EG on Non-Communicable Diseases related to Lifestyles and ......

NCD-FLAG-PRO-1_meeting_23-25_March_minutes_SEMI-FINAL 030611

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EG on Non-Communicable Diseases related to Lifestylesand Social and Work Environments

First Meeting NCD-FLAG-PRO-1Saint Petersburg, Russian Federationfrom Wednesday 23 March 2011 (starting at 09:00)to Thursday 24 March (ending at 10:30)

Meeting venue: Hotel Ambassador, Rimsky-KorsakovAve., 5-7

Title Minutes of the 1st Meeting of Flagship A and B Project of theNDPHS NCD Expert Group (Non-Communicable Diseases related toLifestyles and Social and Work Environments)

Submitted by NCD Secretariat

Summary / Note This document recalls the main discussion points and decisionsmade during the NCD-2 meeting.All the meeting documents can be found on the NCD-2 meetingpagehttp://www.ndphs.org/?mtgs,ncd_project_planning_1

List of Annexes ANNEXES Available under above metioned web-site:Project planning (presentation by Tamsin Rose/ PDF-format)Example matrix for project questions vs. award criteria (TamsinRose/ Excel-format)Flagship A, first draft (ppt-presentation by workgroup A/M.Vienonen)ANNEXES attached to this report:ANNEX 1: NCD FLAG-PRO-1 provisional programmeANNEX 2: NCD FLAG-PRO-1 list of participants

1. Opening of the meeting and welcomeChair of NCD EG Mikko Vienonen welcomed the participants representing Finland, Latvia,Lithuania, Poland and Russian Federation Our main task indeed is to work towards “tangibleresults” through projects, and therefore the FLAG-PRO-1 meeting was called together toelaborate further the project concept approved during the PAC-8 meeting in November at WHO-EURO in Copenhagen.

This Flag-Pro-1 mtg has benefitted from the financial support given by EU. Therefore, manyparticipants have received their travel and accommodation and board expenses covered throughthis facility. The NCD EG expresses our warm thanks to EU for this generous support.

http://www.ndphs.org/?mtgs,ncd_project_planning_1


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2. Adoption of the ProgrammeThe proposed programme (see ANNEX 1.) was adopted without changes and the meetingworked as planned until the NCD-2 meeting started on 24/3 at 11:00 hours. However, as theNCD-2 meeting consisted mainly from the same persons as FLAG-PRO-1, after the necessaryagenda items for NCD-2 were discussed and decided upon, we could continue directly furtherelaborating on the Flagship A and B project concept further until Friday at noon-time.

Development and facilitation of NCD EG Flagship projects A & B

This topic was considered as our most urgent and most important task in NCD-EG. MikkoVienonen and Tamsin Rose introduced the objectives of the planning process to participants. Thepre-meeting document contained the project concept, as elaborated in November 2010. Twoproject concepts now lie on our table, namely:

1) FLAGSHIP-A Project on healthy nutrition, prevention and correction of overweight andobesity, promotion of physical activity among school-aged children1 (7 – 15).

2) FLAGSHIP-B Project on health policy and strategy facilitation for NDP countries (“StopNCD-epidemic now!: Health policy and strategy support to combat NCD and hazardousand harmful lifestyle epidemic in Northern Dimension geographical area”)2.

At the first session all participants were together and Mikko Vienonen and Tamsin Rose briefedthe team about the scope and purpose of the meeting. Background materials are available onthe http://www.ndphs.org/?mtgs,ncd_project_planning_1. Mikko Vienonen’s PP-introductorypresentation is available at the same site (post-meeting documents in PDF-format.

1 FLAGSHIP-A: Food and nutrition plays a hugely important role in causing and preventing many diseases. In Northern DimensionArea cardio-vascular diseases are linked with too much animal fat and salt and too little fruit and vegetables in our diets. Yet, someof our countries can show excellent results through population based dietary changes, which encourages the project to facilitate thechanges in countries still lagging behind. A common nutritional danger is the intake of more food than we need, leading intoobesity and eventually to type-2 diabetes, hypertension, arthrosis and many other complications, loss of quality of life andpremature disability and death. Overweight (obesity), lack of physical activity, low fruit and vegetable intake, high cholesterol andblood glucose is a combination of interlinked problems, which competes on the questionable highest ranking position among publichealth threats with alcohol and tobacco in Northern Dimension countries. Childhood and youth are crucial periods when nutritionaland physical activity habits are formed. Hence, our primary focus should be in school aged children.2 FLAGSHIP-B: Presently the international community globally and in Europe is in the process of scaling up action against NCDs.WHO is leading this process. Recent policy documents provide undisputable evidence that NCDs cause immense human sufferingthrough premature disease and disability and death. The calculations on huge economic losses and burden to our societies providean additional imperative to tackle this problem, where short term commercial interest and profiteering has tried to camouflage thelong term losses to life and productivity. Firstly, we need to demonstrate systematically the importance of life lost prematurely dueto preventable causes in our Northern Dimension Area. Secondly, we need to increase our involvement in the European healthpolicy and strategy process closely collaborating and supporting WHO-EURO. Thirdly, as part of NCD-Flagship project, improvemethods for management of change locally, nationally and regionally to stop the NCD-epidemic among our working agedpopulation.

http://www.ndphs.org/?mtgs,ncd_project_planning_1.


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BACKGROUND MATERIALS FOR NCD PROJECT PLANNING:

BackgroundInfo/1

Salutogenesis and NCDs (Introductory paper prepared by Bengt LindströmMD PhD DrPH. Professor of Health Promotion Nordic School of PublicHealth, Research Director Health Promotion Research, Folkhälsan ResearchCenter)

NCD EGSecretariat

BackgroundInfo/2

The Tallinn Charter: Health Systems for Health and Wealth (WHO EuropeanMinisterial Conference on Health Systems, Tallinn, 2008)

NCD EGSecretariat

BackgroundInfo/3

Action plan for implementation of the European Strategy for the Preventionand Control of Noncommunicable Diseases (2011–2016), WHO-EURONovember 2010

NCD EGSecretariat

BackgroundInfo/4

Developing the new European policy for health – Health 2020 (WHO-EURO,March 2011)

NCD EGSecretariat

BackgroundInfo/5

THE TALLINN CHARTER - A BUILDING BLOCK FOR HEALTH 2020(Presentation by WHO-EURO Regional Director Zsuzanna Jakab, March2011)

NCD EGSecretariat

BackgroundInfo/6

DEVELOPING THE NEW EUROPEAN HEALTH POLICY: HEALTH 2020(presentation by Agis D. Tsouros Head, Policy and Cross-cuttingProgrammes and Regional Director’s Special Projects, WHO-EURO, March2011)

