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MÉDICOS DEL MUNDO

2012 / 2015 STRATEGIC PLAN

OUR RAISON D’ÊTRE: PEOPLE

OUR COMMITMENT, THE RIGHT TO HEALTH

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SUMMARY

INTRODUCTION

CONTEXT

MISSION, VISION, PRINCIPLES AND VALUES

STRATEGIC LINES

INTEGRATION OF STRATEGIC AND INTERVENTION LINES

OBJECTIVES

DEVELOPMENT, MONITORING AND EVALUATION

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1. INTRODUCTION The previous Strategic Plan of MÉDICOS DEL MUNDO consolidated an organizational model according to our mission and set out our vision of health as a universal Human Right, following the concept assumed by the World Health Organization since 1946. So our task was defined from a Human Rights perspective, that is, the person is considered a subject of rights and the State, the guarantor of said rights in full. Today, we continue to defend the right to health of all people, as we are fully convinced that Primary Health Care is the organizational model to develop within the public health systems in order to attain the best health standards for people, as it is recognized since the Declaration of Alma-Ataof 1978. CROSS-CUTTING LINES With this new Strategic Plan, the fourth one for this association, our focus changes: if the previous Plan centred on the areas of activityand when and with whom we carried out our work, with the new Plan the fundamental aspect is how we develop our activity. It is the great challenge and the novelty introduced in our new Strategic Plan: our intervention is designed on cross-cutting lines which are common to all the organization’s areas of work and will show us how we want to develop our activity. These lines determine that the ultimate purpose of our intervention will be social change, that is, to influence the factors determining health, and they will always be developed from the Human Rights and Gender perspective, seeking the highest standards for our projects and activities and with the added value that MÉDICOS DEL MUNDO is an association of volunteers. Following this argumentative line, we have modified the conventional description of our mission lines, albeit its essence does not change much: we continue to develop Humanitarian Action and Cooperation for Development programmes where there are people that live in a situation of poverty or gender inequality or are victims in humanitarian crises. In Spain, we promote Social Inclusion projects where there are groups excluded from the Welfare State, and Education for Development and Awareness projects aimed to create a critical conscience in citizens. However, we do not work any longer “for beneficiary populations” but with “people with rights”. Now our daily activity is described by focusing on three groups identified from a Human Rights perspective: people as subjects of rights, MÉDICOS DEL MUNDOas the holder of responsibilities and the States, apart from other actors, as the holders of the obligation to guarantee that people can exercise their rights in full. This new concept, centred on people from the Human Rights perspective, is much more consistent. So it is no accident that the title chosen for this Strategic Plan should be quite revealing: En el centro, las personas como titulares de derechos (the focus is on the people, the holders of rights). This is the line of work which we intend to become the identity mark of Médicos del Mundo, what makes us different from other NGDOs. 2. CONTEXT Starting point to face the future The crisis that in the last few years has hit the most developed economies quite hard is having a highly relevant impact on several of the European Union countries, including Spain. In spite of the Spanish Government’s efforts, governmental initiatives have not had the desired effect and the Spanish economy has continued its downfall, with dramatic unemployment figures. The financial position of quite a number of public administrations – regional, municipal – is quite dramatic and this fact has led to implementation ofeconomic adjustment and deficit control measures that in many instances do not take into consideration the impact and the importance of social policies.

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The part of civil society that is most aware of the impact caused by the gradual decline of the Welfare State lives this situation with growing concern, as threatening signs are already felt: some public administrations are responding to the crisis by cutting down on public health and implementing initiatives leading to privatization or co-payment. This worrying trend can result in an increase in health inequality, which can affect particularly the immigrant population, for example, due to the toughening of conditions to obtain the health care card. This is the scenario in which MÉDICOS DEL MUNDO must handle the development of this new Strategic Plan, a context that implies, on the one hand, increased demand for care due to increased precariousness and vulnerability for a growing percentage of the population, and, on the other hand, a significant drop in public financing opportunities due to budgetary cuts, which in practice means, inter alia, a drop in funds for grants for NOGs. In some cases, the competitive procedures to obtain public funds for social action projects have been completely eliminated. As for Cooperation for Development, the 3rd

Master Plan fostered a process for geographical and sectorial concentration of the Spanish aid. The negotiation processes of the last few years with the member countries (which materialize in Association Country Frameworks) limit Spanish cooperation to specific areas and to a reduced number of sectors. These dynamics, which were already underway, could be strengthened by a drop in theOfficial Aid for Development.

A WORRYING FUTURE The conclusions of the International Cooperation for Development Commission at the Lower House in the Spanish Parliament put forward some aspects that will mark the Spanish Cooperation for Development in future years. The Commission’s Report, a document presented as the result of consensus among the political forces, places very significant weight on the profit-making private sector, reduces the number of organizations targeted for the Spanish contributions and increases the importance of the Development Promotion Fund as an instrument for financial cooperation. All these aspects have been criticized by the NGO Coordinator for Development in Spain. Decentralized cooperation, in which the NGOs have played an important role, saw significant increases in funds in the years of economic growth, followed by dramatic decrease for which the crisis is blamed. This decrease is one of the factors leading to the weakening of some regional administrations’ structures, after the elimination of Departments and General Directorates in charge of decentralized cooperation. In the next few years, MÉDICOS DEL MUNDO must pay close attention to the processes for geographical and sectorial planning of Aid to Development, so as to identify where there is a coincidence with official priorities and thus participate in procedures for award of public funds, and the other areas of work for which the Association will have to seek financing somewhere else. The organization must coordinate with other organizations, particularly within the scope of the NGO Coordinator for Development in Spain and of health-related networks, in order to have a bearing on planning and promote the importance and centrality of the health sector within the Spanish cooperation. MÉDICOS DEL MUNDO must be capable of identifying new groups in a risk or social exclusion situation which may appear in our society. Caring for these people will continue to be one of the organization’s core interventions, and now more than ever the commitment of volunteers will be fostered, so that the organization can meet the needs it has detected. Long-term work on Education for Development and Awareness will be essential to generate a critical conscience that can promote a fairer and more equitable social order for people. The ultimate goal is to build a civil society, both in the North and in the South, committed to solidarity – participative co-responsibility – and whose demands, needs, concerns and analysis are taken into account when it comes to taking the political, economic and social decisions that affect it.

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DYNAMIC ADAPTATION Internally, the association is faced with a phase of new challenges and needs as a living and dynamic organization that adapts and raises internal changes to improve its response capacity. In this respect, this document frames a new programmatic period with new approaches and proposals for the next four years. The emphasis that the Strategic Plan places on to the Human Rights and Gender perspective and on the Cross-Cutting Lines represents a phase where some lines present in the strategy ended in 2011 are gone into more deeply and continued. So, the question is to go more deeply into the organizational and programmatic bases which are already present. As a matter of fact, last year the organizational structure and the governance and management bodies of MÉDICOS DEL MUNDO adapted to the new proposals contained in the Plan with a purpose in sight: our commitment to the cross-cutting nature of our lines of work, to the integration of approaches and to social change, to incidence and local activity in Spain, in projects both for Social Inclusion and Education for Development. In line with these initiatives, the organization’s Management Committee was renewed and in June next year the Standing Management Board will be partly renewed too. A stronger associative and voluntary movement, with processes for renewal of Regional Boards, has been one of the key identifying marks of the current Management Board and it is one of the challenges to go more deeply into in the next few years. The external circumstances will condition, at least in the first few years, the scope of this Plan. The crisis will force the organization to focus on specific issues and seek internal answers to the paradox of an equation that raises more needs where the vulnerable populations are concerned while at the same time there are fewer funds available to meet those needs. Within this context, stronger private financing and deeper involvement of volunteers in projects will be two unavoidable issues so as to attain the objectives established in this Plan will be. Probably, in the next few years we will see that NGOs and the system for International Cooperation and for Social Action are significantly redefined and reconverted in our country. And these changes will require adaptation and change in organizations like ours. It is essential to consolidate our identity and values, as is done in this Plan, so that our responses and intervention are in keeping with our identity and values and set a consistent course that does not deviate because of a given specific situation. At the same time we will have to be open to changes, flexibility and dynamism, from the perspective of a serious, austere, quality and innovative action, bearing in mind our responsibility towards the least favoured groups or those that risk exclusion.

