FK Norway – Asia Health Research project

Organization(s): FK Norway (Fredskorpset), FK Norway is a public body answerable to the Norwegian Ministry of Foreign Affairs. FK Norway is the funding and facilitating agency in the project. The other organizations (partners) participating in the project are: - Epidemiology Unit, Faculty of Medicine, Prince of Songkla University (PSU), Thailand -Center for Research Training and International Relations (CRTIR), Nepal -Sekwa Eye Hospital, China -Impact Foundation (IFB), Bangladesh -State Research Center on Maternal and Child Health and Human Reproduction (MCH Center), Mongolia

Country (ies): Norway is the funding and facilitating country. Countries participating in exchange of professional staff are Thailand, Nepal, China, Bangladesh and Mongolia.

Overview: This exchange project was established in 2006 aiming to strengthen research capacity and human resources of participating organizations (referred to as partners), in particular with respect to their epidemiological and community health research abilities. Particular goals are to expose and train younger staff of the respective institutions, improve techniques and methodologies of research, and to improve service delivery. To achieve this, the project facilitates one-year international exchange of personnel within the framework of institutional cooperation, supported and facilitated by FK-Norway. The project is implemented under a 6-year time frame and is currently in year 5. A total of 23 participants have been exchanged so far.

Background: FK Norway funds and facilitates reciprocal exchanges of personnel between organizations in developing countries, a facility which is called the South-South Programme. This can be utilized by the organizations as a tool for transfer of competence, organizational development and capacity building. FK Norway is open for project applications from Norway or from the south. The organizations participating in a project can be public, private or within the civil society sector. The Asia Health Research Project applied first time in 2006.

Sekwa Eye Hospital was formerly involved in an FK Norway North-South exchange project with University of Tromso, Norway. They concluded that a South-South exchange would be more relevant to Sekwa Eye Hospital and other organizations in Asia as regards needs, problems and technical skills to be shared in the region. Through the connections of University of Tromso they identified potential new partners from within Asia and the first planning meeting was held by potential partners and FK Norway in 2006.

The partners agreed that Prince of Songkla University would act as the lead administrative partner of the project. University of Tromso acted as a facilitator to help bring the potential partners together but is not a partner in this South-South project.

Although each partner has different background in research, the partners have set a common objective to strengthen research capacity. The partners have agreed to develop their research capacity and human resources contributing to better health services in the community and country.

Epidemiology Unit, PSU have been very active in national and international research and research training activities. Most of the past actions (prior to the FK project) were carried out by senior staff. It is important for young staff to gain more experience in research consultation and be exposed to other research fields. This would enhance staff capacity and contribution role of PSU to research capacity of others.

Sekwa Eye Hospital mainly provides clinical and surgical ophthalmic practices. There are few available experienced research staff and research activities in the organization. The hospital wants to set up a health research unit comprising well-trained research staff and high-quality research outputs related health care services of the hospital and in China.

Stupa Health Care Centre Co-operative (SHCCC) has three wings— Nepal Institute of Health Science (NIHS) which is an academic institute, Stupa Community Hospital which provides health care services, and CRTIR which is in charge of research activities. CRTIR wants to strengthen research capacity through increasing number of experienced researchers and research outputs on public health issues of country. This would enable CRTIR to support the hospital and academic wings and better serve the needs of the community.

Impact Foundation Bangladesh has provided services to improve living standards of rural poor through preventing causes of disability and through health promotion. There are few research experiences and utilizations of medical databases in research. IFB want to increase their research capacity so that it could improve quality of their services.

MCH Center is a research institute on reproductive health in Mongolia and responsible for comprehensive maternal and child health services and prevention but there are few young experienced researchers. The center wants to increase the number of experienced young researchers in producing high-quality research outputs.

By the end of 2009, this South-South programme had facilitated the exchange of 23 participants between the 5 participating institutions/countries, within a broad range of health professions and management functions.

Implementation: Under the framework of the FK Norway exchange program, the partners send out their staff/personnel to work with another organization in another country, and host the staff/personnel from other organizations (we refer to them as exchange participants) to work with them for a period of 10 months. During the exchange, the exchange participants share their professional skills, knowledge and experiences with the host organization and at the same time bring back newly acquired knowledge, skills and experience to their sending organization and community. This signifies reciprocal learning.

All partners are required to send out and receive exchange participants. The age of exchanged participant is between 22-35 years old because they are potential to be future leaders/managers in their organizations and in their countries.

