1
pageSTRATEGIC PLAN 2020
Foreword . . . Executive Summary . . . 1. The Institution and the Country . . .
ICDDR,B: A brief history . . .
a. . . .
Current and future health situation in b.
Bangladesh . . . Challenges and opportunities . . .
c. . . .
2. The Strategic Planning Process . . . 3. ICDDR,B Strategic Plan 2020 . . .
a. Contribute to the improvement in health of the Bangladeshi population through effective translation of knowledge and
research at a national level . . . b. Achieve excellence in the priority areas of
research . . . c. Provide services that support the Mission
statement by leveraging research and the
generation of knowledge . . . d. Develop organizational capacity to achieve
identified objectives . . . . . . 4. Making the Plan Work . . . 5. Monitoring and Evaluation . . . 6. Conclusion . . . 7. Acknowledgement . . . Appendices . . .
Glossary of Terms . . . Abbreviations and Acronyms . . .
Contents
1 2 7 7
8 11 13 14
14
15
19
20
22
23
24
24
25
25
25
1
pageForeword
Following the Board of Trustees (BoT) meeting in November 2007 and the discussions concerning the future direction of ICDDR,B in terms of research and services, the senior management team met to discuss how a Strategic Plan for the next ten years to 2020 should be created. As soon as discussions began, it was clear that while the current Strategic Plan addressed many issues facing the Centre when it was written, the organisation now faces very different challenges, and the focus of many international health agencies has shifted to other areas, such as re-emerging and non- communicable diseases.
Therefore, instead of merely updating the current Strategic Plan, we decided to follow a more indepth approach. We contracted the services of Deloitte & Touche Consulting India Pvt. Ltd., part of Deloitte Touche Tohmatsu, and together developed the process by which we could create a plan that would address current issues, be actionable, flexible and above all, be evaluated on an ongoing basis. For any plan to be effective, we realised that it would be necessary to obtain the full cooperation and “buy-in” of the staff so that everyone would work towards achieving the agreed objectives. It was also felt that to create a plan that was both acceptable and included the traditional activities of the Centre, we had to involve our staff, partners and collaborators, since they were the ones with the most knowledge and experience in the areas under discussion. The work was divided into two parts: the first was to determine what we could do; and the second to determine what we wanted to do.
With this in mind, we embarked on a series of all-inclusive activities and discussed, debated and questioned areas in which we were already working, new areas of research that we wanted to include, the services currently being offered by ICDDR,B, and those that we needed to increase or add as part of our research and social responsibility to the people of Bangladesh. To complete the plan, we incorporated proposals to meet the increasing demand for ICDDR,B-led training both internally and externally, and to enhance our partnership with the James P. Grant School of Public Health at BRAC University.
The new Strategic Plan is the result of the time and effort of many who work at the Centre
scientifically, academically and administratively, as well as our partners who continue to support the development of ICDDR,B. The approach has been inclusive and encompasses all perspectives, and for this reason we believe that the resulting Strategic Plan for the years 2010–2020 is transparent, can be managed, put into action, and evaluated – in other words, a plan that has perfect vision, the ICDDR,B Strategic Plan 2020.
Alejandro Cravioto Executive Director
November 2009
Foreword
2
pageExecutive summary
INTRODUCTION
The International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B or the Centre) is a health research institute located in Dhaka, the capital city of Bangladesh. Established in 1960 as the Pak-SEATO Cholera Research Laboratory, ICDDR,B had two key objectives, namely to research and understand the causes of diarrhoeal disease, and to provide treatment to the people of Bangladesh affected with diarrhoea. Today, the Centre’s scope and vision have expanded with programmes being managed and developed in child health, infectious diseases, vaccine sciences, reproductive health, population sciences, health systems, poverty and health, and HIV/AIDS. After five decades, ICDDR,B continues to be at the forefront of research development and application.
The new Strategic Plan, which will run from 2010 to 2020, needed to be considered and
developed according to the changing trends and needs both locally and globally in the healthcare and research sectors.
The new Strategic Plan 2020 was created following a planning process managed by Deloitte &
Touche Consulting India Pvt. Ltd. that involved a number of workshops, interviews and discussion
groups with staff members from the Centre, external stakeholders, core donors, Government of
Bangladesh agencies and collaborating institutions and organisations. Each planning activity was
analysed in context of the current and future health situation in Bangladesh, the challenges facing
and opportunities available to ICDDR,B and the redefined Vision, Mission and Guiding Values of
the Centre.