NCD EGSecretariat

BackgroundInfo/7

“Social welfare and health care” sector of the Northern Dimension policy -NDPHS background paper to the 2nd Northern Dimension ParliamentaryForum, February 2011

NCD EGSecretariat

BackgroundInfo/8

Project concept for “Healthier People: Management of Change throughMonitoring and Action" (Re: Call for Non-State Actors and Local AuthoritiesProgramme for the Baltic Sea Region (within the framework of priorities ofthe Northern Dimension)

NCD EGSecretariat

BackgroundInfo/9 Beginner's Guide to Logical Framework Approach (Bond) NCD EG

Secretariat

BackgroundInfo/10

A toolkit for the prevention of type 2 diabetes in Europe (publication ofIMAGE project)

NCD EGSecretariat

BackgroundInfo/11

Quality and Outcome Indicators for Prevention of Type 2 Diabetes in Europe– IMAGE

NCD EGSecretariat

BackgroundInfo/12

Potential Years of Life Lost “PYLL” A MAP FOR HEALTH OF THEPOPULATION (ppt presentation of Dr.Vienonen)

NCD EGSecretariat

BackgroundInfo/13

Potential years of life lost - The PYLL rate in monitoring the wellbeing of apopulation (article by Ilkka Vohlonen, Heli Bäckmand, Jari Korhonen)

NCD EGSecretariat

BackgroundInfo/14

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NCD EGsecretariat

Election of the FLAG-PRO-A and FLAG-PRO-B facilitators and rapporteursIt was agreed that when the two groups split and work separately, both nominate their ownrapporteurs. The FLAG-PRO-A group consisting of Dr Elena Bashnina, Dr. Iveta Pudule, Dr. RitaSketerskiene and Dr. Mikko Vienonen, chose Mikko Vienonen as their rapporteur. The FLAG-PRO-B group consisting of Ms Justyna Car, Mr Mikhail Kasatkin, Ms Hanna Koppelomäki, Dr.Anna Korotkova, Ms Katja Lahikainen, Mr Marek Maciejowsk, Ms Karolina Mackiewicz, Dr YuryPetrov, Ms Elena Pfau, and Mrs Anna Skvortsova, chose Karolina Mackiewicz and Anna


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Skvortsova as their rapporteurs. Mikko Vienonen facilitated the project planning process (LFA-methodology) in Group A and Tamsin Rose in Group B.


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Highlights of actual team-work proceedings:

FLAG-PRO A

The Flagship project A (nutrition/obesity) spent a lot of time in the beginning to elaborate theoverall scope on our work. The small team suffered from the fact that the Nordic School of PublicHealth / Gothenburg – Sweden representative was unable to come to SPb, and as they had beenthe initial inventors of the A-concept, we had to do considerable “soul-searching as to what wereally are after:The A-team wanted to focus on:

Issues linking on 7 -15 year old children (compulsory basic education 9 years) We dropped the theme “prevention of diabetes type-2 among children, as the disease is

extremely rare among that age group. Nevertheless, we acknowledge that overweightand obesity among young people often has its roots in childhood and adolescent wrongand harmful nutritional habits and low physical activity.

We discussed the role of genetics as basis of obesity. Although there certainly is geneticdisposition towards obesity in some individuals, we in fact need to understand that ourpopulation probably first time in history is in the position that we have high energy foods(fat and sugar) easily and affordably available, and we are poorly equipped to cope withthis “calory-tsunami” pushing on us accelerated by the commercial interest of food industryto sell more than we actually need.

There is also “social inheritance” of obesity, in the way that children of obese parentsinherit the social habits of over-eating

Flagship-A team elaborated the project concept towards a more comprehensive project plan (seebelow). We realize that a lot still remains to be done at Flag-Pro-2 meeting in Kaliningrad in June.Especially we ran out of time in elaborating on the “Work Packages”, which will be one of thebiggest tasks at the 2nd meeting. As a positive issue in our slowness we saw that we may be ableto gather more international and national expertise on existing similar types of projects. Each ofus promised to do our best in-between Flag-Pro-1 and Flag-Pro-2 in order to be well prepared forthe 2nd round.


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PREVENTION OF OVERWEIGHT AND OBESITY IN SCHOOLCHILDREN (ages 7-15) in Northern Dimension geographicalarea

Context (State the problem that you will address, include information about relevant policy documents or political decisions e.g WHO resolutions)

Child and adolescent health; nutrition; physical activity; public health epidemiology; disease prevention, and health promotion.Food and nutrition plays a hugely important role in causing and preventing many diseases. In Northern Dimension Area cardio-vascular diseases are linked with too much animal fat and salt and too little fruit and vegetables in our diets. Yet, some of our countriescan show excellent results through population based dietary changes, which encourages the project to facilitate the changes incountries still lagging behind. A common nutritional danger is the intake of more food than we need, leading into obesity andeventually in adulthood to type-2 diabetes, hypertension, arthrosis and many other complications, loss of quality of life and prematuredisability and death. Overweight and obesity, lack of physical activity, low fruit and vegetable intake, high cholesterol and bloodglucose is a combination of interlinked problems, which competes on the questionable highest ranking position among public healththreats with alcohol and tobacco in Northern Dimension countries.The roots of nutritional disturbances are complex and multi-factorial. Much new knowledge has been found through recent researchresults. Overweight and obesity can be understood as an epidemic, although clear genetic predesposition also exists. Daughters ofmothers who are obese are more often also overweight and sons of fathers who are obese behave the same. Children who sleep tolittle become more easily overweight. There are clear links with overweight and other eating disturbances like bulimia and anorexia.There is also more knowledge of the high importance of physical activity in helping to prevent overweight among children and adults.Behavioural eating and TV-watching patterns play an important role.Childhood and youth are crucial periods when nutritional and physical activity habits are formed. Hence, our primary focus should be inchildren and young adults. Scientific evidence has proven that such interventions can have long-standing effect.

The project partnership represents the diversity of the region, different institutions (local authorities including especially health-, school-and social-sectors, regional authorities and public health institutions, ministries, NGOs, universities). This partnership, enables toimplement the project that will focus on to stop the overweight and obesity epidemic among school-children (7-15 and eventuallybeyond).

