QA/QI supervisor  can now be shared
  across several institutional members)
How to get there from here?

• What are necessary, but not sufficient elements of
  going from network to association?
  – Vision
  – Mission
  – Champion: Individual or organization that will provide
    leadership
  – Evangelize
  – Buy-in of potential members
  – Activities that bring quick-winds (joint procurement)
  – Organic ?
ASSOMESCA

• Find out what others are doing
• Coordinate  decrease duplication
• Share information
• Collaborate / Associate to save $$$
• Represent / speak with one voice
RISCH Christian Hospital
                                      Network
• Réseau des Institutions Chrétiennes de Santé d'Haïti
• Supply chain assessment of all hospitals
• Each hospital developing strategic plans identifying
  key needs and priorities for next 5 years
• St. Boniface Haiti Foundation coordinating
  development of list for training and support needs
• Hospitals continue discussion of network
  sustainability
Discussion questions

• How can external goodwill stimulate/
  germinate an association?
• Can development of a network towards
  becoming an association be stimulated by
  external (project) funding?
• What is essential/ critical for this
  development? What is necessary, but not
  sufficient in of itself?
• Is there a hybrid for fondations  association

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CCIH 2012 Conference, Breakout 3, Carl Stecker, Faith-Based Pioneering of Primary Health Care: Foundations Associations, and Networks: Oh My! Health Systems Strengthening in Haiti

  • 1. Foundations, Associations, and Networks; “Oh My!”' – Health System Strengthening, a Haiti Experience Carl C. Stecker, RN, MPH, EdD Head of Program Quality Support Unit Catholic Relief Services – Haiti Breakout Session 3 (10:30a-12:00p) CCIH Annual Conference 10 June 2012
  • 2. Objectives • Personal background • Historical context Haiti • AIDSRelief and HSS • Foundations, Networks, Associations • Experience in CAR with ASSOMESCA • Réseau des Institutions Chrétiennes de Santé d'Haïti(RICSH) • Discussion questions
  • 4.
  • 5.
  • 6. St. Francois after the Earthquake
  • 7.
  • 9. The New St. Francois de Sales
  • 10. Health System Strengthening 1) Good health services which deliver effective, safe, high quality health interventions 2) Well-performing health workforce 3) Well-functioning health information system 4) Equitable access to essential medical products, vaccines and technologies 5) Health systems financing 6) Effective leadership and governance (policy frameworks, regulation, system design and accountability)
  • 11. Strengths of FBO HIV/AIDS work  5 reasons FBOs important in HIV AIDS Response:  Extensive networks and reach: rooted in local structures and in virtually present in every community in the world.  Experience/capacity: meeting the needs of individuals, families and communities infected and affected by HIV since beginning of the pandemic.  Leadership and credibility: faith leaders often have the most integrity and therefore seen as most credible members of their community.  Spiritual mandate: FBOs and local communities faith provide compassionate and holistic services to those who are affected by HIV/AIDS—addressing the physical, spiritual, and emotional well-being of the individual and the community.  Sustainability: FBOs have proven sustainability of their work through centuries of continuous presence in human communities. FBOs are in a position to make sustained efforts to address the erosion of communities’ traditional sources of care and support, resulting from the impact of the AIDS pandemic.
  • 12. • Dindiki ba dinkƐkƐ
  • 13. Definitions? • Foundation: external support for one institution or health system • Network: informal grouping of related partners for specific short-term strategic benefit • Association: formalized network with letters of incorporation, constitution and bylaws
  • 14. Fondations • Historical ties • started by returning/ retired missionaries, • Objective to keep the place open (fiscal, fiduciary, financial sustainability), • capacity building of national staff by periodic medical mission trips and internships, • often specifically paired to one organization overseas, • collection/distribution in-kind pharmaceuticals and supplies
  • 15. CRUDEM – Sacré-Cœur de Milot CRUDEM (Center for the Rural Development of Milot) / Hôpital Sacré Coeur – provide accessible health care to the poor – train and nurture a competent Haitian medical staff, supplemented and supported by volunteer specialists – practice Christian compassion and respect for the inherent dignity of every individual
  • 16. St. Boniface Haiti Fondation • St. Boniface Haiti Foundation – committed to helping those in need when no one else can. We work side-by-side with the people of Haiti to break the cycle of poverty and alleviate suffering through health care, education and community development. We work with compassion, respect and love for the people and communities we serve.
  • 17. Networks • Local level between several institutions • Short term collaboration on specific activities (e.g. visiting laboratory technical assistance) • Sharing of information (campaigns, subsidies, grant opportunities, visiting specialist/ clinic) • Short term meeting needs (borrow/ lend supplies, pharmaceuticals, …) • Beginning some joint representation national and international
  • 18. Association • Local level between multiple institutions • Short term and long term collaboration on specific activities (e.g. joint procurement and supply chain) • Recognized by national MOH  joint representation and voice  strong partnership with MOH while able to remain true to historical mission and vision. • National subsidies and international grant opportunities • Joint support/benefit for health education institutions (med school, nursing school, • Sharing of staff (e.g. single institution cannon afford fulltime FTE of laboratory QA/QI supervisor  can now be shared across several institutional members)
  • 19. How to get there from here? • What are necessary, but not sufficient elements of going from network to association? – Vision – Mission – Champion: Individual or organization that will provide leadership – Evangelize – Buy-in of potential members – Activities that bring quick-winds (joint procurement) – Organic ?
  • 20. ASSOMESCA • Find out what others are doing • Coordinate  decrease duplication • Share information • Collaborate / Associate to save $$$ • Represent / speak with one voice
  • 21. RISCH Christian Hospital Network • Réseau des Institutions Chrétiennes de Santé d'Haïti • Supply chain assessment of all hospitals • Each hospital developing strategic plans identifying key needs and priorities for next 5 years • St. Boniface Haiti Foundation coordinating development of list for training and support needs • Hospitals continue discussion of network sustainability
  • 22. Discussion questions • How can external goodwill stimulate/ germinate an association? • Can development of a network towards becoming an association be stimulated by external (project) funding? • What is essential/ critical for this development? What is necessary, but not sufficient in of itself? • Is there a hybrid for fondations  association