3. MISSION AND VISION And our principles and values The MÉDICOS DEL MUNDO 2012-2015 Strategic Plan emerges from the need to review fundamental elements of our organization so we can adapt better to the needs of a changing world. Directly linked to our past history, the proposals contained in the Plan have been reviewed and upgradedby volunteers that, based on their commitment, help improve the organization day after day. MISSION Why? MÉDICOS DEL MUNDO is an international, humanitarian and voluntary associationwhich Works for the universal right to healththrough health assistance, reporting, testimonies, and political and social action, with excluded or vulnerable populations or victims of crises. PRINCIPLES What guides our interventions?

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Since its inception, MÉDICOS DEL MUNDO has been part of the Humanitarian Movement; therefore, the organization shares and promotes the Movement’s principles and code of conduct, such as the protection of, access to and care of victims; denunciation of injustices; universality, impartiality, independence, consent, participation,testimonyand priority, depending on needs. We work from a Human Rights perspective and on this basis our actions are committed to the defence of Human Rights and to non-discrimination for reasons of race, gender, faith or culture. We understand that the political, economic, social and physical environments condition personal health. These social factors that determine healthexplain most of the health inequities, that is, the unfair and avoidable health-related differences within a country or between one country and others. We are committed to the defence and strengthening of the public health systems.Health care is not a good that should be governed by market laws. Public health systems are the best guarantors of universal, fair and quality health care. Equity, fair practices in matters of employment and a fair job, social protection throughout a person’s life, universal health care, healthy environments, political freedom and freedom of expression are key elements to determine the health standards of populations. Our intervention is based on a number of principles within which the main pillars are: care, denunciation and incidence; non-substitution of States in the responsibility they have to guarantee health care to their people; prevalence of the right of victims to be assisted over the sovereignty of States; strengthening of public health systems; and a human-based and psychosocial approach to health care. We work for the empowerment of people. A core strategy of our interventions is training and the exchange of knowledge with the social groups we collaborate with, and we link our health-related action to the promotion of development in the middle and the long term, given the close connection between health and development. It is not in vain that three of the eight MillenniumDevelopment Goals, defined in the fight against poverty by the United Nations in 2000, should focus on health. We are signatories to a number of charts and documents that contain a commitment to work with the groups whose right to access health care is violated: the Cracow Chart or European Chart of Humanitarian Action (1), the Damage Reduction Charter (2), theEthics Charter of Gender(3) and the Health Charter for Foreign Nationals residing in Europe (4

VALUES

)are founding documents of the organization.

Our characteristics 1. Health is a value and a universal Human Right, the base for personal and social wellbeing. 2. We denounce inequities, injustice, abuseand the situations leading to them, from the legitimacy of our action with the victims and with the credibility given by our rigorous testimonies. 3. We work for equity and we have a clear position against exclusion, a determining factor in the loss of personal health and wellbeing. 4. We are an associationindependent from any political or religious filiation or otherwise, autonomous in our actions and criteria and we are accountable only to our members and our organization’s structure. 5. We report our objectives and management to society with transparency, through the rendering of accountsto our members, volunteers and donors, the populations we work with and, in general, to all society. We believe that the rendering of accountsis on a par with explaining continuously, clearly and rigorously what we do and why we doit. The association’s credibility is based on the rigorous, seriousand quality information we provide. 6. We promote a relation and working modelbased on cooperation, collaboration, respect for others, on the inclusion and building of relations based on trust, between peers.

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7. We defend the leading role of the World Health Organization and we vindicate its authority, independence and representativeness (all the United Nations member countries are part of it) in respect of other actors, such as the World Bank, the World Trade Organization, multinational corporations and new private philanthropic agents. 8. As part of an organized civil society, we stand for associative and participative values, democratic proceedings, networking and the right of citizens to participate in the public scene. 9. We work for first-class quality, rigour and efficiencyin our interventions and management of resources; we base our action on the best scientific knowledge available and we are committed to promote respect for the environment.

VISION Where are we headed? MÉDICOS DEL MUNDO seeks to achieve a world where the universal nature of human rights and in particularly of the right to health is real and effective. To contribute its capacities in the pursue of that objective, the organization wants to become a movement of dedicated and committed men and women who are positive in their thinking and effective in their actions; men and women who organize themselves independently from any power and rigorously in their ways to transform a global environment; people that participate on the basis of a number of values for the building of a new life-sharing model from their conviction that the right to health is and must be universal and on an equal footing for everyone; men and women who seek to achieve that gender and physical, economic, environmental or cultural violence should no longer determine the state of health of the world’s population.

4. STRATEGIC LINES: Our cross-cutting lines The strategic lines establish how the work of MÉDICOS DEL MUNDO is organized, in all the association’s spheres and mission areas. Our intervention is all developed from the same perspectives, which cut across the whole Strategic Plan and articulate everything the organization does and give it a global vision. The different areas of work and the issues covered by our projects and actions are crossed and interlinked by the cross-cutting lines, which shed a new light on how to develop our work. So, we must review the intervention methods that we have applied this far in relation to projects and actions: identification, preparation, execution and evaluation. The cross-cutting lines are five:

• Social change • Human Rights and gender • Participation and leadership • Quality, learning and improvement; and •

Associative development

The importance of these cross-cutting lines for MÉDICOS DEL MUNDO is explained below, as well as why they are included in this Strategic Plan and the impact sought.

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LINE 1 SOCIAL CHANGE MÉDICOS DEL MUNDO WORKS FOR A CHANGE IN SOCIETY: THE ELIMINATION OF THE CAUSES OF VIOLATIONS OF THE RIGHT TO HEALTH Considered not only as the absence of illness, health is conditional to social, economic, environmental and cultural factors. These social determinants are at the root of most health inequities, that is, of the unfair and avoidable differences in health care conditions between groups and countries. The only way to guarantee that everyone can benefit from health care is by contributing to the change in unfair and unequal social structures. As an agent for social change, our organization is engaged, through all its interventions, in the elimination of social regulations, policies and practices that tolerate or even foster violations of the right to health care. For MÉDICOS DEL MUNDO, working for social change means:

• Speaking up and getting involved in public actions denouncing violations of Human Rights that we witness, specifically, of the right to health.

• Promoting Education for Development actions and Awareness actions, for society to become aware and understand how social determinants affect its right to health.

IMPACT TO ATTAIN Sustainable improvement in health conditions; the life of people will improve only if we change the rules or regulations that foster unfair situations in society. LINE 2 HUMAN RIGHTS AND GENDER MÉDICOS DEL MUNDO ASSUMES THE HUMAN RIGHTS AND GENDER BASED APPROACH, WHICH CONSIDERS THAT EVERY SINGLE INDIVIDUAL HOLDS RIGHTS, REGARDLESS OF ANY OTHER CONSIDERATION. We base our intervention and practice on Human Rights and Gender, i.e., we consider that everybody, without any exception, holds rights and that the States, holders of obligations, have an undertaking to respect, protect and guarantee the exercise of those rights within a framework of equal treatment and opportunities. This approach gives us a more in-depth and comprehensive vision; it implies a change-based approach and it makes our actions more efficient and effective. For MÉDICOS DEL MUNDO, working from a Human Rights and Gender perspective means:

• Abandoning the concept of “beneficiary population” and considering that the people targeted for our interventions hold rights.