3
pageTHE STRATEGIC PLAN 2020
The strategic objectives of the plan were identified as follows:
a) Contribute to the improvement in health of the Bangladeshi population through effective translation of knowledge and research at a national level
b) Achieve excellence in the priority areas of research
c) Provide services that support the Mission statement by leveraging research and the generation of knowledge and its effective application
d) Develop organizational capacity to achieve identified objectives i) Research Themes, Types and Programmes
More flexibility in the nature and type of research will be achieved through the management of programmes across broader research themes allowing greater opportunity for more extensive and multidisciplinary studies. The themes are: Healthy Life Course, focusing on factors that affect the health and well-being of the population from birth to old age, such as population characteristics,
Executive summary
GUIDING VALUES
Excellence in research, training and service High ethical standards
Promotion of human rights, gender equality and diversity
Open and responsive to change Partnership development
Needs of the poor and vulnerable as a priority
Environmental awareness and sustainability Transparency and accountability
Fiscal prudence
VISION AND MISSION
Vision
Healthier people – Better lives through evidence-based solutions
Mission
We will help solve significant
public health challenges facing
the people of Bangladesh
and beyond, especially the
most vulnerable, through the
generation of knowledge and
its translation into policy and
practice.
4
pagegenomics and lifestyle; Mitigating Risks and Vulnerability encompassing research that identifies and modifies the factors and choices, which influence health and quality of life; Combating Priority Diseases concentrating on disease burden and the development of strategies for preventing and treating diseases that have a high public health priority; and Equitable Health Systems, which will include research relating to the development and evaluation of systems that provide access to quality services, information, medical interventions and technologies for all sectors of the population.
Within these thematic areas, research will be categorised according to one of four types within what is known as the “4D framework”, allowing the focus of ongoing and future research in the Centre to be assessed. The 4Ds are Discovery, Development, Delivery, and Delivery Evaluation, which respectively represent research concerning the nature and causes of a problem or issue;
research that develops solutions or a response to a problem or issue; research that delivers these solutions; and research that evaluates whether the delivery of the solutions is having the desired impact.
The research programmes that will be carried out within the 4D framework according to the research themes will include, but will not necessarily be limited to:
Reproductive Health
Child Health and Development Nutrition
Infectious Diseases and Vaccine Sciences Health Systems
Population Sciences Poverty and Health HIV/AIDS, TB, Malaria
Environmental Health, Urbanisation and Climate Change Non-Communicable Diseases
Gender, Health & Human rights ii) Supporting Services
The term “services” was redefined during the strategic planning process to denote any activity or series of activities provided as a solution to an external recipient. The planning process considered this redefinition and categorised its services into three main areas:
i) Services that translate the research expertise of the Centre into income-generating activities ii) Humanitarian services in response to emergencies, both within and outside Bangladesh
Executive summary
5
pageiii) Support services that are not linked to research but which have the potential to generate
income
The income-generating services will manage and run programmes as diverse as counselling and advisory services on child nutrition, micronutrient deficiencies, lipid disorders and obesity, through clinical trials and access to demographic surveillance data, to external training and capacity building of health professionals. Meanwhile, with its decades of expertise in the treatment of cholera and dysentery and the management of large epidemic outbreaks, ICDDR,B will continue to support other nations facing these problems. Non-research related services will be offered through a full range of clinical and diagnostic services, and the Centre will open a blood bank.
iii) Organisational Management
In many organisations, the main asset is their staff and ICDDR,B is no exception to this. The expertise and experience of the physicians, scientists, technicians and support staff will continue to ensure that objectives are met and the Strategic Plan 2020 is followed and achieved. ICDDR,B is committed to building a world class culture for attracting, retaining and nurturing the right talent through a number of key initiatives.
Executive summary
6
pageIn order to attract the best talent from around the world, ICDDR,B is committed to implementing the processes and practices, and providing the facilities and equipment associated with a Centre of Excellence. Structured training programmes covering both technical and behavioural competencies are being developed, as well as management training courses in areas such as communication, team building, leadership skills and mentoring. The Strategic Plan 2020 also includes additional initiatives to enhance and expand the existing gender equality policy as it moves forward into the second decade of the century.
Environmental responsibility continues to be a major policy of the Centre and ICDDR,B is
committed to promoting sustainability and environmental awareness at all levels of decision making.
The Strategic Plan 2020 includes requisite safeguards to ensure that the Centre reduces energy consumption, purchases renewable, reusable, recyclable and recycled materials to the maximum extent possible, minimises the generation of solid and hazardous waste, conducts environmentally significant research, employs non-toxic materials for research purposes, and avoids research and activities that may have a detrimental impact on the environment.
MAKING THE PLAN WORK
In order for any plan to work, the organisation needs to ensure that the plan has “buy-in” and that its infrastructure and codes of conduct and practices are aligned to support the initiatives outlined in the plan. Through human resources, organisational development, financial management, and information technology investment, ICDDR,B will provide suitable support to enable the Strategic Plan 2020 to be implemented and achieved.