The following WHO-EURO documents will provide a solid basis for project implementation:Challenge of obesity in the WHO European Region and the strategies for response (The) 2007


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Which are the known causes and consequences of obesity, and how can it be prevented?Addressing the socioeconomic determinants of healthy eating habits and physical activity levels among adolescentsWhat is known about the effectiveness of economic instruments to reduce consumption of foods high in saturated fats and otherenergy-dense foods for preventing and treating obesity?WHO European action plan for food and nutrition policy 2007-2012How can health systems respond to population ageing?WHO European Action Plan for Food and Nutrition Policy 2007–2012

The following European Union documents will provide a additional strategic guidance for project implementation: Prevention of Obesity in Europe – Consortium for the prevention of obesity through effective nutrition and physical activity

actions – EURO-PREVOB 2010Take action to prevent diabetes. IMAGE. Executive Agency for Health and Consumers. 2010

General objective (Your overall goal in relation to the problem)

FINAL DEVELOPMENT OBJECTIVE: Our final development objective is to aim at sustainable nutritional and physical activity changes among youth so that in their

adulthood their weight would remain within normal range (BMI> 25) and hence their risk to develop metabolic syndrome and/ordiabetes-2 would be significantly less than without the intervention. It will be understood that the measuring and verification ofthe final development objective could not be included in the actual project frame, because we would talk about the time when the15-year olds finishing the intervention would be in their adulthood over 25 years.

Specific project (What you want to achieve with this project and how does that contribute towards the overall goal?)

IMMEDIATE OBJECTIVE: Physical activity among school children permanently increased Excessive empty calories intake among school children permanently decreased Our short-term measurable development objective is to stop the growing trend in numbers of overweight and obese children

at 15-years of age. Our long-term measurable development objective is to turn down the growing trend of overweight and obese children at 15-

years of age (-> fewer overweight and obese children).


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Activities (How will you address the problem? What activities are you proposing? Identify the different work packages and the organisations that areinterested in leading/participating in the work packages. Note that Coordination, Evaluation and Dissemination are usually obligatory work packages)

Work Package descriptions (to be further elaborated)

WP 1 Structures for leadership / responsibilities for implementationThis Work Package focuses on recognizing the leadership structures and institutions that are responsiblefor implementation of local, regional and national child and adolescent health nutrition and physical activitystrategies. Clear structures of responsibilities, clear definition of tasks and proper allocation of resourceswill improve the carrying of strategies.

WP 2 Knowledge management and mobilizationThe Work Package will identify evidence based experiences in the participating countries for lessonslearned on the methods that work and create the positive behavioural change for over-weight and obesityprevention and increase of school –children’s physical activity. Well documented action plans provided byWHO-EURO and EU (see above) will be used and adjusted for local needs. The tools will be collected andthe experiences will be shared.

WP 3 MeasurementsIn order to create effective and efficient interventions to tackle overweight/ obesity epidemic among school-children, it is crucial to know what the size and impact of NCD is. Therefore the tools for measurement andmonitoring of the issue and the progress need to be collected.

WP 4 Stakeholders engagementThis Work Package will focus on creating the platform for practical action in schools and families andsociety as a whole to tackle problems identified through LFA in the “problem-tree” (see ANNEX 1) andachieving the objectives as indicated in the “objectives-MATRIX” (see ANNEX 2) in order to ensure thechange in nutritional and physical activity patterns in the school-aged children (7-15 years) of project targetpopulation.

WP 5 Project management and dissemination of results

Lead organisationParticipantsWP1 Partner responsible:to be determine

WP2 Partner responsible:to be determine

WP3 Partner responsible:to be determined

WP4 Partner responsible:Partner responsible:to be determined

WP5 Partner responsible:to be determined


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Outputs (What deliverables will be produced - listthese per work package. These should be tangible,concrete and can be quantified)

Outcome (What results will you achieve with youractions? List these per work package. How will thesituation be changed by your project?)

Indicators (How can you measure thesuccess of your actions? List these perwork package)

1.1 Network for exchange of good practiceson implementing overweight and obesityprevention strategies among school-children1.2 Guidelines about structure to implementoverweight and obesity prevention strategiesamong school-children at national / regional /local level2.1 Analytical tools for local and regionalauthorities – especially cost effectiveness ofinterventions2.2 Directory of interventions that work /produce sustainable behavioural change

3.1 Monitoring and measurement tool thatillustrate size and impact of overweight andobesity problem4.1 Ongoing engagement of Parliamentarians,local decision makers on overweight andobesity issue among school-children.4.2 Platform for NGOs / stakeholders to shareideas and experience

1. Clarity and improved governance forimplementation of overweight and obesityprevention strategies among school-children

2. Focus on sustainable behavioural changeand wide range of tools to achieve that

3. Improved systematic and updatedinformation on size and impact of overweightand obesity4. Consensus on the importance of fightingNCD epidemic and increased momentum ofaction / change by politicians andstakeholders.

Not developed yet


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Assumptions (What important external factors are preconditions for the project to work? For example, the issue continues to be an EUpriority)

Following assumptions are made: Tackling over-weight and obesity among children takes work by many actors at many levels Major implementation gaps for nutrition and physical activity policy NCD burden (and overweight –> obesity –> diabetes-2 –> CVDs etc. remains high priority among politicians and decision

makers to intervene Inequalities will be addressed in all Work-Packages Research into what works is ongoing WHO and other actors are engaged and can provide a foundation for work Tackling over-weight and obesity among children is cost-effective and possible (evidence based) Tackling over-weight and obesity among children will eventually lead into less obese adults and hence into less diabetes-2 and

its inevitable consequences

Risks (What external factors could affect your ability to implement the project - and what can you do to reduce the risks?)Following risks have been identified:

There will be “losers” who oppose (e.g. junk-food industry, breweries and soft-drink producers, sweets-industry and candy-shops, ice-cream producers and other sweet dairy product producers)

Economic crisis Reduced public health capacity Over-weight and obesity and ultimately diabetes-2 considered as “inevitable” (“genetically” determined) and too

complex/difficult/hopeless to fight. Commitment to process is not genuine Taboo that individual weight is everyone’s own business and focusing on it is intruding into privacy (“I am big and proud of it!”


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PROBLEM TREE: OVER-WEIGHT & OBESITY IN SCHOOL-AGE 7-15vicious circle Low self esteem vicious circle vicious circleIn later age

metabolic syndrome& diabetes-2

Blood-pressure

BulimiaAnorexia

social isolation, schoolproblems, drop-outs

Clumsiness/accidents

Poor physicalcondition

Depression andother mental

problems

Becoming target forbullying

More need for medicalassistance

PHYSICAL PSYCHOLOGICAL SOCIAL ECONOMICALConsequences EFFECTS?