• Strengthening the capacities of people to learn and claim their rights. • Strengthening the capacities of the holders of obligations to comply with them. • Considering the impact that gender has, as a social structure that causes inequalities, on

people’s health. • Promoting development of non-discriminatory opportunities in the access to and control of

goods, resources and spaces for decision. • Working for a change in unequal power relations. • Developing strategies for women’s empowerment, to guarantee they can exercise their rights

in full.

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IMPACT TO ATTAIN The whole association’s commitment to defend the Human Rights – particularly the right to health – and equality and non-discrimination. LINE 3 PARTICIPATION AND ACTIVE ROLE MÉDICOS DEL MUNDO CONSIDERS THAT THE PEOPLE’S PARTICIPATION AND MAIN ROLE IS THE MANIFESTATION OF THEIR LEGITIMATE RIGHT TO PLAY AN ACTIVE ROLE IN THE TAKING OF DECISIONS WHICH AFFECT THEM AND CAN IMPACT ON THEIR DESTINY AND THAT OF THEIR SOCIETIES. Any intervention must count on the involvement of the peoplewhose reality is affected by the intervention. The people, as holders of rights, must be able to appropriate the processes for change and construction of their development; the control and power they can exercise over their individual and social environment must be promoted and maintained, to solve their problems and attain changes both in their environment and their social structure. In addition, this empowerment guarantees efficiency and sustainability of projects. For MÉDICOS DEL MUNDO, the participation and active role of people means:

• Managing people’s diversity in an inclusive manner, on the basis of their realities and identities.

• Consolidating the intercultural perspective in our actions. • Guaranteeing their effective participation in our interventions, which means that the people

accept projects and consider them their own. • Promoting and strengthening the people’s capacities, given that their participation and

active role is part of the right to health. • Strengthening the capacities of organizations, as holders of responsibilities.

IMPACT TO ATTAIN Empowered and strengthened civil societies, which can demand a real rendering of accounts system from the holders of obligations. LINE 4 QUALITY, LEARNING AND IMPROVEMENT MÉDICOS DEL MUNDO CONSIDERS THE SEARCH FOR QUALITY, RIGOUR AND EFFICIENCY AN UNAVOIDABLE RESPONSIBILITY, IN ITS WORK AND IN THE USE OF ITS EXPERIENCE TO GENERATE KNOWLEDGE THAT ENABLES THE ORGANIZATION TO OPTIMIZE THE RESULTS OF ITS PROJECTS AND MANAGEMENT. The commitment to quality carries certain responsibilities that range from environmental respect and protection to transparency and rendering of accounts in relation to the activities carried out, the degree of achievement of objectives and the efficiency in economic resources management. The very work of the association, in all its richness and complexity, is an opportunity for learning which can enhance continued improvement processes, quantitatively and qualitatively, and from the perspective of people as holders of rights as well as from that of institutions as holders of responsibilities and obligations. Simultaneously with the promotion of evaluation dynamics, communication and participation channels must be strengthened in the organization as a whole, including field teams (here, in Spain, and there, in the poor countries), so as to gather the lessons learned, base our reflections on our

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experience, identify areas for improvement, ensure the loyalty of the association’s members and achieve better social transformation practices, within an action-reflection-action circle. In this way trust will be generated and the impact of our interventions will be greater. For MÉDICOS DEL MUNDO, the commitment to quality, learning and improvement means:

• Adjusting continuously or constantly our intervention to reality. • Being more efficient and effective in the promotion of the Human Right to health of the

populations we collaborate with, assuming our responsibility to them. • Optimizing the management of resources. • Guaranteeing transparencyand the rendering of accounts. • Keeping the loyalty of the people that make up our organization, and motivating and

strengthening their capacities. • Establishing synergies inside and outside the organization. • Improving the capacity for impact and social transformationof the results of our projects

and interventions. • Introducing an operational safety culture in all organizational levels. There can’t be quality

unless the safety issues are taken into account, since safety is about guaranteeing efficiency in operations, watching over and promoting actively the protection of Médicos del Mundo volunteers and employees on contract and that of the people covered by the action and, lastly, that of the very organization, its image, work and resources.

IMPACT TO ATTAIN To become a health organization of reference, whose approach is based on the Human Rights and Gender. LINE 5 ASSOCIATIVE DEVELOPMENT MÉDICOS DEL MUNDO CONSIDERS IT FUNDAMENTAL TO INTEGRATE ITS SOCIAL BASE AND GUARANTEE ITS ACTIVE PARTICIPATION IN ALL THE ORGANIZATION’S LEVELS AND SPACES. To attain a more just society, people that are organizedand committed to social change are needed. Associative Development means involving the social base in the association’s political life, as an essential element for cohesion as well as control. This approach guarantees the association’s independence vis-à-vis governments and public powers and it benefits its sustainability. For MÉDICOS DEL MUNDO, Associative Development means:

• Having added value in our work, in two ways: as an association and as an organization of voluntary people. This element distinguishes us from most organizations.

• Strengthening the voluntary people’s commitment to the organization. • Guaranteeing the association’s stability through democratic and periodical renewal of its

governing bodies. • Promoting the association’s leadership as a factor that can influence and change society. • Asserting our associative philosophy. • Maintaining our organization’s identity as an association made up of volunteers. • Improving the association’s capacities, voluntary commitment, associative stability and

leadership. IMPACT TO ATTAIN Involvementof an active social base, committed to the organization’s mission and values and critical of the causes of inequalities, in the association’s political life.

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5. INTEGRATION of cross-cutting and intervention lines The action of MÉDICOS DEL MUNDO is framed within the Mission set out in this Plan and its purpose is the defence of the right to healthof the most vulnerable or disadvantaged populations or people that risk social exclusion. Our work in the international context is specific to the Human Action and Cooperation for Development mission areas; in Spain, we focus on the Social Inclusion and Education for Development and Awareness areas. Given that the rights-based approach means that “people must be the focus”, by way ofputting into words what we do, our intervention targets the following three profiles:

1. Populations and groups that hold rights which are violated, in particular the right to health, the sphere where our organization operates. 2. Individuals and groups in civil society, as the holders of responsibilities. 3.

The cross-cutting lines of the Strategic Plan bear on this intervention missionareas in such a way that they define the working method of MÉDICOS DEL MUNDO, and show our identifying mark. The general and specific objectives of the Plan must be developed in the Annual Operational Plans, with definition and specification in each missionarea of the actions needed for their achievement.

Groups and individuals who hold obligations, that is, individuals who have influence and the capacity to change the laws and regulations that lie at the root of social inequality.

