Strategic Plan

Centre for International Child Health

BC Children’s Hospital and

Child & Family Research Institute

STRATEGIC PLAN 2011 to 2015

1. Background

In 2004 the BC Children’s Hospital (BCCH) in partnership with the Child and Family Research Institute approved the creation of the Centre for International Child Health to be located at the BCCH. The creation of the Centre for International Child health (CICH) was made possible by funding support received from the BC Children’s Hospital Foundation.

The CICH was established to:

i. focus and support the international activities of child health professionals from the BCCH and UBC,

ii. help build expertise and capacity within BCCH, UBC and our partner organizations in conducting projects in least and mid-developed countries, and

iii. support the engagement of trainees in global child health

From its very beginning, the aim has been to develop international partnerships within which capacity building, support for quality health services and applied research could be conducted, with an initial focus in China, South Asia and Uganda because of important historical relationships.

2. A Global Health Conceptual Framework

The terms “international” or “global” health are subject to a wide range of interpretations and, therefore, expectations. While not wanting to oversimplify this, the CICH was created to strategically position the BC Children’s Hospital and UBC as an effective international player in child health. Our partnerships directly aim to improve the health and well being of children and mothers, in particular those most vulnerable and those living in less developed settings or countries.

Nearly 8 million children under the age of five die from preventable illnesses each year. Of all these deaths, 98% occur within least developed and emerging economy countries, in particular among the poor. While under-five mortality rates are improving in many regions of the world, progress lags far behind what is required to meet the maternal and child survival Millennium Development Goals set for the year 2015. In several sub-Saharan countries the situation is actually worsening. Of the 67 countries defined as having high child mortality rates, only 10 are currently on track to meet the MDG target.

Least developed countries can generically be described as severely limited in material and human resources and in their capacity to deal with an overwhelming array of urgent problems. Within their under-funded health systems, health workers are inadequately supported and underpaid. Strengthening capacity through training and opportunities for self learning, improved pro-poor health policies and decision making, and the provision of essential equipment and supplies will be critical challenges for any developing country and those who partner with them in the effort to reduce unnecessary deaths and improve the health of children and their families.

Countries with rapidly emerging economies, such as China and India, have a considerably strengthened resource base upon which to reform their health systems and the delivery of services. Nonetheless, they face enormous challenges in terms of the health needs of their rural and urban poor populations, persistent poverty, inefficient health systems and insufficient local clinical and public health capacities. 

The CICH is well positioned to strengthen local capacities through the transfer and exchange of knowledge and appropriate technologies that will impact on the above raised issues. These skills need to address clinical, public health and rehabilitation sciences without creating artificial boundaries between them. To do this will require the involvement of BCCH staff (in partnership with other UBC faculty, local institutions such as the BC-CDC, and Canadian non-governmental organizations) with competencies in all aspects of global health, including an understanding of health systems and how capacity building can most effectively reach those in greatest need. Thus, an important goal of the CICH will be to develop projects that go beyond institutional partnerships and are better positioned to have a lasting impact on child health through more effective integration into host country health systems and service delivery. This will necessitate greater attention being paid to a wider range of health determinants (e.g. social and environmental) and to identifying local public, private or NGO sector leadership able to influence policy and the delivery of health services to those in greatest need.

3. Vision, Mission and Guiding Values

Vision: Through international partnerships, the CICH can strengthen the delivery of sustainable health services that enhance the likelihood children will reach their full health potential, in particular among those at greatest risk due to poverty and underdevelopment.

Mission: In partnership with host country institutions, to exchange knowledge, skills and best practices that will strengthen our combined ability to reduce preventable deaths and improve the health and well being of children and their families globally.

Guiding Values

• Promoting health, reducing disease burden and saving lives among children and mothers
• Linking the health of children to the health of mothers
• Health equity in terms of gender, socioeconomic status and where one lives
• Universal access to health care
• Respecting the rights of children
• Ethical and transparent conduct of projects
• Generating new knowledge directly applicable to the delivery of health services
• Knowledge translation
• The integration of public health and clinical services within strengthened health systems
• Equal partnerships with reciprocal benefits

4. CICH Strategic Directions 2011 - 2015
 
4.1 International Partnerships

Projects offer the opportunity for BCCH staff to be actively engaged in a global health activity under an institutional arrangement. Project development can either be led by CICH staff or by BCCH staff with our support. It is essential is that projects have institutional and divisional support plus ownership and not be founded upon the personal interests of individuals.

Cross-cutting themes: Projects undertaken by the CICH will include consideration of the following:

• Human resources for health and capacity building
• Health systems
• Health behavior change communication
• Equity
• Poverty (reaching the poorest)
• Development to delivery research and evidence-based decision making
• Bringing proven, appropriate interventions or programs to scale

Goal:

1. Building upon the expertise that exists within the BCCH and UBC, the goal is to conduct interdisciplinary projects in partnership with least or mid-developed country institutions or organizations that address high priority health issues identified by the host country. While not excluding any opportunity, priority will be given extending existing bilateral relationships in China, South Asia (Bangladesh) and East Africa (Uganda). We will aim have a minimum of one active initiative in each of the three regions.

