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7 Closing Remarks Highlights and Main Points Made by Individual Speakers and Participants â¢ When a partnership creates impact and leads to success, it creates a virtuous cycle that leads to further success (Kumar). â¢ Partnership brokers or liaisons are important between sectors, and individuals within an organization can assume this role (Byrkit). â¢ Partnership brokers could employ diplomacy to advocate for more capacity building (Silberschmidt). â¢ Removing ideological barriers is important (Silberschmidt). â¢ Often, the beneficiaries of PPPs are absent from the table when solutions and partnerships are being discussed, but allowing some beneficiaries to share their stories about initiative impacts could influence and inform future work (BenDor). â¢ Health literacy is important for engaging audiences of initiatives; people need to understand medical information in direct, simple terms and to know how to access products and services (OâSullivan). In the final session, Seema Kumar described key messages from the participants that were gathered throughout the workshop and discussed how to disseminate them. The objective of this session was to generate enthusiasm to test and build models for multi-sectoral engagement with defined value propositions and with a focus on areas where innovation is needed (see Box 7-1). 81 PREPUBLICATION COPYâUncorrected Proofs
82 VALUE PROPOSITION AND INNOVATIVE MODELS BOX 7-1 Objectives for Session 4: Actionable Recommendations for the Way Forward To generate enthusiasm to test and build models for multi-sectoral engage- ment with defined value proposition and with a focus on areas where innovation is needed. â¢ What are the key messages from the workshop? â¢ What actions and strategies should be prioritized to spur progress in test- ing and building these models? â¢ When the goal is to expand the range of sectors and individual stakehold- ers engaging in global health, how should the identified messages and the related actionable recommendations be disseminated? KEY MESSAGES FROM THE WORKSHOP AND PRIORITY ACTIONS AND STRATEGIES One of Kumarâs takeaways was that when a partnership creates impact and leads to success, it also creates a virtuous cycle that leads to further success. In addition, sharing stories of partnership success is important; doing so undermines the idea that partnerships only have challenges. She noted the workshop presented multiple innovative mod- els that work well and are scalable and sustainable. The necessity of trust- ing other entities and creating an environment that fosters trust was also a key takeaway. Johnson agreed that a key point was honesty about both successes and challenges in partnership efforts. Colatrella shared two messages and suggested priority actions and strategies. First, she addressed the unnecessary bias generated by precon- ceptions about organizations and what they do. She noted the importance of educating oneself about the realities of an organization and of hav- ing conversations with its members to identify potential ways to work together. Second, she noted that much work remains in order to create solutions that are both sustainable and fully integrable into governments and communities. Jessica Herzstein, a preventive medicine specialist, noted another takeaway: value takes multiple forms. It denotes not only saving lives but also, for example, enhancing an organizationâs mission, forming new relations, expanding into new markets, or learning from partners. Mona Byrkit emphasized the need for partnership brokers or liaisons and suggested that interested parties could take greater ownership of brokering between sectors or even within organizations. PREPUBLICATION COPYâUncorrected Proofs
CLOSING REMARKS 83 Ratzan suggested that ideology continues to present challenges and noted the importance of questions around how to obtain valid, reliable information about the efficacy of PPPs or publicâprivateâacademic part- nerships. Although funding is needed to evaluate an initiativeâs impact, evaluation results may not be as trustworthy if the same entity funds both the evaluation and the program itself. Ratzan pointed to a need for trust- worthy evaluations or assessments to inform future investments and policy decisions. Kumar agreed and noted that anecdotes are often used to explain what works and what does not, but a need exists for real, longitudinal data and evidence. Kumar suggested that an independent party from the pub- lic, private, or academic sector own the evaluation. Ratzan also noted that evaluation findings, depending on what they are, could either change or reinforce an ideology. Nevertheless, Ratzan suggested that evaluation find- ings not be discredited simply because they were funded by industry; they may provide useful information. Ratzan also posed the question of how to apply existing programs to other regions as a takeaway from the workshop. John Monahan added another takeaway to the discussion: value proposition has different components for each sector and organization involved. He pegged the brokering function as particularly interesting because it implies an ability to find aligned interests. Monahan sug- gested that more brokering be facilitated in the real world and ques- tioned whether the PPP Forum could fulfill that role. Another important message was that partnerships are a means to an end and not an end in themselves. Monahan noted the global health community still questions whether partnering is the most efficient and effective way to accomplish work and whether measuring such efficiency is possible. Silberschmidt agreed with Monahan about the importance of bro- kering and noted that the noted that liaisons who broker can also be diplomatic and advocate for more capacity building. He noted that bro- kering cannot be imposed, but it is possible to identify people who have the skill sets and motivation to broker. Another takeaway, Silberschmidt explained, was his observation that people tend to identify problems where they do not existâoften because of ideology. Although the work- shop did not discuss this topic, he suggested that people may not see existing problems because of their ideologiesâfor example, an ideology may blind them to the fact that an entity does not belong in a specific part- nership or a particular role. Silberschmidt highlighted the importance of removing such ideological barriers. Kumar added that although problems sometimes exist with a partner, they can also exist when a partnership does not deliver outcomes that positively impact health. BenDor raised the point that beneficiaries of PPPs are often absent from the table when solutions and partnerships are discussed, yet they are PREPUBLICATION COPYâUncorrected Proofs