End result: physical, psychological, social economical

MORE CHILDREN AND YOUTH BECOME OBESEMORE CHILDREN AND YOUTH BECOME OVERWEIGHT

ENERGY (Kcal /Kjoule) INTAKE BIGGER THANWHAT IS CONSUMED

PHYSICAL ACTIVITY REDUCED OR NONEXISTENT. LESS THAN MINIMUMREQUIREMENT

Reasons WHY? Reasons causing the problem

FAMILY SCHOOL PROFESSIONALS RESEARCHNot preparing foodat homeNot eating together

Vending machinescontaining soft-drinks and candy

The norms/standardsfor defining over-weight are not up-to-date in all countries ofour regionUn-coordination!

Knowledge does nottranslate intobehavioural change ineating habits

Parents do notrecognize that thatchildren under 15cannot managetheir meals alone

School curricula toolittle P.E.

School facilities notsuited for P.E.

If data on childnutrition andoverweight availableto researchers, it is notcommunicated to ITpracticians

Impact of socio-economic differences:poor more obese

Watching TV wheneating ->over-eating

Designing schoolmeals childrenstaste notconsidered/ notinvolved

Seriousness ofchildhood overweight& obesity notknown/available

Children do not like/not used tovegetables & fruit

Too little financialresources for tastyand nutritionallyright school meals

Fast-food“addiction”Too little playingoutside/ safety issueToo little sleep


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OBJECTIVES MATRIX: OVER-WEIGHT & OBESITY IN SCHOOL-AGE 7-15Food andPhysicalactivity

Policies &politics

Family-role Health- sectorrole

School-sector role

Foodindustry &marketing

Other issues &sectors e,g,

city planning

Taxation:higher tax onsugar & softdrinks, lowertax onvegetables,fruit

Food traditionneeds to be re-invented.On growing ofvegetables re-invented

Monitoring ofchildren weightand growthimproved(school-health)

Providingopportunitiesfor physicalactivityduringbreaks

Limitations(voluntaryor byregulations)advertisingof(junk)food

Involve media(press, TV, radio)Empowerment offamilies torecognizeoverweight anddo somethingabout it

Families needmore time forpreparingfood.Helpingfamilies tointroducevegetablesand fruit tochildren whenyoung

Diagnosis ofover-weight andobesity improves

Makingphysicalactivityclasses morefun also“non-sportive” andoverweightchildren

Labelling ofproductsbetterregulated(energy ,sugar, fat)

In kinder-gardenmaking tastingnew foods(vegetables,berries and foodespecially)something fun:“food theatre”exploring raw-materials andpreparing food.

Swimmingpools andother sportsfacilities mustbe subsidisedbymunicipalitiesso thatfamily’seconomicsituation doesnot preventchildren andparents fromusing them

Poor familiesneedassistanceand subsidisedfoods

Interventionsto react onoverweight andobesity whendiagnosed with achild

Zero-toleranceagainstbullying

Recognizing therole of grand-parents andrelatives as aresource(sometimes as arisk also)

Improvingawareness ofimportance ofgoodbreakfast, andlunch.Good snacks.

Organizinginterventions-individual-groups-whole families

Parent-teachermeetings todiscuss waysto improvephysicalactivity

Rules/limitations forchildren towatch TV andplay with PC

Nutritionalrecommendations more clear andless confusing forlay peopleIntroduce regularat least annual“EIBI.NUT”3 in allschool-healthsystems-how you eat?-how often andwhen you eat?-how much youeat?-what you eat?

In city planningmakearrangementsthat increasenatural physicalactivitySUCH AS:- safe walkingpaths-safe bikingpaths-better lighting-less bushes anddark corners inparks-places for skiingand skating inwinter.-safeplaygrounds-reconsider rulesfor schooltransport:


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enhance walking

Stake-holders and partners and previous experiences & knowledge (overweight andobesity prevention among school-children (7-15 years of age):Need to review all on-going initiatives

EU project on preventing childhood obesity WHO school-age surveys (Health behaviour of school-age children survey) FINBALT surveys (in Finland, Estonia, Latvia and Lithuania) since 1990s. WHO-EURO initiated in 1990s “Schools for Health in Europe”. Many countries

including Lithuania (Aldona Jociute) and Latvia have participated. However, inLithuania the pupils in schools which participated were not found to have anybetter/healthier lifestyles than those who did not participate. So what is the impact?Was the method not efficient? Yet, participating schools were “happy toparticipate”.

Stakeholder meeting to be held in Riga in april 2011 (Iveta Pudule knows) Childhood obesity meeting in Portugal (June 2011)? EU Symposium on Obesity, Brussels 17/5/2011

WHO-EURO Regional adviser for nutrition: Ms Trudy Wijnhoven

“Health Centres” (new innovation and establishment in Russia which started in 2008 byministerial order) focus on disease prevention and health promotion for individuals. Theycould be helped to work more population based to cover/help more people.

PUBLIC-PRIVATE partnership is not fully used. Not an easy instrument (good and badexperiences). E.g. collaboration with food industry, shops, restaurants, bars, dairies,agriculture/food producers. Seek for win-win arrangements (remember successful North-Karelia Project in Finland 1970-1980).

Nutrition scientists. Recommendations about healthy food are too complicated, messagesunclear or controversial, different in different countries (e.g. Russian scientistsrecommend higher calory intake than rest of Europe), internet confuses people,sometimes recommendations over-simplified.

In school physical education (sports and gymnastics): Classes are too competitive (orientation towards active sportsmen/women). Less

sportive considered and made feel as losers and “pariah”, with an outcome thatthey hate any physical activity for life.

When feed-back given to a pupil is constantly negative, interest in school and fee-time P.E.

Need to find more joy into in school and fee-time P.E. Need to find individual interests and strengths in school and fee-time P.E. Focus more on P.E. teachers’ skills

3 EIBI /NUT = Early identification and brief intervention of hazardous and harmful excessive calory intake amongchildren through regular auditing and evidence based intervention (Note: this same idea is being widely used inprevention of alcohol related harm and hazard)


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END OF FLAGSHIP-A PROJECT ELABORATION


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FLAG-PRO-BThe facilitator referred the following issues vis-à-vis the LOG-Frame:

Construct project in 4*4 matrix; use If… Then… Logic; vertical and horizontal logic; HOW and WHY logic (simple but powerful questions) Create a problem tree:

o Core problemo Determine which related problems are “Causes” and which are

“Effects” (So what?)o Arrange hierarchyo Cause (Why?)

And convert it into Objective tree (positive statement) Problem: Police do not properly investigate corruption Objective: Improved investigation of corruption claims by the police

Technical quality SANCO evaluation grid:

Max total score 100 (Policy and contextual relevance of the project 40+ Technical quality 30 + Management quality and budget 30) (Seecopy in ANNNEX 3]

Scoring used by DG Research:o 0 (proposal fails) – 5 (excellent)

FLAG-pro B team continued elaborating the problem-tree (what we can do together, whatmakes sense), and objectives’-tree. Following this the B-team continued elaborating moreon the Logframe and decided about how to present the project’s outcomes.