INTERVENTION LINES MÉDICOS DEL MUNDO sees Humanitarian Action as an intervention to assist the victims of disasters caused by natural catastrophes or by conflicts. In addition to guaranteeing the basic needs of the populations affected, we seek to put a halt on the process that increases their vulnerability, by setting up the necessary bases for rehabilitation and development – linking the Humanitarian Action intervention to that of Cooperation for Development – and promoting the integration of prevention against disasters into our humanitarian action. The Cooperation for Development intervention promotes Primary Health Care from the standpoint of Public Health, with special attention to and control over the social factors determining health and the violations of the right to health.In addition, it includes the cross-cutting lines contained in the current Plan, with special emphasis on the development of Political Incidence actions and on the participation of the populations targeted by our intervention. The Social Inclusion actions developed by Médicos del Mundo in Spain aim to make it possible for the people who risk social exclusion or are already socially excluded to gain access to the existing social and health services, following criteria of fairness, adaptability, quality and availability, and to exert influence so that the State assumes its responsibility as holder of obligations, through networking and Political Incidence actions. Since the intervention centres on groups who risk exclusion, the context must be analyzed all the time so we can respond to any new social needs that may arise. Similarly, we seek to generate a critical conscience so as to strengthen a new civil society committed to social change, working with the holders of rights, obligations and responsibilitiesto eliminate the causes leading to the violation of the right to health and for the construction of more just societies. For this, we are committed to Education for Global Development, i.e., Education for Citizenship, consistent with our mission and linked to and interdependent with the actions in other mission areas. So, the Education for Development that we will develop in the next few years will focus on the right to health and we will stress the research, training, awareness and political incidence themes.

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HOLDERS OF RIGHTS Populations affected by natural disasters, social or political conflicts or displacement are the target groups we are going to focus on in our international projects. Specifically, our international work on these populations involves:

a) Health interventions in emergency situations, a set of actions aimed to reduce suffering, guarantee subsistence, defend dignity and protect fundamental rights, in particular the right to health, of victims of natural disasters or armed conflicts. b) Prevention, watch and specific treatment of epidemic and endemic diseases, which affect the public health of certain population groups, such as cholera, meningitis, severe diarrhea, dengue, mumps, infections caused by shigella and rotaviruses and other transmissible diseases. c) Mental health and psychosocial support interventions, for those people that after a complex emergency situation or a humanitarian crisis suffer from alterations and/or posttraumatic stress, by supporting public health systems, for development of psychosocial care services and the introduction of humanitarian standards. d) Development of Sexual and Reproductive Health programmes which combine the HIV/AIDS and Sexual Transmission Diseases programmes and services with health and sexual and reproductive rights programmes (mother-child care, children’s health, the sexual and reproductive health of adolescents and the young, and family planning services). e)

Within the state context, the identified groups are immigrants, prostitutes, transsexuals, the homeless, drug users and other groups that require special attention because of their vulnerability.

Damage reduction programmes, intended to reduce health risks associated with practices and behaviours that involve health risks, such as drug consumption or unsafe sexual relations.

For and with these groups, we develop: a) Projects and actions to facilitate theirfair accessto social and health care resources. b) Projects and actions focusing on damage reduction. c) Projects and actions for promotion of health and social and health inter-cultural mediation on the public health system. d)

Monitoring of the deterioration of people’s conditions in critical and tough situations.

HOLDERS OF RESPONSIBILITIES Our international work is also developed in conjunction with local health and pro-human rights organizations and local health professionals, whom we consider to hold responsibilities vis-à-vis the populations in question. For and with these groups, we will develop the following actions:

a) Recovery of the response capacityof the local health systems affected by natural disasters, displacement of population or conflicts. b) Strengthening of civil society, organized and informal, developing its health management capacities, since civil society holds rights and responsibilities. c) Promotion of networkingwith other organizations that deal with the essential functions of Public Health and the social factors determining health that have a direct impact on our intervention mission areas.

At a domestic level, in Spain, we will work with students and teachers from the formal education system, preferentially, with social and health professionals and society in general. With these groups we develop Education for Development and Awareness projects and actions, with the right to health as the core issue.

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Médicos del Mundo will facilitate the work of groups of immigrants in the development of their countries. HOLDERS OF OBLIGATIONS Within the international context, a number of groups has been identified and as far as our intervention is concerned we consider them to hold obligations vis-à-vis the populations involved. These identified groups are the following:

• Local, regional, national and international agents in charge of health and political matters. • Those that hold responsibilities in public institutions (Regional, State or international), and have competences in Official Aid to Development.

With these groups, we will work on: a) Institutional reinforcement of the local health care systems in the development of their

capacities as holders of responsibilities in relation to the right to health and following the six strengthening pillars recommended by WHO: governance, human resources, economic resources, technological resources, information systems and quality health care systems.

b) Promoting the development of Primary Health Care, with an intercultural and gender (equality) approach and sustainability, quality, acceptability, accessibility, availability and fairness characteristics.

c) Recovery of the reaction capacity of the local health care systems affected by natural catastrophes, displacement of populations or conflicts.

d) The promotion of actions with a Political Incidence at local, regional, national and international levels, and of professional health training and the exchange of experiences and learning on virtual spaces, by using Information and Communication Technologies.

At State level, the identified groups are people with the power to take political decisions and with executive capacity in public organizations (General Directorates in Regional Departments, local directorates covering health centres, professional associations, etc.). With these groups we develop Awareness and Political Incidence actions.

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LINES – GENERAL OBJECTIVES – SPECIFIC OBJECTIVES

LINE 1 – SOCIAL CHANGE 1.1

NETWORKING

1.2

EDUCATION FOR DEVELOPMENT

1.3

POLITICAL INCIDENCE

Strategic alliances and networking

Formal education area Objectives of Incidence in strategies, projects and actions

Groups of health professionals and young people

Social awareness and mobilization

Médicos del Mundo as a social point of reference

Médicos del Mundo

International Network Studies, testimonies and reports

Strengthening internal communication

LINE 2 – HUMAN RIGHTS AND GENDER APPROACH 2.1

INCLUSION OF THIS APPROACH IN MDM

2.2 HOLDERS OF RIGHTS

2.3 HOLDERS OF

OBLIGATIONS AND RESPONSIBILITIES

Institutional regulations and proceedings framework

Valuation in diagnostics and identification

Promotion of the right to health with other agents and

networking

All projects and actions Empowerment processes

Creating awareness and denunciation

Training, information and tools Contextualization of actions according to social & cultural

reality

LINE 3 – PARTICIPATION AND MAIN ROLE 3.1

PARTICIPATION OF HOLDERS OF RIGHTS

3.2.

STRENGTHENING HOLDERS OF

RESPONSIBILITIES

3.3

ACTIVE ROLE IN INSTITUTIONS HOLDING

OBLIGATIONS

Empowerment Civil society networks Representativeness

Comprehending and analyzing the surrounding environment

Strengthening the capacities of organizations

Democratic governance

Participatory methods Active role in social change

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LINE 4 – QUALITY, LEARNING AND IMPROVEMENT 4.1

CAPACITIES AND SENSE OF BELONGING

4.2

CONTINUED EVALUATION AND MANAGEMENT OF

KNOWLEDGE

4.3

DECISIONS BASED ON MISSION AND VALUES

Involvement and loyalty

Integral monitoring & learning strategy

Strengthening of the decision and responsibility areas and of

internal communication

Training plans

Continued improvement and quality in policies, strategies and mission and management

areas

Human Resources management and support

Analysis of information on exchange of experiences and

knowledge

Sustainability and economic independence

Environmental sustainability

LINE 5 – ASSOCIATIVE DEVELOPMENT 5.1

CRITICAL AND ACTIVE SOCIAL BASE

COMMITTED TO SOCIAL CHANGE

5.2 DEVELOPMENT OF CAPACITIES AND INTEGRATION OF

VOLUNTEERS

5.3

PARTICIPATION AND COMMITMENT OF

EMBERS AND VOLUNTEERS

Active participation and relation

Increasing volunteers and keeping their loyalty

Participation of members in the governing bodies

Participation in actions and campaigns for social change

Spaces for participation and different areas

Political itinerary for volunteers towards the governing bodies

Making the social base dynamic through internal communication

Support processes

Internal communication and training for political leadership

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The indicators detailed below express minimum objectives to attain in the four years of validity of this strategic plan, unless another time frame is specified in the indicators.

