Doris Duke Charitable Foundation African Health Initiative

Doris Duke Charitable Foundation’s Mission Improving the quality of people's lives through: The performing arts Environmental conservation Medical research The prevention of child maltreatment Preservation of the cultural and environmental legacy of Doris Duke's properties

Challenge from Foundation’s Board Ideas for new grantmaking initiatives –fit within foundation’s general grant making programs, but be “new and catalytic” In 2007, two $100 million initiatives were launched. –Environment Program - Climate Change Initiative –Medical Research Program - African Health Initiative

African Health Initiative Goal: To help catalyze a shift from the current focus on single disease programs, to an emphasis on strengthening health systems that are able to deliver integrated primary care to underserved populations Specific Aims: Increase the knowledge required for evidence-based health systems planning Achieve significant, measurable health improvements in up to 6 communities/districts in sub-Saharan Africa Strengthen health systems in those regions in a manner that enables local and national governments to sustain those improvements

Approach: Fund up to 6 Population Health Implementation and Training (PHIT) Partnerships $8 to $16 million each to support: –Delivery of integrated primary health care to populations of >250,000 –Strengthening of regional health systems –Implementation research to measure what works

Implementation Research Each PHIT Partnership is expected to design an implementation research plan that includes: -Program evaluation -Economic evaluation and; -Monitoring and operations research. Implementation Research Framework - developed by the Institute of Health Metrics and Evaluation provides a starting point for applicants.

PHIT Partnership Selection Process February teams invited to submit planning grant proposals October 2008 Awarded 6 month Planning Grants to 11 teams June 2009 Award PHIT Implementation Grants to up to 6 teams September 2007 Call for Letters of Interest

The Challenge: Translating Evidence to Policy What information is needed? –Within the original country –Before transfer to another country How to evaluate conflicting evidence? What happens when evidence conflicts with current accepted practice?

The role of science academies Sifting all evidence Analyzing the reasons for disparate results Looking at context—can one country’s success be transferred across borders? Challenging projects like this one to produce evidence of maximum utility