Doris Duke Charitable FoundationDoris Duke Charitable FoundationAfrican Health InitiativeAfrican Health Initiative

Doris Duke Charitable Foundation’s Mission

Improving the quality of people's lives through:

• The performing arts • Environmental conservation• Medical research • The prevention of child maltreatment • Preservation of the cultural and environmental legacy of

Doris Duke's properties

Challenge from Foundation’s Board

• Ideas for new grantmaking initiatives – fit within foundation’s general grant making

programs, but be “new and catalytic”• In 2007, two $100 million initiatives were

launched.– Environment Program - Climate Change

Initiative– Medical Research Program - African Health

Initiative

African Health InitiativeGoal: To help catalyze a shift from the current focus on single disease programs, to an emphasis on strengthening health systems that are able to deliver integrated primary care to underserved populations

Specific Aims:• Increase the knowledge required for evidence-based health systems

planning

• Achieve significant, measurable health improvements in up to 6 communities/districts in sub-Saharan Africa

• Strengthen health systems in those regions in a manner that enables local and national governments to sustain those improvements

Approach:

• Fund up to 6 Population Health Implementation and Training (PHIT) Partnerships

• $8 to $16 million each to support:– Delivery of integrated primary health care to

populations of >250,000 – Strengthening of regional health systems – Implementation research to measure what

works

Implementation Research

• Each PHIT Partnership is expected to design an implementation research plan that includes:

- Program evaluation

- Economic evaluation and;

- Monitoring and operations research.

• Implementation Research Framework - developed by the Institute of Health Metrics and Evaluation provides a starting point for applicants.

PHIT Partnership Selection Process

February 200829 teams invited to submit planning grant proposals

October 2008Awarded 6 month Planning Grants to 11 teams

June 2009Award PHIT Implementation Grants to up to 6 teams

September 2007Call for Letters of Interest

The Challenge: Translating Evidence to Policy

• What information is needed?– Within the original country– Before transfer to another country

• How to evaluate conflicting evidence?• What happens when evidence conflicts

with current accepted practice?

The role of science academies

• Sifting all evidence • Analyzing the reasons for disparate results• Looking at context—can one country’s

success be transferred across borders?• Challenging projects like this one to

produce evidence of maximum utility