84 VALUE PROPOSITION AND INNOVATIVE MODELS the ones impacted. She suggested that allowing some of the beneficiaries to share their stories about initiative impacts could influence and inform future work. Next, Brink highlighted two central messages. First, the case studies presented at the meeting demonstrate that extraordinary work has been achieved, and none of it would have been possible without partnerships. Partnerships are what enabled innovation and advances. Second, Brink suggested that partnerships are difficult and require much work to initi- ate and to sustain. Gael OâSullivan from Georgetown University seconded Ratzanâs point about the importance of multiple datasets, including longer studies with metrics that show impacts and outcomes; case studies that provide part- nership models and explain the roles of different entities; and examples of best practices and lessons learned. She noted that multiple products would help disseminate messages to wider audiences and create more shared value in untapped markets and sectors. OâSullivan also explained the importance and relevance of health literacy and noted that, in order to be engaged, the people targeted by initiatives need to understand medical information in direct, simple terms and to know how to access products and services. In her experience, medical people often overwhelm audiences with a lot of technical information that is unnecessary or is pre- sented in the wrong format for the audience. In order to design effective partnerships, it is important to keep in mind the knowledge, skills, and abilities of the audience. Wilkinson noted that the ability to create effective partnerships is growing at the same rate as improvements in global health. Although he acknowledged causality may be absent, he suggested these two growth rates are correlated. He also agreed with the point about the benefits of increased capacity to broker better partnerships. Wilkinson suggested that there is often too much hesitation around moving forward with partner- ships and that partnerships may never be perfect. Finally, Wilkinson men- tioned that significant change is occurring in the consumer marketplace as people gain access to more information, knowledge, and tools to manage their own health. These marketplace shifts will necessitate continual evo- lutions in partnerships to remain aligned with changing consumer needs. Responding to the conversation about brokers, another participant added that brokering diplomacy requires understanding the perspec- tives of all involved sectors. The participant agreed that the voices of beneficiaries, as well as those of local governments, need to be amplified. Related to sustainability, the participant added that time lines for seeing intervention deliverables may differ across stakeholders and that lack of alignment may be problematic. For example, the profitability time line for PREPUBLICATION COPYâUncorrected Proofs
CLOSING REMARKS 85 the drone initiative in Rwanda is much shorter than the time necessary to see the economic benefits of improved health in the country. SUGGESTIONS FOR DISSEMINATION Kumar asked participants about their thoughts on how to dissemi- nate workshop takeaways to audiences beyond those at the meeting. OâSullivan suggested the PPP Forum could support an effort to publish more research and case studies among a larger audience to share infor- mation about what works, what lessons were learned, and which best practices were identified. Kumar agreed that disseminating messages more broadly is important but noted that questions remain about who constitutes appropriate audiences and how to get messages to them. She noted that publishing reports may be the appropriate vehicle for certain audiences, but others may seek information from alternative sources. Coughlan described the need for more information and data in public health so that they may be used to make well-founded business decisions. He noted a central question: what role could the National Academies play to ensure information derived from forums such this would contribute to more successful interventions? BenDor suggested that, as a first step, workshop participants could share the themes and lessons learned from the workshop with their colleagues and begin to build capacity within their organizations by becoming partnership brokers. She also suggested working with aca- demic institutions and students of public health and business to advance these messages because they represent the future of the field. Silber- schmidt addressed the importance of engaging middle-income people in middle-income countries because they form the majority of the worldâs population. Mistry added that it is as important to learn from unsuccessful part- nerships as it is to learn from successful ones. He suggested the need for a more deliberate communication strategy that could be led by the American Association for the Advancement of Science or by a subcommit- tee of the PPP Forum. Mistry suggested this strategy could address social media communications, best-practice tools, and checklists or guidelines for effective partnerships. Ratzan noted the need for recommendations that a certain percent- age of project funds be dedicated to evaluation, monitoring, assessment, and communications and that these activities be built into a project from the start. He also commended the idea of developing and implementing checklists, guidelines, and principles, which he called âfrugal innova- tion.â Ratzan noted he is working on such lists related to multi-sectoral PREPUBLICATION COPYâUncorrected Proofs
86 VALUE PROPOSITION AND INNOVATIVE MODELS engagement for sustainable health with a group at the Harvard Kennedy School. He also suggested that some of the National Academiesâ strategies already effectively disseminate ideas: the PPP Forum, the webcast of the forum, and the proceedings that are developed and disseminated from it. He also suggested a need for ongoing social media engagement to combat counterfactual information. Monahan agreed with earlier points about the importance of capacity building, which he noted needs to include education and training at levels from students and professionals to executives. Because professionals may not have much time for outside classes, he suggested exploring ways to disseminate the information to organizations that support professionals who manage partnerships. He also agreed that social media may be an important tool for distributing more messages and ideas about best prac- tices around PPPs. Additionally, Monahan noted the importance of con- vincing government officials that partnerships can offer ways to accom- plish public purposes that are part of a governmentâs mission. Kumar then acknowledged the importance of segmenting audiences and being clear about what messages and strategies are appropriate for which audiences; goals and strategies may be different, for example, for government officials, students, frontline health care workers, and a com- panyâs own employees. PREPUBLICATION COPYâUncorrected Proofs