MONITORING AND EVALUATION
In 2007, ICDDR,B developed a Monitoring and Evaluation (M&E) Framework as part of an agreement with its development partners who provide multi-year and unrestricted funding to the Centre. The same framework will be used to monitor and evaluate the progress in achieving the new strategic and operational objectives as identified in the Strategic Plan 2020. The framework has been adapted with a new set of quantitative and qualitative markers to avoid duplication and multiplicity of existing indicators.
CONCLUSION
With an increased flexibility to adapt to situations and the current strengths of ICDDR,B, the Centre is well placed to face the challenges and take advantage of the opportunities that will arise in the next decade, especially in the areas of climate change, urbanisation, environmental health and non-communicable diseases for which most development partners have earmarked a significant part of their future donations.
The Strategic Plan 2020 is a significant step in enabling the Centre to maintain its pre-eminence and rightful place in the developing world, something that it enjoys due to its geographical location, its diverse yet complementary skill set, and its unique and flexible operating model.
Executive summary
7
page1 THE INSTITUTION AND THE COUNTRY
a) ICDDR,B: A Brief History
The International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B or the Centre) is a health research institute located in Dhaka, the capital city of Bangladesh. Established in 1960 as the Pak-SEATO Cholera Research Laboratory, ICDDR,B had two key objectives, namely to research and understand the causes of diarrhoeal disease, and to provide treatment to the people of Bangladesh affected with diarrhoea. This commitment to research and treatment led to the discovery and development of Oral Rehydration Salts (ORS), which is a simple mixture of salt and sugar that has become the cornerstone of treatment around the world to treat diarrhoeal dehydration.
Over a number of decades, the Centre has made a conscious effort to expand its research and medical service programmes to address a number of public health issues relating to infectious diseases, as well as to population demographics, nutrition, and maternal and child health. While continuing to be at the forefront of diarrhoeal disease research and treatment, the Centre has increased its focus and work in respiratory diseases, HIV, parasitic disease and meningo-encephalitis.
In addition, the Centre has become a leader in the research, understanding and management of poverty and health, reproductive health, health systems, safe water, sanitation, food safety, and more recently, climate change and food security.
Through its research station and hospital in Matlab, ICDDR,B maintains one of the most
comprehensive and longest running, longitudinal data resources in the developing world. With over 40 years of continuous demographic information on a rural population of over 225,000, Matlab has become ICDDR,B’s major rural field site and global public health resource. Matlab is considered to be a model for public health strategies around the world with public health decision makers often referring to Matlab to understand underlying trends and factors that are important for designing and developing policies, strategies and intervention programmes.
Apart from Matlab, ICDDR,B maintains a further six rural and two urban field sites to carry out research and interventions in different areas of public health. These sites contribute to the Centre’s ongoing surveillance of more than 400,000 people. In Matlab alone, the Centre has recorded data of over 8 million person/years in 225,000 people, with details of 500,000 births and 100,000 deaths, the latter being obtained through verbal autopsies. The data cuts across the demographic and epidemiological changes that have been taking place in Bangladesh where fertility and mortality have fallen by more than half in the past 20 years. Although demographic systems are never
The institution and the country
8
pageintended to provide national level data, the multiple sites gathering information for ICDDR,B provide reliable population and health data for the country on which those responsible can make well-informed decisions. The ICDDR,B system is also well equipped to identify emerging challenges, especially in resource constrained settings that will be useful at an international level.
For almost fifty years, ICDDR,B has been saving lives through evidence-based management and treatment at its two hospitals in Dhaka and Matlab. These patient-care facilities address some of the most critical health concerns facing developing countries today, ranging from improving neonatal survival to maternal health and HIV/AIDS. The Dhaka Hospital is a unique facility for the care and management of patients suffering from diarrhoea and in the last decade alone, it has treated over one million patients, 300,000 of whom would have died without immediate care at the hospital.
b) Current and Future Health Situation in Bangladesh
Bangladesh has had mixed success in meeting the challenges it faces in terms of public health. Over the years, Bangladesh has seen a reduction in the rate of population growth, as well as a significant reduction in the mortality rate of under-five year olds
1. Measures taken to affect these two
indicators have also resulted in an increase in the life expectancy among Bangladeshi citizens from 58 years in 1994 to 65 years in 2007. However, Bangladesh still has the highest maternal mortality rate in the entire South Asia region and unacceptably high neonatal mortality rates.
As with many other developing countries, Bangladesh faces emerging health challenges. Rapid and unplanned urbanisation is outstripping the pace of social development with the increase in slum settlements exacerbating the already poor standards of living, hygiene and health. Children suffer particularly in these conditions with a noticeable increase in diarrhoeal and respiratory infections.
As has been widely reported in the international news media, Bangladesh has been identified as one of the countries most vulnerable to the effects of climate change. Indications suggest that climate change will lead to increased prevalence of diseases, such as cholera and dengue, as well as respiratory diseases and malnutrition due to food scarcity and reduction in food production. The threat of prolonged flooding will also impact available space for the construction of housing and the cultivation of crops and farming of animals.