One round of the exchange project usually lasts for one year. There is a planning meeting with all potential partners and FK before the start of the exchange. The project starts with recruitment of exchange participants. The partners are encouraged to recruit the exchange participants within the office or from the network so that the knowledge transfer from the exchange participants can be more sustainable. The process continues with 1 month for exchange participants to attend preparatory training organized by FK to prepare them for working and living abroad; 10 months for posting abroad; a mid-term review among partners half-way through the posting period; 1 month for exchange participants to conduct activities to transfer the acquired knowledge and skills to their organizations and society; a debriefing meeting for all partners and exchange participants together to review and share experiences and results of the exchange.

The details of the project ie goals, needs, skills to be shared, types of staff to participate in the exchange, roles and responsibilities of partners, budget are made at the partner planning meeting held before the start of the project. Partners are responsible for recruiting the exchange participant, preparing themselves to send/receive participants, develop the work plan with the incoming participant, supervise the incoming participant while they are in the host country to help them to achieve their work objectives, ensure that that the new skills are transferred from returning participants back into the home organization.

One partner in the project is assigned to be a lead partner to coordinate the project and communicate between Fredskorpset and other partners and exchange participants, in this case, PSU. The lead partner is contractually responsible to FK Norway.

FK Norway has the role in explaining the exchange program framework, sharing best practices collected from other exchange projects, facilitating partner and participant preparatory courses and debriefing, providing guidance and recommendations to the partners, monitoring and evaluating the project (parallel to that of the partners) and providing financial support.

Outcomes: The outcomes of the exchange project can be found at individual and organization levels. The impact at the society level is not clearly shown yet as the project is still in progress and analysis requires more time.

Individual level
At the individual level, the exchange participants have enhanced their theoretical knowledge and practical experiences in conducting health research in various contexts such as in terms of community public health issues, clinical health researches, research database management, research consultation and manuscript preparation. Additionally, as English is a working language, all exchange participants have improved English communication skills and become more confident in their communication. Working in another country for a long period also makes the participants more culturally sensitive and have better understanding of self and others. We believe the improved communication skills, familiarity of other norms, greater self-confidence, exposure to and developing networks serves to make the exchange participants future leaders, stakeholders and players in international cooperation. There are a number of examples to be quoted of impressive career developments of former exchange participants.

Organisational level
At the organization level, the exchange project has contributed to better relationships and increased collaboration among the partners in the project. Through the works of exchange participants, several collaborative research projects that reflect public health problems in the partner countries have been initiated and conducted. In addition, publication in national and international journals has also been achieved. With the supervision of PSU, four research manuscripts have been published in reputable national and international publications, which is evidence that the research outputs are of high standard. Additionally, four manuscripts have been recently completed and submitted for future publication.

Though the project is still ongoing, we see that several of the organizational aims of the partners in the exchange project are being achieved:
PSU is underway to realize their goal to strengthen research capacity and human resources in Asia, to make strong linkages in public health research in partner countries, and to enhance research experiences of young staff.

Sekwa Eye Hospital has established an epidemiological research unit that has the potential to support health care improvements for Beijing and China. Their capacity on data analysis has been strengthened, and new research projects on community eye care study and epidemiological molecular genetic studies have been started. With the facilitation of Epidemiology Unit, PSU, the research collaboration between Sekwa Eye Hospital and School of Public Health of Beijing University was established. As a result, the collaborative proposal on diabetes has been submitted to the Chinese Medical Broad.

CRTIR in Nepal has submitted their research proposals to the University Grant Committee, and academic research activities have become more active in NIHS. As a result, the Nepal Health Research Council has granted the permission for NIHS to set up an Institutional Review Committee for future ethical clearance of any research projects proposed or conducted in NIHS.

Impact Foundation Bangladesh has realized the importance of strengthening research capacity and plan to establish a research position in the organization chart.
In Mongolia, the MCH Center has more young researchers who have been involved in national and international health researches. The results of the MCH Center and Impact Foundation are yet to be clearly shown, since the partners joined the project at a later stage.

As an unplanned outcome of the exchange project, the partners have also expanded their network domestically and internationally. For example, Epidemiology Unit, PSU have beyond the project established a network with University of Oslo since 2007, resulting in several fellowships and guest lecture invitations.
Sekwa Eye Hospital has been granted the national project on community cataract screening by the Chinese government. It has established a collaboration project with HOVE Medical Incorporated, Norway on hospital information management, and cooperated with Beijing Tongren Hospital and Beijing Chinese Medicine University on community research related to age-related macular degeneration and diabetes retinophathy. CRTIR has established a new cooperation between NIHS, Bangladesh Institute of Health Sciences and University of Aberdeen on student exchanges.

