The 7 Steps to an International

Partnership made in Heaven

Prof Tony Ryan, UCC, Cork

1. Projects past and Present

2. What have we learned?

3. The 7 Steps

1. Omdurman Maternity Hospital, Sudanest. 1957

• 26,000 deliveries per annum

• 2002: Return of UK-trained obstetricians.

• Reorganization of obstetrical services.

• Partnership with CUMH (2002-10).

• Logbook (1956-2007).– Evaluate & compare all 60

years of data.

Cork Omdurman Partnership Project

• 24hr consultant cover with handover

• MgSO4 for PET• Prophylactic antibiotics• Thromboprophylaxis• Improved anaesthesia• Antenatal care

Returned Obstetricians

2002• €165,000 Irish Aid• €1.5 million

equipment• Enhanced training &

education• Support &

encouragement

Partnership with CUMH2002-11

Maternal Mortality RatioOMH

2007Ireland: 1/100,000OMH: 36/100,000

(# actual deaths)

725

266

Stillbirths DownNeonatal Deaths Unchanged

30

1916

24

(Ireland)

(6)

(4)

Irish Health Awards Winner 2011

2. Helping Babies Breath

 HBB: The Golden Minute

Current Study

Conclusions

The intervention: Helping Babies Breath

Conclusion

Study design: Pre-Post HBB

80 Midwives

Completed 2013

Sponsorer Irish Aid

The Problem98% of newborn deaths occur in

resource poor countriesEvery year four million newborns die

during their first month of life, 50% dying during delivery and the first

24 hours of life.

The Aim

The PrincipleAt birth, every infant deserves, at least, an initial evaluation and a trial of basic resuscitation efforts

by a trained individual

To reduce neonatal mortality by teaching HBB to Village Midwives

in Sudan

3. CORK - CHACAS JOURNEY

Peru vs Ireland

INDICATOR PERU IRELAND

Population 30 million 4.5 million

Infant Mortality Rate 19 4

Neonatal Mortality Rate 11 2

% of < 5y underweight 6 -

% of < 5y with stunting 24 -

Maternal mortality ratio 98 3

% of population below international poverty line (1.25 U$/day)

8 0

Preventing High Altitude Renal Disease in the Peruvian Andes

Dr. Jackelina Pando-Kelly

Dept of Paediatrics UCC

SCREENING PROGRAM FOR RENAL DISEASE IN CHILDREN IN THE

PERUVIAN ANDES

Operation Mato Grosso in Chagas

• 1970 - Italian volunteers settled in the Peruvian Andes

• 1994 -“Mama Ashu “ Hospital in Chacas – 11,000 ft

The Highest Pub on Earth Paddy Flaherty’s

in Perū

Future Peruvian Projects

Inaugural UCC Medical Student Electives

2012

The 7 steps to a Global Partnership made in Heaven

1. Find a Partner

2. Recognize the importance of Context

3. Get to Know Your Stakeholders

4. Decide your Objectives

5. Use an Outcome Logic Model

6. Design, Develop, Deliver

7. Look for the Stickiness factor in your Project?

Step 1

1. Find a Global Partner– The Law of the Few: the 80/20 principle– Find a Connector– Who are the Influencers? – Who do people turn to when they want to

find out about something?

Step 2. Context is important1. Opportunities arise because of Real World Events

2. Epidemics are sensitive to the conditions and circumstances of the times in which they occur.

Human behavior is sensitive to and strongly influenced by its environment.

3. Persuasiveness is an important skill

Step 3

2. Get to Know Your Stakeholders? – What assumptions are you making

about them?– What do they Want?– What do they Need?– It’s not just about you!

Step 4

Decide your Objectives– Make a Contract – What Resources can you bring?– What Activities need to be done?

Step 5Use an Outcomes Logic Model

1.

Inputs

2.

Activities

3.

Outputs

4.

Outcomes short to medium

term

5.

Impact

Long term Outcomes

In order to accomplish our set of activities, we will need the following:

In order to address our problem or asset, we will conduct the following activities:

We expect that once completed or under way these activities will produce the following evidence of service delivery

We expect that if completed or ongoing these activities will lead to the following changes in 1-3 then 4-6 years

We expect that if completed these activities will lead to the following changes in 7-10 years

Step 6

Sesame Street: Enhanced effective Educational retention in tandem with Entertainment.

Step 7Find the Stickiness Factor

The specific content of a message that renders its impact memorable.

The 7 steps1. Find a Partner

– Find a Connector

– The Law of the Few: 80/20 Principle

– Who are the influencers? Who do people turn to?

2. The importance of Context: Epidemics3. Get to Know Your Stakeholders?

– What do they Want?– What do they Need?