Introductory note:

LINE 1

GENERAL OBJECTIVE 1.1 SOCIAL CHANGE

TO PROMOTE STRATEGIES FOR ACTIONS TARGETING SOCIAL CHANGE, WITH AN INCLUSIVE AND COMMUNITY-BASED APPROACH VIA THE PARTICIPATION IN NETWORKS SPECIFIC OBJECTIVE 1.1.1

To foster strategic alliances and networking with entities related to the Mission of Médicos del Mundo.

INDICATORS:

1. Approval of 1 network participation strategy (which defines networks, implication, objectives and points of reference).

2. Application of 1 network participation strategy. 3. Increased presence of Médicos del Mundo in networks and alliances, by sector and areas of

work, with entities related to our Mission. 4. 1 annual report is submitted to the Board of Directors, evaluating network participation and

alliances, specifying their impact on the association. SPECIFIC OBJECTIVE 1.1.2

To develop strategies whose aim is to involve health workers, groups and the younger segment of the population in actions and projects for recognition and protection of the right to health care.

INDICATORS:

1. Cooperation agreements with associations of social and health professionals are developed in the different Regional Offices.

2. Increased number of social and health organizations in Regional Offices and in the Field, which join our political incidence actions concerning the right to health care.

3. 80% of Regional Offices and 50% of field teams carry out Development for Education and Awareness projects and political incidence actions aimed at the young population.

SPECIFIC OBJECTIVE 1.1.3 To consolidate synergies and boost collaborative work with the International Network of Médicos del Mundo as an actor of social change.

INDICATORS:

1. Participation in 1 annual meeting of the International Network in all intervention and management areas.

2. Definition of 1 joint collaboration project or plan of action, together with International Network members in each area of intervention and management.

3. 2 delegations of the International Network are assisted and supported. GENERAL OBJECTIVE 1.2 TO STRENGHTEN EDUCATION FOR DEVELOPMENT AND AWARENESS IN ORDER TO CREATE GLOBAL AND COMMITTED CITIZENS, PLACING A SPECIAL EMPHASIS ON THE RIGHT TO HEALTH CARE

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SPECIFIC OBJECTIVE 1.2.1 To develop, preferably in the context of formal education, Education for Development projects intended to promote the values and principles of Médicos del Mundo amongst the younger generations. INDICATORS 1.2.1

1. Implementation of 1 Education for Development strategy, with indicators of results and impact on the critical conscience of the targeted students.

2. The Regional Offices execute and apply in a coordinated manner 2 proposals for E for development intervention.

3. The experiences and results of the Education for Development projects are shared annually and recommendations are made to improve their quality and impact.

4. Regional Offices and field teams participate annually in 1 Education for development project connected to international cooperation interventions.

SPECIFIC OBJECTIVES 1.2.2 To develop Awareness projects and actions, so as to contribute to the development of critical and informed citizens, active supporters of the right to health care. INDICATORS 1.2.2

1. Multiannual Awareness actions are approved, consistent with the priority political incidence and communication themes.

2. Regional Offices and field teams participate in 5 Awareness and Social Mobilization actions, of which at least 3 will be part of a joint action carried out by the whole association.

SPECIFIC OBJECTIVE 1.2.3 To boost diagnostic procedures via studies, testimonies and reports on the right to health care. INDICATORS 1.2.3

1. Presentation and debate of 1 Map of Studies and Reports in progress, which shows their connections to the priority Political Incidence themes and specifies their goals.

2. 1 Focalization Proposal is approved in the studies and reports area, consistent with the Political Incidence strategy and including social research methods.

3. 2 Diagnostics Reports are prepared, about access to health care of the most vulnerable populations, including proposals for social change.

GENERAL OBJECTIVE 1.3 TO DEVELOP POLITICAL INCIDENCE ON THE RIGHT TO HEALTH CARE SPECIFIC OBJECTIVE 1.3.1 To include Political Incidence and Awareness objectives when identifying and designing strategies, projects and actions. INDICATORS 1.3.1

1. Approval of the priority Political Incidence Theme Lines for the length of the Strategic Plan, focusing on at least one cause every year.

2. 1 Model showing the Cross-Cutting Nature of the Political Incidence is prepared, including tools and methods.

3. 40% of international and local projects include Political Incidence or Awareness objectives. 4. 50% of Political Incidence strategies in the Regional Offices and field teams include public

policy monitoring mechanisms (in relation to the right to health care) and assessment of the impact produced by Political Incidence actions.

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SPECIFIC OBJECTIVE 1.3.2 To position Médicos del Mundo as a social point of reference in issues related to our intervention and established as a priority. INDICATORS 1.3.2

1. Definition of spokespersons for each theme line and creation of a supporting document (which defines key messages, key data, stakeholder map, etc.).

2. The participation of our organization, as a relevant actor in the priority themes defined, is increased in the media, institutions and social organizations.

SPECIFIC OBJECTIVE 1.3.3 To strengthen External Communication with strategies, speeches, actions and capacities, increasing the impact and effectiveness of its contribution to the goals for social change. INDICATORS 1.3.3

1. 1 External Communication Strategy is implemented. 2. 1 strategy on-line for Communication and presence on social networks is implemented,

framed within the Communication Strategy. 3. Our communication includes speeches on Education for Development. 4. 300% increase in the visitor and user traffic within our on-line environment (website,

redXlasalud, blogs, social networks, micro sites, etc.). 5. References to our actions multiply by two in the media. 6. Issues related to intervention and established as priority by Médicos del Mundo account for

50% of references in the media.

LINE 2

HUMAN RIGHTS AND GENDER APPROACH

GENERAL OBJECTIVE 2.1 TO ENSURE THAT THE HUMAN RIGHTS AND GENDER APPROACH IS INCORPORATED INTO THE POLICY, CULTURE AND STRUCTURE OF MÉDICOS DEL MUNDO. SPECIFIC OBJECTIVE 2.1.1 To adapt the regulatory and institutional proceedings framework to the Human Rights and Gender approach. INDICATORS 2.1.1

1. 100% of internal policies are reviewed and adjusted. 2. 100% of Protocols in all intervention and management areas are reviewed and adjusted. 3. 90% of measures proposed in the Equality Plan are implemented. 4. The Country and Regional Strategies and those for Development of Regional Offices include

the Human Rights, Gender and Inter-cultural approach. SPECIFIC OBJECTIVE 2.1.2 To guarantee the incorporation and monitoring of the Human Rights and Gender approach in all projects and actions by using the appropriate tools and mechanisms. INDICATORS 2.1.2

1. Reference groups are set up to guarantee inclusion and monitoring of the Human Rights and Gender approach, in 90% of the Regional Offices and 50% of the field teams.

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2. 1 Group of Volunteers specialized in the Human Rights and Gender approach is set up, to give strategic support and oversee the process and make it more dynamic.

3. 90% of all our projects and actions include the Human Rights and Gender approach. 4. 80% of all our projects and actions include a Monitoring and Evaluation System with

indicators for assessment of the Human Rights and Gender approach. SPECIFIC OBJECTIVES 2.1.3 To inform and train volunteers, members and employees and give them the necessary tools to implement the Human Rights and Gender approach. INDICATORS 2.1.3

1. Implementation of areas for annual information, exchange and training in 85% of the Regional Offices and 50% of the field teams and in Main Headquarters.