Aid Effectiveness: This exchange project is a good example how organizations in the south can benefit from working together and sharing their experiences for their mutual benefit. The current results of this exchange project show that the model of FK Norway exchange can be an effective tool for sustainable development at individual and organizational level. We think there can be outcomes at social level as well but as the project is still in progress the outcomes are still emerging.

As organizations participating in the project each define their own objectives, the project reflects the need of the organizations involved. FK Norway does not define the goals for the partners. Equally important, as the partners have to plan and implement the exchange project together, it creates a sense of ownership to the project which stimulates greater commitment.

The exchange project does not involve only one country. It involves partners from different countries and the partnership reflects the goal and priority of partners themselves within the framework of national priorities.

At this stage, this FK Norway exchange project as a whole does not coordinate with other programs and development actors. However, the partners may coordinate with other development actors individually. For example, PSU and MCH Center have worked closely with World Health Organizations (WHO) as part of the exchange project activities.

Capacity Development: The FK Norway program concept accomplishes different things from one platform. The program works at individual skills development level; organizational human resource development and organizational capacity building; targeted social impacts; international networking, collaboration and understanding, and ultimately helping to create and sustain an enabling environment of sustainable development and peace.

Individual Level
Upon completing the exchange program, participants feel that they improve English communication skills, become more confident and independent, are more culturally sensitive, have better understanding of self and of others and have better career advancement.

In most cases, participants have improved their technical and/or management skills relevant to their work. These skills would vary depending on the posting and project. They also establish professional and personal networks with other participants and partners. In some cases, the participants demonstrate strong leadership.

Institutional Level
Change at institutional level can be divided into three broad categories. First, organizations/partners develop technical knowledge/skills specific to theme of the project. Second, there is an improvement in the management and administration in the partner’s organization; this includes financial management, human resource management, communication, IT and database management. Third, most partners/organizations expand their network and establish relationship with FK’s partners and participants as well as other people/organizations attending FK events. In several occasions, the network leads to collaboration beyond the exchange program.

Social Level
We encounter some difficulties in assessing change at the social level. It may be generally stated that the partners’ work, in one way or another, contributes to social, political and economic development. But it is difficult to define the scope of social level. i.e. whether it refers to society in a large/generic context, specific geographical area/demographic group or both. Based on our experience and current monitoring and evaluation template, it is very difficult to assess the direct impact of the exchange program if the scope is large/generic.

On the other hand, it is possible to assess the impact and claim attribution to society if the scope of society is more specific to a certain geographical area/demographic group/target group or partner. In most cases, we become aware of such change through partners’ testimonial, discussion with partners and narrative report.

Goal of PSU at the social level is to create a climate of trust, friendship and strong long-term relationship among people in the conflict affected areas in Southern Thailand. PSU has four campuses in South of Thailand some of which are in conflict areas. The staff and students of the campuses come from the local community. The FK exchange participants are recruited from the local community. PSU actively engages people from different religious and cultural backgrounds in order to create inclusiveness and understanding. They have contact persons in the different communities who in turn will network with each other in order to support greater communication, trust, cooperation and peace among the local communities.

Duration: There are 6 rounds of exchange for this particular project; the project is still ongoing. Phase 1: 2006-2007, Phase 2: 2007-2008, Phase 3: 2008-2009, Phase 4: 2009-2010, Phase 5 2010-2011.

Budget (Optional): The total project budget from 2006 - 2010 is USD 881.000. The project is ongoing and budget from 2010 onwards is not included. Breakdown 2006-2010: - PSU, Thailand: USD 395.000 - CRTIR, Nepal: USD 114.000 - Sekwa Eye Hospital, China: USD 156.000 - Impact Foundation Bangladesh, Bangladesh: USD 93.000 - MCH Center, Mongolia: USD 123.000

File (Optional): Participant story--Doctor Ding.doc

Name of Primary Contact Person: Dr. Virasakdi Chongsuvivatwong

Title of Primary Contact Person: Professor and Chairperson, Epidemiology Unit, Faculty of Medicine, Prince of Songkla University

City: Songkhla, Thailand

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