The WG on Health Policy looked into: 2020 Health strategy WHO – find way of implementing it Problem related to health policy – write on a paper (at least 3) what you

would like to work on then we’ll find common problem – NCD diseases

It was felt by the group that there are good strategies but no resources in themWe have specific problems in this region and we need to find solutions – nationally andinternationally;

Do we have responsibilities of our organizations to commit ourselves to thisproject? Mandate and what budget?

What are criteria for you – when you see project idea, then you can say:“Yes, I’ll take it”. How do you make decision on participation in project?

When we approach partners for funding of the projects, we need to know about thecriteria that they have set. (= what do you pay attention to) such as:

Project brings some value to the country, city, organization…


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Gives opportunity, tools, publicity or knowledge to the organization, city… Measurable results Interesting way of approaching population not starting with diseases Scientific relevance of the project Problem recognized as urgent in the city Cooperation with local authorities and other stakeholders Measurement of problem and progress

Flagship-B’s Mission Statement could be: Need to produce Operational document – What will help to to make political

decisions operative? Need to tie down the Implementation gaps between ministerial policy and

real change NEW MANAGEMENT OF CHANGE

To keep in mind: Call for proposal - fp7 new EU research program – July or Augustwill be open for universities and research institutes. In order to attract this funding, theproject needs to have clear knowledge sharing element in it.

Flag-pro-B team continued to elaborate on project’s work packages (WP):WP 1: Structures for leadership / responsibility for implementation (Russia, Latvia)WP 2: Knowledge management and Mobilisation NDI (Latvia?), Canada? ?NHV??WP 3: Measurements (of problem and of progress) (interest of Poland, Latvia)+Finland,EstoniaWP 4: Stakeholder engagement (local authorities and e.g.. Healthy Cities Network and/or

SPb?), for NGOs Anna Skvortsova?, SPb

Flag-pro-B team continued to elaborate on project’s OUTPUTS:

For WP1: Network for exchange of good practice on implementing NCD Guidelines about structure to implement NCD at national/regional/local level

For WP 2: Analytical tools for local and regional authorities – especially cost

effectiveness of intervention Directory of interventions that work / produce sustainable behavior change

For WP 3: Monitoring (system set up) and measurement tools that illustrate size /

impact of NCD problem (what will happen if not do this – how much it’ll cost(20% more children = diabetics)

Monitoring of change / progress (could be pilot project)For WP4:

Ongoing engagement of Parliamentarians and local decision-makers onNCD issues (UBC,BSPC,BSSSC) platforms for NGOs / stakeholders/CSO toshare ideas / experience (you have to have people involved)

Flag-pro B General objective:


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Operationalised political decision on NCD epidemic that is implementable indifferent European countries (NCD strategies are operationalized andimplementable)

Flag-pro B Specific objective: Develop effective and efficient mechanisms for implementation that identify

tasks, results, resources and responsibilities Number of people who will die from NCD in both developed and developing

countries will rise in next 20 years; UN – Big conference on NCD coming inSeptember 2011, following the WHO Global Conference on Lifestyles andNCDs will try to tackle this problem (“slow-motion catastrophe/ tsunami”)

Strong focus will be on alcohol (in RF) and on other NCDs such as CVDsand cancer.

RESULTS/ OUTCOME

4 results/outcomes to be anticipated:1. (WP 1) Clarity and improved governance for implementation of NCD strategy2. (WP 2) Focus on sustainable behavioural change and wide range of tools to

achieve this3. (WP 3) Systematic and updated information about size and impact of NCD

problems4. (WP 4) Consensus on the importance of fighting against NCD epidemic and

increased momentum of action / change by politicians /stakeholders

The Flag-pro-1 meeting ended in a brainstorming session on:The participants acted as project evaluators, based on the presentations of Flag-pro Aand Flag-pro B presentations:

There were two main project criteria to evaluate on:1. Clarity: is it clear what is project about? This is the most important thing for

evaluator2. Logic - examine how things get together; score – do you see clear

relationships between projects activities and its results? Will project likelyhave impact on the problem presented?

A good project writer does not finish the planning-work when it is written. First evaluationwill show if we need to strengthen our logic or move on. It is not a school exercise; it is forthe development of project idea. Our evaluation exercise brought to following 4conclusions:(WP 1) Clarity and improved governance for implementation of NCD strategy(WP 2) Focus on sustainable behavioural change and wide range of tools to achieve this(WP 3) Systematic and updated information about size and impact of NCD problems(WP 4) Consensus on the importance of fighting against NCD epidemic and increasedmomentum of action / change

END OF FLAGSHIP-A PROJECT ELABORATION


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Peer-assessmentThe meeting made a peer assessment of the clarity of the project concept/plan as presented byeach group (A and B) to the whole planning team at the end. The outcome of this evaluation waswith a scale 0= very unclear -> 5= very clear that Flagship-A project received on average about2 points and Flagship-B project on average about 4 points. Hence it is obvious that Flagship-Aproject will need still quite a lot of work and thinking on the overall concept, logic, and justification.In this respect Flagship-B team seems to be much further in their development. It was evendiscussed, whether we should abandon Flagship-A project elaboration and focus all our efforts toFlagship-B project planning. The outcome of this discussion, however, was that we neverthelessshould continue with both projects at the 2nd Flag-Pro meeting in Kaliningrad and see if we cancorrect the existing weaknesses and drawbacks.

Next FLAG-PRO-2 meeting

As for the next project planning meeting tentatively agreed to take place in Kaliningrad, differentdates in May were presented here but later it was agreed agreed to set the dates for 30-31 May4.Anna Korotkova was agreed to follow up with local organizers so that we can confirm the datesand venue as soon as possible. We will benefit from the EU support to the Kaliningrad meetingas for this one, and Ms Tamsin Rose will be able to act as our facilitator even there. This will bemade possible through the NDPHS Secretariat appropriations account, which will be atremendously important asset for us, and NCD EG highly appreciataes this opportunity. The mainmessages were that we should “not invent the wheel” as WHO and other organizations includingEU have done a lot of research and practical work, which is all well documented and available tous. So we should as much as possible benefit from this work and focus on implementation andnational adaptation implementation. Tamsin Rose provided valuable information on the logicalframework format that we need to adopt in order to make our proposal lucrative and possible tofund by EU and other funding agencies. We also discussed the recent EU call for projectapplications for 2011 (deadlinein May 2011) but came to the conclusion that the topics referred todid not include the themes suitable for us now. Therefore, it will be an important task after projectA and B really are taking better form to be in contact with EU/ Brussels and Luxemburg that thecall for Proposals 2012 would include the types aof activities eligeable for funding as tacklingobesity (Flagship A) and Monitoring and facilitating change (Flagship B).