2. Updating of 100% of the RedxSalud resources and making them available to the platform members.

3. 50% of users value positively the available tools and resources. 4. 1 Guide for Application of the Human Rights and Gender approach is prepared, adjusted to

the organization’s different areas. 5. 60% of volunteers, 50% of members and 100% of hired workers in relation to implementation

of the Human Rights and Gender approach in projects and actions. GENERAL OBJECTIVE 2.2 TO HELP THE PEOPLE, THE HOLDERS OF RIGHTS, WHO ARE IN A VULNERABLE OR UNFAIR SITUATION, TO EXERCISE THEIR RIGHT TO HEALTH CARE SPECIFIC OBJECTIVES 2.2.1 To include the assessment of the right to health care in initial diagnoses as well as when identifying projects and actions. INDICATORS 2.2.1

1. 90% of diagnoses include an assessment of the right to health care. 2. 30% of our projects and actions assess the impact, when the Rights approach is applied. 3. Specific reports and studies are prepared, and data collection regarding situations in which the

right to health care has been violated is systematized, as well as use of these data in project identification.

SPECIFIC OBJECTIVES 2.2.2 To generate empowerment procedures in all projects and actions. INDICATORS 2.2.2

1. 70% of projects and actions implemented by Regional Offices and the field teams include, within their project cycle, empowerment aspects, for example, inclusion of vulnerable groups, strengthening of the social fabric, improving quality of life, etc.)

2. Assessment of the impact produced by the empowerment processes in 50% of projects and actions carried out by Regional Offices and field teams.

SPECIFIC OBJECTIVE 2.2.3 To contextualize actions according to the social and cultural reality of the populations with which work is done. INDICATORS 2.2.3

1. 70% of the Regional Offices and field teams design projects and actions on the basis of participatory diagnoses reflecting the social and cultural reality of local populations.

2. 70% of the Regional Offices and field teams design projects and actions on the basis of participatory diagnoses including representatives of civil society and vulnerable populations.

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3. Civil society participates in the design and assessment of 40% of our projects and actions. 4. 70% of projects, events and actions include the Intercultural approach throughout

(identification, execution, monitoring, assessment). 5. 1 Leaving Strategy is included so as to facilitate continuity, contextualization and assumption

by our counterparts in 50% of the projects and actions developed in the field. GENERAL OBJECTIVE 2.3 TO ENSURE THAT HOLDERS OF OBLIGATIONS AND RESPONSIBILITIES

ADOPT THE HUMAN RIGHTS AND GENDER APPROACH AND GET INVOLVED IN RESPECTING, SAFEGUARDING AND COMPLYING WITH THE RIGHT TO HEALTH CARE.

SPECIFIC OBJECTIVE 2.3.1 To promote the right to health care and the Human Rights and Gender approach when networking or working with other agents. INDICATORS 2.3.1

1. 70% of projects developed by the Regional Offices and field teams include actions for Political Incidence in the right to health care.

2. The impact produced by Political Incidence actions is assessed, for 30% of our projects and actions.

3. 50% of projects developed on the field include tools for monitoring and public policy incidence, for inclusion of the Human Rights approach and the right to health care.

4. Awareness is created and information is given on the application of the Human Rights and Gender approach on 20% of the networks and platforms where we participate and in the relations we keep with other agents.

SPECIFIC OBJECTIVE 2.3.2 To raise awareness in civil society regarding violations of rights and to strengthen reporting procedures. INDICATORS 2.3.2

1. The different areas (Political Incidence, Awareness, Education for Development, Social Inclusion, International Operations, etc.) include the protocol for collection of Violations of Human Rights as a diagnostics tool for the planning of Strategies.

2. Three times a year, activities about the most relevant Human Rights violations registered are publicly communicated or developed.

LINE 3

PARTICIPATION AND ACTIVE ROLE

GENERAL OBJECTIVE 3.1 TO STRENGTHEN THE EFECTIVE PARTICIPATION

OF HOLDERS OF RIGHTS

SPECIFIC OBJECTIVES 3.1.1 Developing the areas and capacities of the holders of rights in order to empower them. SPECIFIC OBJECTIVE 3.1.2 To promote involvement and connection by the holders of rights in the comprehension and analysis of their social, economic and cultural environment. 3.1.1 and 3.1.2

1. 70% of projects and actions carried out by Regional Offices and field teams include actions for training and strengthening of the social fabric.

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2. The impact of the strengthening actions is assessed in 30% of projects and actions carried out by Regional Offices and field teams.

3. 50% of the population and grassroots organizations related to projects in the field join the project decision making process.

4. 2% of the holders of rights taking part in Social Inclusion projects become health care agents or promoters.

5. 20% of projects and actions for Raising Awareness are based on testimonies from the holders of rights holders, promoting their participation in the denunciation processes.

SPECIFIC OBJECTIVE 3.1.3 To apply an approach based on participatory methods in all phases of the project. INDICATORS 3.1.3

1. 90 % of projects and actions include participatory methodologies in all their phases. 2. 50% of projects and actions include results and/or initiatives resulting from application of

participatory methods. GENERAL OBJECTIVE 3.2 TO STRENGTHEN

THE CAPABILITIES OF THE ORGANIZATIONS THAT HOLD RESPONSIBILITIES

SPECIFIC OBJECTIVE 3.2.1 To support the organization and creation of civil society networks in the areas where Médicos del Mundo operates. INDICATORS 3.2.1

1. 2 civil society organizations and networks are supported or strengthened in each cooperation for development country.

2. Based on the support provided by Médicos del Mundo, 1 network or alliance with capacity for autonomous and sustainable action is set up in each cooperation for development country towards the end of 2013.

3. 2 civil society organizations and networks are supported or strengthened by the Regional Offices.

SPECIFIC OBJECTIVE 3.2.2 To strengthen the capabilities of civil society organizations so that they can participate in, and have a political impact on health care and development policies. INDICATORS 3.2.2

1. 70% of the projects and actions carried out by Regional Offices and field teams include actions to strengthen civil society in Political Incidence.

2. 30% of projects in cooperation for development countries assess the initiatives and actions developed by civil society organizations in relation to the right to health care.

3. 1 network or alliance driven by the organization applies Political Incidence tools and methods.

SPECIFIC OBJECTIVE 3.2.3 To develop participatory methods in order to promote the inclusion of local organizations as actors in social change. INDICATORS 3.2.3

1. 50% of the projects and actions carried out by Regional Offices and field teams include citizens’ organizations in local contexts so as to contribute to social change.

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2. 30% of projects in cooperation for development countries assess the local organizations as are included through the organization’s actions.

GENERAL OBJECTIVE 3.3 TO PROMOTE AND DEFEND THE RIGHT OF PEOPLE TO LEAD AN ACTIVE ROLE IN THE DECISIONS TAKEN BY INSTITUTIONS THAT HOLD OBLIGATIONS

AND WHICH AFFECT THEM, AS WELL AS IN BUILDING THEIR OWN DEVELOPMENT

OBJETIVO ESPECÍFICO 3.3.1 To support civil society organizations in order to improve representativeness and effective participation of their social or community bases. INDICATORS 3.3.1

1. 50% of the identified local organizations take part in initiatives for social change and the right to health care, as promoted by the organization.

2. 100% of the projects measure the number and kind of areas through which civil society organizations and citizens participate.

3. The projects in the different intervention areas (Social Inclusion, Awareness, International cooperation, etc.) include 2 initiatives related to the right to health care, from civil society organizations.

SPECIFIC OBJECTIVES 3.3.2

To contribute to the democratic governance of public health care institutions via people’s participation. INDICATORS 3.3.2

1. 50% of our projects and actions have a bearing on the existence or the articulation of democratic health care related decision making areas where the holders of rights are included.

2. 100% of the projects which have a bearing on the existence or the articulation of democratic decision making areas include training the holders of rights so as to ensure their effective participation.

3. Citizens develop an initiative related to the right to health care in each project having a bearing on the articulation of democratic spaces.