4. Decide your Objectives– Make a Contract – What Resources can you bring?– What Activities need to be done?

5. Use an Outcomes logic Model– How are you going to measure success

6. Design, Develop, Deliver

7. Look for the Stickiness factor in your project

“Now there are Three Steps To Partnership HeavenJust listen and you will plainly seeAnd as life travels onAnd things do go wrongJust follow steps one, two and threeStep one - you find Global Partners to loveStep two - They fall in love with youStep three - You work together and hold them tightlyYeah! that sure seems like heaven to me”

The 3 Steps to an Partnership Heaven

Thank you

The 7 steps1. Find a Partner

2. Context is important

3. Get to Know Your Stakeholders?

4. Decide your Objectives

5. Use an Outcome Logic Model

6. Design, Develop, Deliver

7. What is the the Stickiness factor for your project?

Milgram distributed letters to 160 students in Nebraska, with instructions that they be sent to a stockbroker in Boston (not personally known to them) by

passing the letters to anyone else that they believed to be socially closer to the target. The study found that it took an average of six links to deliver each letter.

Of particular interest to Gladwell was the finding that just three friends of the stockbroker provided the final link for half of the letters that arrived successfully.[17] This gave rise to Gladwell's theory that certain types of people are key to

the dissemination of information.

Step 4Find the Influencers

The tipping point is that magic moment when an idea, trend, or social behavior crosses a threshold, tips, and spreads like wildfire.

Just as a single sick person can start an epidemic of the flu, so too can a small but precisely targeted push cause a fashion trend, the popularity of a new

product, or a drop in the crime rate.

Step 4Find the Tipping Point

The Law of the Few", or, as Gladwell states, "The success of any kind of social epidemic is heavily dependent on the involvement of people with a

particular and rare set of social gifts."[3] According to Gladwell, economists call this the "80/20 Principle, which is the idea that in any

situation roughly 80 percent of the 'work' will be done by 20 percent of the participants.

Step 4Find the Tipping Point

Connectors, are the people who "link us up with the world ... people with a special gift for bringing the world together."[5] They are "a handful of people

with a truly extraordinary knack [... for] making friends and acquaintances".[6] He characterizes these individuals as having social networks of over one

hundred people.

Step 4Find the Tipping Point

Mavens are "information specialists", or "people we rely upon to connect us with new information."[4] They accumulate knowledge, especially about the

marketplace, and know how to share it with others. Gladwell cites Mark Alpert as a prototypical Maven who is "almost pathologically helpful", further adding, "he can't help himself".[8] In this vein, Alpert himself concedes, "A Maven is

someone who wants to solve other people's problems, generally by solving his own".[8] According to Gladwell, Mavens start "word-of-mouth epidemics"[9] due to their knowledge, social skills, and ability to communicate. As Gladwell states, "Mavens are really information brokers, sharing and trading what they know".

[10]

Step 4Find the Tipping Point

Salesmen are "persuaders", charismatic people with powerful negotiation skills. They tend to have an indefinable trait that goes beyond what they say, which

makes others want to agree with them. Gladwell's examples include California businessman Tom Gau and news anchor Peter Jennings, and he cites several

studies about the persuasive implications of non-verbal cues, including a headphone nod study (conducted by Gary Wells of the University of Alberta

and Richard Petty of the University of Missouri) and William Condon's cultural microrhythms study.

Step 4Find the Tipping Point

The Power of Context: Human behavior is sensitive to and strongly influenced by its environment. As Gladwell says, "Epidemics are

sensitive to the conditions and circumstances of the times and places in which they occur."[11] For example, "zero tolerance" efforts to combat

minor crimes such as fare-beating and vandalism on the New York subway led to a decline in more violent crimes city-wide. Gladwell

describes the bystander effect, and explains how Dunbar's number plays into the tipping point, using Rebecca Wells' novel Divine Secrets of the Ya-Ya Sisterhood, evangelist John Wesley, and the high-tech firm W. L. Gore and Associates. Gladwell also discusses what he dubs the rule of

150, which states that the optimal number of individuals in a society that someone can have real social relationships with is 150.[12]

Step 4Find the Tipping Point

Real world events

Changing minds

• In his latest book, Harvard psychologist Howard Gardner offers insights into the phenomenon of changing minds. Why is it so mysterious? How do people become set in a certain way of thinking? And what does it take to change a perspective? As he did in previous books about intelligence, creativity, and leadership, Gardner challenges traditional thinking. He draws on decades of cognitive research to show mind change not as a sudden “epiphany” but as a gradual process that can be actively and powerfully influenced. He identifies seven levers that aid or thwart the process of mind change and provides an original framework that shows how individuals can align these levers to bring about significant changes in perspective and behavior.