HOME-WORK FOR FLAG-PRO-2:In SPb mtg we agreed that we will send the questionnaire/ MATRIX (see ANNEX 3 in Englishand in Russian) to all FLAG-PRO-2 participants to think and assess in advance in theirhome countries/ institutions as to what are the most important reasons for their country/institution to join the project application. It needs to be reminded that if/when we finalize aproject proposal/application for EU funding, there will be quite detailed requirements as tothe commitment of partners to join the project. Furthermore, a crucial issue will be co-financing, as usually EU requires at least 20% own funds in order to be able to apply for theremaining 80% from EU. Even more cofinancing will not hurt, and would increase thechances to get a positive response. In other words, if a 1 million euro project proposal is inour expectations, it would mean that minimum 200.000 euro would need to be identifiedfrom own resources. This funding must be “real”, in other words in-kind contributions donot count, just real cash on project account.

4 Later in May it became obvious that for the end of May date many participants had difficulties in attending andtherefore the meeting was shifted to a later date 13-15 June, which seemed to suit more people. The secretariatapologizes for the inconvenience caused due to the change of date.


19


20

Adoption of the Flag-Pro-1 meeting minutes

The meeting minutes draft and FlagPro report drafts, prepared by NCD EG Secretariat, will bedistributed among participants for their possible comments and amendments.

All meeting presentations will be made available in web (practically done already).

Closing of the meeting

FLAG-PRO-1 meeting was closed at 12 hours on 25 March

Draft notes for approval by meeting participants of the FLAG-PRO-1 meeting were prepared by

Dr. Mikko VienonenNCD EG ChairNDPHS/NCDSysimiehenkuja 100670 HelsinkiFinlandPhone: +358-50-4421 877Fax: none


21

ANNEX 1./ NCD-2First Meeting NCD-FLAG-PRO-1 provisional programme

EG on Non-Communicable Diseases related to Lifestylesand Social and Work Environments

First Meeting NCD-FLAG-PRO-1Saint Petersburg, Russian Federationfrom Wednesday 23 March 2011 (starting at 09:00)to Thursday 24 March (ending at 10:30)(Flag-Pro-1 meeting was continued after the NCD-2 meeting ended in theafternoon 24/3 and continued until Friday 25/3 noon)Meeting venue: Hotel Ambassador, Rimsky-Korsakov Ave., 5-7

Reference NCD-FLAG-PRO 1/2/1

Title Provisional Programme (update 11.03.11)

Submitted by NCD EG Secretariat

Summary / Note This Provisional Programme includes also annotations specifying organizations and other relevant information

Requestedaction

For further elaboration and comments by meeting participants

First day Wednesday 23 March 20118:30 – 9:00 REGISTRATION AND COFFEE / TEA

09:00 -09:10 Opening of the meetingNCD EG Chair Mikko Vienonen

09:10-09:30 “Setting of the scene”NCD EG Chair Mikko Vienonen and Consultant Ms Tamsin Rose

1. Introduction of meeting participants2. Explanation of the scope and purpose of the meeting.

09:30-11:00 Essentials in EU-project planningConsultant Ms Tamsin Rose

LFA (Logical Framework Approach) EU “do’s and don’t’s” Partner requirements (add list…)

Discussion

11:00-11:30 COFFEE / TEA BREAK

11:30-13:00 Group work session I :We split into two groups further elaborating on:1) FLAGSHIP-A Project on healthy nutrition, prevention and correction of

obesity, diabetes-type-2 primary prevention, and physical activity promotionamong school-aged children and youth

2) FLAGSHIP-B Project on health policy and strategy facilitation for NDPcountries (“Stop NCD-epidemic now!: Health policy and strategy support tocombat NCD and hazardous and harmful lifestyle epidemic in NorthernDimension geographical area”)


22

13:00 – 14:00LUNCH

14:00 – 15:30 Group work session II :work continues:

FLAGSHIP-A ProjectFLAGSHIP-B Project

15:30-16:00COFFEE / TEA BREAK

16:00 – 18:00 Group work session III :work continues:

FLAGSHIP-A ProjectFLAGSHIP-B Project

19:00-20:00 DINNER

Second day Thursday 24 March 20119:00-10:30 Feed-back from Group work:

two groups’ elaborations on:1) FLAGSHIP-A Project2) FLAGSHIP-B Project

Discussion

Plans forword

10:30 END OF THE NCD-FLAG-PRO-1 MEETING AND FAREWELL COFFEETOGETHER WITH STARTING NCD-2 MEETING

The NCD-FLAG-PRO meeting participants are warmly welcome to join theNCD-2 meeting, especially as it is the purpose to present the outcome of theNCD-FLAG-PRO-1 results and to discuss and elaborate the plans further

(see NCD-2 meeting programme and agenda for details)


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ANNEX 2. / NCD/ FLAG-PRO-1

EG on Non-Communicable Diseases related to Lifestylesand Social and Work EnvironmentsNCD Project planning meeting, 23.-25. March 2011St.Petersburg, RussiaFinal list of participants

Dr Elena BashninaChief Youth Endocrinologist of St PetersburgPHCSt Petersburg191023 M.Sadovayay,1Russian FederationPhone: 8-921-770-44-58; (812) 296-35-00Fax: (812)296-35-00E-mail: [email protected]

Ms Justyna CarM.D. Public Health SpecialistNational Institute of Public Health - NIHChocimska 2400-791 WarsawPolandPhone: +48 22 54 21 377mobile +48 608 48 40 57Fax: +48 22 54 21 375E-mail: [email protected]

Mr Mikhail KasatkinSpecialistPHSM.Sadovaya, 1191023 St PetersburgRussian FederationPhone: (812) 571-10-96Fax: )812) 315-54-42E-mail: [email protected]

Ms Hanna KoppelomäkiNCD EG International Technical AdvisorNDPHS/FIOH/MoSAHTopeliuksenkatu 41 a A00250 HelsinkiFinlandPhone: +358503808540Fax: +35830 474 2629E-mail: [email protected]

Dr. Anna KorotkovaDeputy DirectorFederal Research Institute for Health CareOrganizationand Information of MoH&SD of RFDobrolubov str., 11127254 MoscowRussian FederationPhone: 8(495)6181109Fax: 8(495)6181109E-mail: [email protected]

