1. It focuses on AIDS, TB, or malaria but is not coordinating or harmonized with global fund activities in country.
2. The staff are all clinicians, with no public health people.
3. The staff are all public health people, with no clinicians.
4. There is no plan to involve local or national health authorities in the project.
5. The project director is a clinician with no management experience.
6. It is planning on developing its own training content instead of adapting existing curricula to the current situation.
7. It depends on practicing physicians to serve as trainers, but has no plan to teach them the skills they will need to become trainers.
8. There are no women on staff.
9. It ignores the role of nurses in health care.
10. The underlying conceptual model doesn’t make any sense or staff have trouble explaining it in a way that makes sense.
11. The only monitoring indicator is how many people were trained.
12. Training success is identified by pre and post tests of participant knowledge instead of testing their skills and whether they are actually using new skills in practice.
Special guest additions:
13. Local partners/beneficiaries cheerfully insist that another expat program manager is the ONLY WAY to make the next phase sustainable… (from Tales from the Hood)
14. It’s a two-year contract and the only local staff are secretaries and drivers. (from Texas in Africa)
15. You visit the public health office and they want to know why you’re taking away their public health volunteers. (from Good Intentions Are Not Enough)
16. The per diem for your capacity building event is less than that for the World Bank project just down the road. (from Ian Thorpe)
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Photo Credit: REDRUM AYS
Chosen because searching for “doom” on flickr gets scary quickly, and my initials are AYS
[…] This post was mentioned on Twitter by Solar Africa, Texas in Africa and Tales From the Hood, Alanna Shaikh. Alanna Shaikh said: New Blood and Milk post – fifteen ways to tell a health project is doomed http://bloodandmilk.org/?p=1433 […]
Love number 11. We’ve had that challenge in our unrelated field of technology dissemination. There’s often a tradeoff between quantity and quality of training. The side that is more easily measured is the one that people usually care about.
Good to see you back,
B
Hey. I’m not sure about number one (and this probably isn’t a ranking). Up front and centre I’d put coordination with local and national health authorities rather than coordinating with wasteful and inefficient funds like GF.
Otherwise, on the money!
A few thoughts about the Global Fund:
1) Whatever you think of their programs, they are likely to be the big fish in most places on AIDS and TB. If your approach is opposed to theirs, you’re the one who’ll be ignored or eliminated, not them. You need to plan for that – that is what I meant by the word “harmonize” – even if you disagree with what they are doing, you can choose a project that goes around them, but you need to know they’re there.
2) I don’t think there is anything inherently wasteful or inefficient about activities that are funded by GF. Instead, I think many CCMs don’t have the capacity to ensure good programs get funding, so it’s a very mixed bag. But GF money is not somehow corrupting to a well planned program.
3) You’re correct it’s not a ranking, just a list.
Hi again. Your first point is fair enough, though there is growing dissatisfaction with the parallel structures of bodies such as the fund, – something the GF will have to respond to and adapt.
Re the second point, I guess I’ve seen the more mixed end of the bag. But I think that structures that are parallel to already established ones and that channel huge resources in pre determined directions will lead to inefficiencies and waste. The inefficiencies and waste may not be seen in any particular GF project (though I have seen such) but be more widely spread through the sector.
forgot to say: I prefer it when you blog here! And have a good 2010