4. 20% of our projects and actions in the field include actions that generate changes in the organic and functional structure of the public health sector and foster the people’s participation.

5. Emphasis is placed on increasing the health care sector budget according to the needs identified by the population in our areas of work.

LINE 4

QUALITY, LEARNING AND IMPROVEMENT

GENERAL OBJECTIVE 4.1 TO PROMOTE THE CAPACITIES AND SENSE OF BELONGING OF ALL THE PEOPLE WHO ARE PART OF MÉDICOS DEL MUNDO SPECIFIC OBJECTIVE 4.1.1 To involve and keep the loyalty of all those people who are part of Médicos del Mundo, following the association’s ideology.

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INDICATORS 4.1.1 1. 50% of workers hired to carry out tasks unrelated to the Mission occasionally take part in

Social Inclusion, Humanitarian Action, International Cooperation, Education for Development projects.

2. 50% of hired workers visit spaces where the association’s life develops: Assembly, meetings, demonstrations, etc.

3. The hired staff turnover is reduced. SPECIFIC OBJECTIVE 4.1.2 To implement training plans in order to improve the professional and social competences of the people who are part of Médicos del Mundo. INDICATORS 4.1.2

1. Annual training plans for hired workers and volunteers are implemented and assessed), with allocated sums of money to ensure their viability.

2. Training plans include the results of the previous years’ assessment and the needs identified by participation.

3. Exchanges of good practices in the intervention and management area are implemented. 4. 80% of workers hired under the Spanish legislation receive training according to the needs

identified by the departments and in consistency with annual plans. 5. 40% of workers hired under other countries’ legislations receive training according to the

needs identified by the departments and in consistency with annual plans. SPECIFIC OBJECTIVE 4.1.3 To include assessment in human rights management and support for personal development as a tool for learning and continuous improvement of personal skills. INDICATORS 4.1.3

1. Annual assessment of performance is implemented in all the organization’s areas. 2. Annual support plans for Human Resources management are designed and implemented,

according to the needs identified and the performance assessment results. 3. The Human Resources policy is updated on a yearly basis; it must be known across the whole

organization association and include the Human Rights and Gender approach and conciliation.

GENERAL OBJECTIVE 4.2 TO PROMOTE A CULTURE BASED ON QUALITY AND LEARNING VIA CONTINUOUS ASSESSMENT AND KNOWLEDGE MANAGEMENT

ACROSS THE WHOLE ASSOCIATION.

SPECIFIC OBJECTIVE 4.2.1 To include tools for performance assessment and experience systematization on all levels and areas within the association as a comprehensive monitoring strategy. INDICATORS 4.2.1

1. Assessment is included in all areas of the organization, identifying improvements to be made in:

a. 90% of planning procedures. b. 60% of institutional proceedings. c. 60% of mission procedures (projects, programmes, etc.) d. 30% of impact of health and technical quality on projects for cooperation for

development. e. 60% of the supporting procedures.

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2. An internal audit has been implemented in 50% of Regional Offices, 40% of field teams and 60% of Main Headquarters departments, in order to identify weaknesses and improvements to be made.

3. 25% good practices in assessment procedures in all levels and areas are identified, disseminated and implemented.

4. 100% of identified improvements are included in annual plans. SPECIFIC OBJECTIVE 4.2.2 To develop procedures for reflection, learning and knowledge production via analyzing information and following good practices in internal as well as external areas. INDICATORS 4.2.2

1. Knowledge that improves the organization’s practical work is identified and disseminated twice a year.

2. Experiences from different areas identified in the organization are systematized twice a year. 3. The Resources Centre includes information on good practices and knowledge, as identified

for dissemination, and follows up their use and how users value them. GENERAL OBJECTIVE 4.3 TO STRENGTHEN THE DEVELOPMENT OF THE ORGANIZATION IN A RIGOROUS WAY, ACHIEVING TRANSPARENCY AND ECONOMIC INDEPENDENCE SO THAT THE ORGANIZATION CAN

TAKE DECISIONS BASED ONLY ON ITS MISSION AND VALUES.

SPECIFIC OBJECTIVE 4.3.1 To develop an organizational model through the strengthening of the decision-taking, responsibility and internal communication areas, so as to consolidate decentralization. INDICATORS 4.3.1

1. 100% of the committees keep active and involved. 2. 100% of Management Boards keep active and involved according to the defined functions. 3. The model of relations with field teams is reviewed and adjusted every year, to strengthen its

relations with the associative area (established channels, identified changes, etc.). 4. Decentralizing procedures in International Cooperation projects are defined and reviewed

every year. 5. 1 Internal Communication strategy is defined, which includes and implements the channels

and tools defined. SPECIFIC OBJECTIVE 4.3.2 To include an approach based on continuous improvement in quality, policies, strategies and missionary and management areas. INDICATORS 4.3.2

1. The quality criteria and key aspects are defined for all areas. 2. 100% of policies and strategies are reviewed and adapted to include the necessary procedures

for pre-defined quality management. 3. 90% of our projects and actions include “health quality” elements which make it possible to

assess the impact of our intervention on health. 4. The model for the health and technical quality of the activity is reviewed, as well as the

structure of International Operations.

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SPECIFIC OBJECTIVE 4.3.3 To secure a strategy of sustainability and economic independence, with a firm commitment to transparency and accountability. INDICATORS 4.3.3

1. 1 public funding and private funding (major and minor donors) strategy is defined; it is reviewed on a yearly basis and it includes the approved ratios and criteria.

2. 50/50 private/public funding ratio is attained. 3. 10/90 international/state ration is attained. 4. 30/70 major/minor donors’ private funding is attained. 5. The percentage of members that collaborate and the income derived from them increases by

20%. 6. Actions for capturing funds are implemented in all Regional Offices. 7. In each regional Office, a project is financed with private funds. 8. The cash ratio stands at 6-7 months (it is possible to meet operating costs for at least 6

months). 9. Funds obtained through the international network increase by 35%. 10. Annual and biennial budget forecast plans are implemented, according to changes in the

economic context and economic limitations. 11. Annual contingency economic plans are prepared, to face unforeseen issues. 12. Monthly cost control is established in all areas of the organization, following a philosophy of

austerity. 13. A transparency group that designs an internal and external accountability plan is set up, and

specific actions are implemented right from year 1. SPECIFIC OBJECTIVE 4.3.4 To include the sustainable environment perspective in the working method applied to all interventions. INDICATORS 4.3.4

1. An environmental diagnosis of all areas of the association is prepared. 2. Annual training is given on the environmental impact of the association’s different activities. 3. 100% of the internal audits include the environmental assessment of Headquarters, projects

and departments. 4. The environmental approach is included in 50% of processes in all the organization’s areas. 5. A Good Environmental Practices Manual is prepared. 6. 80% of the Regional Offices, Headquarters departments and Field Teams apply the Good

Environmental Practices Manual. 7. 30% of our projects and interventions include the environmental approach and analyze its

impact on health.

LINE 5

ASSOCIATION DEVELOPMENT

GENERAL OBJECTIVE 5.1 TO PROMOTE AND DEVELOP A SOCIAL BASE MADE UP OF MEMBERS AND VOLUNTEERS COMMITTED TO THE ORGANIZATION, CRITICAL WITH THE CAUSES OF INEQUALITIES AND MILITANT ENOUGH TO ACHIEVE SOCIAL CHANGE.

SPECIFIC OBJECTIVE 5.1.1 To enhance the social base and achieve the active participation of members and volunteers in the organization and their connection thereto.