How:

• Create a CICH project start-up support team
• Monitor new funding opportunities from government and private sector donors.
• Work with the BCCH Foundation in support of CICH fund raising, including presentations and stewardship of existing or potential donors.
• Prepare solicited and unsolicited concept and project proposals in collaboration with BCCH/UBC staff and international partner institutions.
• Network and link project development with other international/global health centres at UBC or within PHSA.

4.2. Pediatric residency training in global health

There is unparalleled interest in international health among young Canadian health professionals. This includes UBC pediatric residents, many of whom have chosen UBC because of the opportunities offered in global health.

Goals:

1. All pediatric residents trained at BCCH will have core global health competencies, as defined by the Canadian Pediatric Society and the Royal College of Physicians and Surgeons of Canada.
2. Pediatric residents with global health career interests will receive a core global health curriculum and be provided opportunities for field placements ranging from 1 to 6 months.
3. Establish a 1 to 2 year fellowship in global pediatrics.

How:

• Create a global health residency training committee that addresses curriculum, field placements and career opportunities.
• Elective training sites will be created in South Asia, East Africa and Latin America that offer training experiences for residents (and other BCCH trainees).
• Advocacy within the Royal College for the designation of global health as a “discipline”
• Membership in the Global Health Education Consortium (GHEC) and Consortium of Universities for Global Health (CUGH) which provide access to training curricula and materials as well as networking with other global health centres across North America.

4.3. Global health awareness

The large majority of BCCH staff, though keenly interested in global health, will not be directly engaged. Nonetheless, they want to be supportive and better informed of local and international initiatives addressing health disparities in less developed countries. These initiatives can be extended to include PHSA staff, academic faculty and the general public. Furthermore, this offers an opportunity to highlight the benefits of international partnerships, both here in British Columbia and abroad.

Goals:

1. BCCH staff are aware of the CICH and its international health initiatives.
2. Interested BCCH, UBC and PHSA staff be knowledgeable of Canadian and international initiatives addressing global child health.

How:

• In collaboration with the other UBC clinical specialties, host monthly International Health lectures
• On a bi-annual basis, host the Don and Liz Hillman Lecture in Global Health
• Present at least once per year at Department of Pediatrics grand rounds
• Preparation of an annual CICH report for general circulation
• Maintenance of a CICH website describing and updating its activities and providing links to other relevant Canadian and international programs.

4.4  Global health – BCCH
At present global health initiatives exist within pediatrics (CICH), surgery (OPSEI), anesthesia (Pediatric Anesthesia Research Team), and at BC Women’s Hospital (BCW). These are not organizationally or operationally linked.

Goal:

1. Global health activities within the BCCH and BCW be clearly organized based upon agreed operational directives and coordination of effort.

How:

• Establish a consensus among leadership in each of the global health activity centers existing within the BCCWH and make recommendations to the Presidents of Children’s and Women’s, respectively.

4.5. Global health – UBC

At present there exist several global health “silos” across UBC. These include groups representative of the basic sciences, public health and nutrition, clinical disciplines and the social sciences.

Goal:

1. Integrate the activities of CICH into a linked network of global health initiatives across UBC to be referred to as “Global Health –UBC”.

How:

• CICH will support and participate in any initiative to organizationally coordinate or integrate its activities into those of Global Health-UBC.

4.6. Global health research: Child & Family Research Institute (CFRI)

Traditionally, the international health projects supported by CICH have focused on training. More recently this has begun to change, with research studies underway or recently completed in South Asia, China, and Africa. It is important to recognize that research findings carried out in developed country populations in many, if not most instances cannot be directly translated to developing country populations.

Goal:

1. Develop, obtain funding and conduct implementation research protocols that address priority health issues in each of the countries the centre is actively engaged in.

How:

• Respond to call for proposals under the Canadian Global Health Research Initiative and Grand Challenges Canada.
• Seek funding from private research foundations.
• Include research and evaluation activities within future project performance frameworks.

5. Management, Governance and Financing

5.1. CICH Operations

To support and maintain the activities of CICH, the following staff are required:

Centre Director

Manager

Program Coordinator

Administrative and Financial Assistant

Depending upon activities and external funding support, human resource requirements could change.

5.2. CICH Governance

Steering committee will be made up of:

• President, BCCH
• Chair, UBC Department of Pediatrics
• President, BCCH Foundation
• Executive director, CFRI

If applicable, changes in CICH mandate will be reflected in committee representation. This could be broadened to include:

• Chairs, Departments of Pediatric Surgery or Anesthesia
• President, BCW

Reporting accountability:

The Director, CICH reports to the President, BCCH or his/her designated intermediary.

5.3. Financing

The CICH will continue to work with BCCH, BCCHF, UBC pediatric department and CFRI to identify and secure resources necessary to cover operational costs, support new project development and engage additional professional staff.

Goals:

1. Establish a long-term funding formula that covers the operations costs of CICH at a minimum of $350,000 per year.
2. Increase the CICH endowment fund from its current $1.8 million to at least $5 million.
3. Identify funding to support two or more pediatric global health fellows per year.