Ms Katja LahikainenCoordinatorLappeenranta University of TechnologySkinnarilankatu 3453850 LappeenrantaFinlandPhone: +358400570603Fax: +35856217199E-mail: [email protected]

Mr Marek MaciejowskiHead of SecretariatNDPHSStrömsborg103-11 StockholmSwedenPhone: +46 8 4401938Fax: +46 8 4401944E-mail: [email protected]

Ms Karolina MackiewiczCoordinatorBaltic Region Healthy Cities AssociationVanha Suurtori 720500 TurkuFinlandPhone: +35822514909; +358 40 5075 069Fax: +35822623425E-mail: [email protected]

Dr Yury PetrovHead of the DepartmentInternational DepartmentM.Sadovaya

Ms Elena PfauProject coordinatorInternational DepartmentM.Sadovayay, 1

mailto:[email protected]









24

191023 St PetersburgRussian FederationPhone: (812) 314-52-17Fax: (812) 315-54-42E-mail: [email protected]

191023 St PetersburgRussian FederationPhone: (812) - 314-18-39Fax: (812) - 315-54-42E-mail: [email protected]

Dr. Iveta PuduleSenior Public Health AnalystThe Centre of Health Economics12/22 Duntes StreetLV-1005 RigaLatviaPhone: +371 67501588Fax: +37 67501591E-mail: [email protected]

Ms Tamsin RoseDirectorTamarack72a Rue de la Poudriere1000 BrusselsBelgiumPhone: +32 2 230 34 38Fax: +32 2 230 34 38E-mail: [email protected]

Dr. Rita SketerskieneHead of Public health Care DivisionPublic Health DepartmentVilniaus str. 33LT-01506 VilniusLithuaniaPhone: +370 5 26047169Fax: +370 5 266 1402E-mail: [email protected]

Mrs Anna SkvortsovaExecutive directorNGO Development CenterLigovsky pr. 87, office 300191040 St. PetersburgRussian FederationPhone: +7-812-7183794Fax: +7-812-7183794E-mail: [email protected]

Dr. Mikko VienonenNCD EG ChairNDPHS/NCDSysimiehenkuja 100670 HelsinkiFinlandPhone: +358-50-4421 877Fax: noneE-mail: [email protected]









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ANNEX 3: Useful material produced/collected dueing Flag-pro-1 meeting:

MATRIX DEVELOPED AT FLAG-PRO-1 mtg IN SPb 23-25/3/11 FOR TESTING THE FEASIBILITY OF PROJECT CONCEPTSFOR EACH PARTNERS’ NEEDS AND INTERESTWhat are your criteria for decision-making about joining a project? (mark what is most suitable category for you?)

0= nothing at all for us 5= very relevant for usCriteria 0 1 2 3 4 5Strategic importance of the issue to my organisationBuilds on an area of existing knowledge/strengthResults will be concrete / measurableUrgency for my country/region/cityPartnerships with local and regional authoritiesPartnerships with civil societyPartnerships with universitiesMy organisation gets something from it (publicity, opportunity, knowledge,tools)There is an appropriate role for my organisationScientific relevance (opportunities for publication)Innovative approachOpportunity to learn some new toolsAccess to fundsother criteria (add)other criteria (add)other criteria (add)ANNEX 3 in RUSSIAN:


26

FLAG-PRO-1 23-25/3/2011

, ? ()

0= 5= 0 1 2 3 4 5

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( ) ( ) ( )


27

MATRIX DEVELOPED AT FLAG-PRO-1 mtg IN SPb 23-25/3/11 FOR TESTING THE FEASIBILITYOF PROJECT CONCEPTS FOR EACH PARTNER’s NEEDS ANDINTERESTWhat are your criteria for decision-making about joining a project? (mark what is most suitable category for you?)

Criteria 0 1 2 3 4 5Strategic importance of the issue to my organisation 0 1 0 0 4 2 7Builds on an area of existing knowledge/strength 0 0 0 3 3 1 7Results will be concrete / measurable 0 0 0 1 3 3 7Urgency for my country/region/city 0 0 1 1 1 4 7Partnerships with local and regional authorities 0 0 1 5 0 1 7Partnerships with civil society 0 1 3 2 1 0 7Partnerships with universities 0 1 3 3 0 7My organisation gets something from it (publicity, opportunity, knowledge,tools)

1 0 0 2 2 27

There is an appropriate role for my organisation 1 0 0 1 4 1 7Scientific relevance (opportunities for publication) 0 2 0 2 1 1 6Innovative approach 0 1 1 1 4 0 7Opportunity to learn some new tools 0 1 1 2 2 1 7Access to funds 0 0 0 1 2 4 7

0= nothing at all for us <- -> 5= very relevant for us


28

MATRIX DEVELOPED AT FLAG-PRO-1 mtg IN SPb 23-25/3/11 FOR TESTING THE FEASIBILITYOF PROJECT CONCEPTS FOR EACH PARTNER’s NEEDS AND INTERESTWhat are your criteria for decision-making about joining a project? (mark what is most suitable category foryou?)

Criteria 0 1 2 3 4 5 Total score1 Strategic importance of the issue to my organisation 1 16 10 272 Builds on an area of existing knowledge/strength 9 12 5 263 Results will be concrete / measurable 3 12 15 304 Urgency for my country/region/city 2 3 4 20 295 Partnerships with local and regional authorities 2 12 5 196 Partnerships with civil society 1 6 6 4 177 Partnerships with universities 1 6 12 19

8My organisation gets something from it (publicity, opportunity,knowledge, tools)

0 6 8 1024

9 There is an appropriate role for my organisation 0 3 16 5 2410 Scientific relevance (opportunities for publication) 0 2 6 4 5 1711 Innovative approach 1 2 6 16 2512 Opportunity to learn some new tools 1 2 11 8 5 2713 Access to funds 3 8 20 3114 To satisfy the need given to us by the ministry 5 5

7 respondents: Car, Korotkova, Mackiewicz, Pfau, Pudule, Sketerskiene,Vienonen

0= nothing at all for us <- -> 5= very relevant for us


29

MATRIX DEVELOPED AT FLAG-PRO-1 mtg IN SPb 23-25/3/11 FOR TESTING THE FEASIBILITYOF PROJECT CONCEPTS FOR EACH PARTNER’s NEEDS AND INTERESTWhat are your criteria for decision-making about joining a project? (mark what is most suitable category for you?)