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INDICATORS 5.1.1 1. A strategy for participation of the social base is developed and assessed. 2. 1 annual training activity aimed at members and volunteers is developed, regarding the

organization’s mission, values and principles. 3. 1 space for exchanging experiences and meetings between Regional Offices is implemented,

so as to foster their social base. 4. 40% of the social base takes part or has taken part in groups or in other participation areas,

according to the priorities defined by the organization. 5. Participation of the social base in the regional assemblies and the State Assembly increases by

80%. 6. The State Assembly debates and approves the organization’s policies. 7. The State Assemblies and other associative areas include contents for social change, to be

debated once a year. SPECIFIC OBJECTIVE 5.1.2 To promote the participation of volunteers and members in actions and campaigns for social change. INDICATORS 5.1.2

1. 1 annual action or campaign for social change is designed and implemented so as to make more dynamic the incorporation of volunteers and members into the regional area.

2. 40% of volunteers and 30% of members take part in the Political Incidence actions and campaigns on a yearly basis.

SPECIFIC OBJECTIVE 5.1.3

To strengthen the bonds make the social base more dynamic, using internal communication strategies targeting members and volunteers.

INDICATORS 5.1.3 1. 1 Internal Communication Plan aimed at the social base is defined, so as to facilitate the

participation of volunteers and members. 2. 70% of the social base uses information and communication technologies, with social change

and activism content. GENERAL OBJECTIVE 5.2 TO ENSURE THE PARTICIPATION AND DEVELOPMENT OF CAPACITIES OF VOLUNTEERS, SO THAT THEY BECOME MORE INVOLVED AND INTEGRATED INTO THE ASSOCIATION. SPECIFIC OBJECTIVE 5.2.1 To increase the number of volunteers involved in the association and to keep the loyalty of the already existing volunteers. INDICATORS 5.2.1

1. The number of volunteers is increased by 20%. 2. 80% of volunteers become members of the organization. 3. The degree of satisfaction of volunteers with the management of the voluntary work cycle is

kept at 80%. 4. 40% of volunteers participate in training actions organized according to the needs of the

projects and the organization. 5. The voluntary work cycle as defined by the association is developed and assessed.

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SPECIFIC OBJECTIVE 5.2.2 To consolidate the involvement of volunteers in the organization’s different areas for participation and association. INDICATORS 5.2.2

1. 30% of volunteers take part or have taken part in Groups according to the established procedures.

2. 10% of volunteers take part or have taken part in field activities according to the established procedures.

3. Identification and preparation of all the International Cooperation projects includes the Field Volunteers’ programme every year.

4. 10% of volunteers take part actively in networks and platforms. 5. 90% of volunteers in Regional Offices take part in the different mission areas. 6. 90% of Regional Offices include volunteers in their management boards (extended boards). 7. 10 State Groups (thematic as well as geostrategic) are operational and working.

SPECIFIC OBJECTIVE 5.2.3 To strengthen the procedures for volunteers’ support. INDICATORS 5.2.3

1. Annual training programmes are implemented and assessed in the Regional Offices with allocated sums of money to ensure their viability.

2. 40% of volunteers take part in the training actions and areas developed every year. 3. 2 volunteers are identified as points of reference in all Regional Offices, to support and

encourage the volunteers’ involvement. 4. The degree of satisfaction of volunteers in the different participation areas is kept at 80%.

GENERAL OBJECTIVE 5.3 TO CONSOLIDATE AND STRENGTHEN THE PARTICIPATION AND COMMITMENT OF MEMBERS

AND VOLUNTEERS, AS WELL AS THE ORGANIZATION'S STABILITY.

SPECIFIC OBJECTIVE 5.3.1 To increase the number of members and their participation in decision-making procedures. INDICATORS 5.3.1

1. The number of members is increased by 50%. 2. 50% of members participate in associative life areas (assemblies, meetings, groups,

committees). 3. 20% of members are involved in the governing bodies. 4. The renewal of the Management Board and of the Regional Boards is assured, with no less

than 1/3 of new members. SPECIFIC OBJECTIVES 5.3.2 To support volunteers in their political itinerary so as to achieve their involvement in the governing bodies. INDICATORS 5.3.2

1. 1 line for action aimed at strengthening the association is prepared and followed up and reviewed on a yearly basis, so as to contribute to the development and introduction of this strategic line.

2. Annual training actions aimed at volunteers are developed, with political and strategic content as well as the association’s values.

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3. 80% of the Regional Boards include members in their extended boards. 4. 100% of the people who every year take part in the committees, in representation of the

Regional Offices, streamline the participation and decision making procedures concerning their Regional Offices.

5. 90% of the Committees include state group work plans on a yearly basis, assessing and monitoring them.

6. 20% of volunteers from areas participate in state groups every year. 7. Spaces for the exchange of experiences are created, as well as for “tutorship” between

regional Offices and regional Boards once a year. 8. The different positions on the Regional Boards are strengthened and made visible, and they

meet once a year to exchange experiences. SPECIFIC OBJECTIVE 5.3.3 To develop an internal communication strategy and training procedures to encourage political leadership. INDICATORS

1. A defined Training Plan for Regional Boards is put into practice and assessed. 2. 100% of the Regional Boards are briefed after their election. 3. The Internal Communication Strategy includes annual contents for the Regional Boards. 4. 80% of the members of the Regional Boards and the management Board use information and

communication technology tools. 7. MONITORING AND EVALUATION Learning based on our Strategic Plan We cannot finish this strategic document without referring to the evaluation of our strategic plan as an inseparable part thereof. At the end of the 2011-2015 period, we intend to verify the reach and impact of our strategic plan, but not only that; we also intend to use the plan as a guideline in decision-taking, so that it helps us to adjust to the evolution of the context within which we work in the next few years and to learn from our practice. In short, to continue making progress in quality and transparency in our organization. The Management Board will be responsible for ensuring the validity and application of the Plan. For this, we will monitor it periodically and keep track of the context, so that we can include measures that befit any social or economic evolution as may take place. The development of this evaluation process will be based onthe level of achievement of the specific objectives through the monitoring of the indicatorsdefined for them. Similarly, the evaluation of the annual plan will give us supplementary data on the implementation of the strategic plan, as it is also a corrective and guiding element on the four-year path established by the strategic lines. These conclusions will be put together in an annual report and in a final report that facilitates communication and dissemination of the conclusions. In addition, the implementation of the recommendations as arise in the period will also be included annually. The strategic plan will be monitored and assessed at two levels. On the one hand, a technical and operative analysis of its implementation, the integration of the strategic lines and intervention lines, by the Management Committee and technical team; and on the other hand, a political analysis, by the Management Board, to measure (from the standpoint of our principles and values) the ultimate purpose of our intervention: social change, with the focus on people, as the holders of rights. MÉDICOS DEL MUNDO. WE FIGHT ALL DISEASES, INCLUDING INJUSTICE.

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NOTAS AL MARGEN: 04 –

Increased social exclusion and barriers that prevent certain groups from accessing health care, due to the economic crisis.

05 –

Networking and political incidence, fundamental to defend official aids for health care development.

Assistance for excluded people and creating social awareness.

Challenges: more private funding and more volunteers.

06 –

Assistance, testimony and denunciation

We fight all diseases, including injustice.

07 –

Health is not a luxury item

Being cured is a right

09 –

Changing the circumstances that lead to unfair distribution of money, power and resources.

10 –

Poverty and the lack of access to health care is a violation of the Human Rights.

11 –

Civil societies must be empowered of their own change.

12 –

Continued evaluation within a reflection-action circle.

13 –

The social base guarantees the association’s independence and sustainability.

14 –

Rehabilitation, development and prevention, to reduce vulnerability.

The focus is on the people, the holders of rights.

Primary Health Care as a public health-care model

Non-stop analysis of the surrounding environment, to create a critical conscience.