Notas del editor

  1. Carl: CRS > 10 years, last 28 months HaitiSpent 16 years in Cameroun and CAR with ALC and ELCA church as medical missionaries4 years hospital work12 years in PHC and starting ASSOMESCAEarthquake response at HSFS, Sacré-Coeur-Milot, and AIDSRelief / HSS in Haiti
  2. Graphic from: Contact n°189 – January - March 2010http://www.oikoumene.org/fileadmin/files/wcc-main/documents/p4/contact/Contact%20189%20English.pdf
  3. often historical ties, started by returning/retired missionaries, to keep the place open (fiscal, fiduciary, financial sustainability), capacity building of national staff by periodic medical mission trips and internships, often specifically paired to one organization overseas, collection/distribution in-kind pharmaceuticals and suppliesCRUDEM (Center for the Rural Development of Milot) / Hôpital Sacré Coeur provide accessible health care to the poor train and nurture a competent Haitian medical staff, supplemented and supported by volunteer specialistspractice Christian compassion and respect for the inherent dignity of every individualfounded in 1968 by the Brothers of the Sacred Heart of the Montreal Province. The brothers built roads, schools, wells and several co-operative ventures. In 1986, the Brothers constructed a hospital in the area: Hôpital Sacré Coeur. However, they had an operating room with no equipment and no surgeons. Around that same time, Dr. Ted Dubuque, Jr. KM, a surgeon from St. Louis, Missouri, became fatally ill and he promised God that if he recovered he would go to work in the missions. He had a complete recovery and true to his word he traveled to Hôpital Sacré Coeur and spent 6 months there performing 250 surgeries. In 1993, the Brothers ended their involvement in CRUDEM and the Archbishop of Cap Haitien gave operating responsibility for Hôpital Sacré Coeur to The CRUDEM Foundation, a tax-exempt public charity established by Dr. Ted Dubuque, Jr., a surgeon, and Carlos Reese, a businessman, both of St. Louis. In January 2005, a Protocol Agreement between The CRUDEM Foundation, Inc. and the Archdiocese of Cap Haitien, Haiti, was signed to confirm this operating, fiscal, and management arrangement and to reaffirm that the organization would be focused primarily on health care provided by Hôpital Sacré Coeur.