Criteria Total score1 Access to funds 312 Results will be concrete / measurable 303 Urgency for my country/region/city 294 Strategic importance of the issue to my organisation 275 Opportunity to learn some new tools 276 Builds on an area of existing knowledge/strength 267 Innovative approach 25

8My organisation gets something from it (publicity, opportunity, knowledge, tools) 24

9 There is an appropriate role for my organisation 2410 Partnerships with local and regional authorities 1911 Partnerships with universities 1912 Partnerships with civil society 1713 Scientific relevance (opportunities for publication) 17


30

NCD-Flagship project decision making criteria

31 30 29 27 27 26 25 24 2419 19 17 17

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31

Urgency for mycountry/region/city

Access to funds

Results will beconcrete / measurable

Strategic importanceof the issue to my

organisation

Strategic importanceof the issue to my

organisation

My organisation getssomething from it

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Partnerships withuniversitiesPartnerships with

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0

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32

PROJECT TEMPLATE

Context (State the problem that you will address, include information about relevant policy documents or political decisions e.g WHO resolutions)

General objective (Your overall goal in relation to the problem)

Specific project (What you want to achieve with this project and how does that contribute towards the overall goal?)

Activities (How will you address the problem? What activities are you proposing? Identify the different work packages and the organisations that areinterested in leading/participating in the work packages. Note that Coordination, Evaluation and Dissemination are usually obligatory work packages)Work Package descriptions Lead organisation

Participants


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Outputs (What deliverables will be produced - listthese per work package. These should be tangible,concrete and can be quantified)

Outcome (What results will you achieve with youractions? List these per work package. How will thesituation be changed by your project?)

Indicators (How can you measure thesuccess of your actions? List these per workpackage)

Assumptions (What important external factors are preconditions for the project to work? For example, the issue continues to be an EU priority)

Risks (What external factors could affect your ability to implement the project - and what can you do to reduce the risks?)


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COVER LETTER TO THE EXCEL-table Evaluation matrix

This (see Excel) is the evaluation matrix that we developed for the DG SANCO 2010 call for projects.

I would recommend that all project writers run a test evaluation exercise using a 'fresh' pair of eyes before finalising their proposal.

What we did was try to find a way of cross referencing how the evaluators will allocate marks with the way the the application form isconstructed, we tried to identify in which questions the evaluators might look for 'evidence' for the scoring. This is, of course, subjectivejudgement... unless they are given a central tool like this in the Commission, each evaluator takes a different approach.

This Excel file is designed to help the evaluation. On the first sheet there are all of the evaluation criteria listed, with the total points for thatcriteria together with the explanation from the work programme of what they are looking for. On Sheet two, the title of all of the questionnumbers is listed.. so you can easily cross check what question 3.2 was.

At the end of the exercise, hopefully you will have some idea of which criteria you scored slightly lower on and how you could pick up the vitalextra few marks that will allow the project to get funded.

Tamsin RoseStrategic advice on health, civil society [email protected] phone (+32) 486 76 75 57Tel/Fax (+32) 2 230 34 38



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Project Title:Evaluator / DateDate:Overall scoreAward criteria Score Question number

2 2 3 3 3 3 4 4 4 4 4 4 4 4 5 55,3 6 6 6 6 7

1. Policy and contextual relevance of the projects (40 points,threshold 20 points)(a) Project's contribution to meeting the objectives and priorities of thesecond Health Programme as defined in the Work Plan for 2010 (8points), Less focus on new ideas, close fit to work programme, buildingblock for policy x x x x x(b) Strategic relevance in terms of relevance to the EU Health Strategyand in terms of expected contribution to the existing knowledge andimplications for health (8 points) Comprehensive and long termapproach, link in to past work at EU and national level? x x x xContribution to relevant EU policies, contribution to enhancement ofEU citizens health status, facilitate update of new health techniquesand tools by policy-makers? x x(c) Add value at European level in the field of public health (8 points) x x x x x x x- impact on target groups, long term effect and potential multipliereffects, such as replicable, transferrable and sustainable activities- contribution to complementarity, synergy and compatibility withrelevant EU policies and other programmes x x- Does the project address an issue that otherwise would not have beenaddresses by the Member States(d) Pertinence of the geographical coverage (8 points) x xapplication must ensure a geographical coverage of the project isappropriate with regard to its objectives, explaining the role of theeligible countries as partners and the relevance of the project resourcesor target populations they representProposals with national or sub-national dimension (i.e., which involveonly one eligible country or a region of a country) will be rejected


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(e) Adequacy of the project with social, cultural and political context (8points) xApplicants must relate the project to the situation of the countries orspecific areas involved, ensuring the compatibility of envisaged actionswith the culture and views of the target groups

2. Technical Quality of the project (30 points, threshold 15 points)(a) Evidence base (6 points) x x xApplications must include a problem analysis and clearly describe thefactors, impact, effectiveness and applicability of measures proposed(interventions)(b) Content specification (6 points) x x x x x x xApplicants must clearly describe the aims and objectives, target groups,including relevant geographical factors, methods, anticipated effectsand outcomes(c) Innovative nature, technical complementarity and avoidance ofduplication of other existing actions at EU level (6 points) x x x x x x xApplicants must clearly identify the progress the project intends toaccomplish within the field in relation with the state of the art andensure that there will be neither inappropriate duplication nor overlap,whether partial or total, between projects and activities already carriedout at European and international level(d) Evaluation strategy (6 points) x x xApplicants must clearly explain the kind and adequacy of methodsproposed and indicators chosen (process, output and outcomes/impact).A full and independent evaluation is needed(e) Dissemination strategy (6 points) x x xApplicants must clearly illustrate the adequacy of the envisagedstrategy and methodology proposed to ensure transferability of resultsand sustainability of the dissemination (dissemination plan, stakeholderanalysis) Effective and professional, real efforts to distribute?

3. Management Quality (30 points, threshold 15 points)(a) Planning and organisation of the project (5 points)Applicants must describe the activities to be undertaken, timetable andmilestones, deliverables, nature and distribution of tasks, risk analysis(b) Organisational capacity (5 points) x x x


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Description of the management structure, competency of staff,responsibilities, internal communication, decision making,monitoring and supervision(c) Quality of partnership (5 points) x x x xApplicants must describe the partnership envisaged in terms ofextensiveness, roles and responsibilities, relationships among differentpartners, synergy and complementarity of the various project partnersand network structures(d) Communication strategy (5 points) x x x xApplicants must describe the communication strategy in terms ofplanning, target groups, adequacy of channels used and visibility ofCommunity co-funding.(e) Overall and detailed budget including financial management (10points, threshold 5 points) xApplicants must ensure that the budget is relevant, appropriate,balanced and consistent in itself, between partners and in relation tothe specific objectives of the project. The budget should be distributedwithin partners at a minimum reasonable level, avoiding excessivefragmentationApplicants must describe the financial circuits, responsibilities,reporting procedures and controls.Overall score

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