The institution and the country
1 National Health Policy: an update. Ministry of Health and Family Welfare, Government of Bangladesh. 2008.
9
pageThe recent H1N1 outbreak around the world has reinforced the belief that all countries and
populations are facing the continued threat of emerging infectious diseases, such as severe acute respiratory syndrome (SARS), avian influenza and swine influenza, with many of these assuming pandemic proportions.
Current infectious diseases are expected to remain a major threat with HIV/AIDS, diarrhoeal diseases, tuberculosis, childhood-cluster diseases, and intestinal nematode infections likely to contribute significantly to the Disability Adjusted Life Years (DALY) indicator in the coming years.
Finally, as with all areas of the world, Bangladesh is facing an exponential rise in non-communicable diseases, such as hypertension, heart failure, diabetes and cancer. It is estimated that by 2010, 59%
of all mortality will be due to non-communicable diseases
2.
The public health challenges facing Bangladesh are further impacted by a shift in the methods and means of health financing. Traditionally, healthcare spending was supported by the Government of Bangladesh (GoB), which was supplemented by contributions from development partners such as the World Bank, United Nations agencies and the Department for International Development.
The funding patterns of development partners were driven by their own objectives but recently they have begun to follow the GoB’s Health, Nutrition and Population Sector Programme (HNPSP) for 2003-2010, which is one of the largest initiatives of its kind in the developing world. Recently, Bangladesh has begun to receive donations from private enterprises, philanthropic organisations, and health initiatives, such as the Global Alliance for Vaccines and Immunisation (GAVI) and the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), with the latter two accounting for 7% of the total HNPSP. Whatever the source, funding is becoming more coordinated in its approach to ensure maximum use of every dollar given and specific return on investment.
International health research is also undergoing a major transformation as new challenges and opportunities arise. There is an increasing focus on health systems and community-based interventions in the treatment of pneumonia, diarrhoea and malnutrition. In addition, health information systems, which collect, store and share data are becoming increasingly important, as is the equitable access to essential drugs and vaccines. Collaboration and partnerships in research programmes by governments, development partners, civil society, the pharmaceutical industry, and health research organisations is on the increase. These relationships are likely to become more common in years to come as financial restrictions come into play and multi-centre studies continue to grow.
The institution and the country
2 Streatfield et al. ‘The future pattern of disease’ in Health Futures in Bangladesh: Some Key Issues and Options, Oxford Policy Institute, 2001
10
page11
pagec) Challenges and Opportunities
ICDDR,B success over the past fifty years is in large due to its highly qualified and competent scientific and support staff. Its well established research infrastructure, its hospitals, urban and rural field sites, state-of-the-art laboratories and its demographic surveillance system, all help to maintain the Centre’s position as a world leading research facility. This is clear from the ease in which ICDDR,B explores and nurtures a wide range of national and international partners and collaborators. These strengths have enabled the Centre to detect emerging pathogens and associated risk factors, identify disease outbreaks and their locations, provide timely information
to government bodies for early action and implementation of appropriate prevention and control measures, and to disseminate findings to healthcare professionals involved in providing patient care. Most importantly, knowledge generated in ICDDR,B has been progressively translated by the Government of Bangladesh and others into policies and actions designed to improve the health of the population.
More locally, ICDDR,B has become known for its community programmes and services, such as the voluntary counselling and testing (VCT) services for HIV, which began in 2002. The Centre’s maternal, neonatal and child health programmes are spreading throughout the country, with both homecare and clinical facility services being offered on an ever-increasing basis through community health workers, doctors and nurses.
Despite the steady growth of ICDDR,B both physically and scientifically, the Centre faces some challenges in the coming years. Firstly, the direction in which international research will take is not easy to predict but current trends suggest a shift in funding from governments, development partners and other sources to global disease areas, such as HIV/AIDS, tuberculosis and malaria or emerging problems like the new H1N1 influenza pandemic. It is anticipated that in the next ten years new thematic areas of research will emerge and therefore, ICDDR,B needs to be flexible in order to remain at the cutting edge of the most important research areas. Secondly, the increasing ease for relocating to other institutes and countries, which may offer a seemingly greater potential for career development will create growing pressure on ICDDR,B to maintain its current high level of skilled and motivated scientists, physicians and technical staff.
Nevertheless, ICDDR,B is well placed to take advantage of opportunities arising from global and donor community concerns and needs. There is an increasing desire for health systems research, including primary health care with a focus on strengthening health systems, as well as research
The institution and the country
12
pageto reduce the threats from chronic diseases and climate changes that are expected to affect the poor most severely. Since the Centre’s scientists and researchers command a significant reputation in their respective fields, ICDDR,B is well placed to provide independent advice on a variety of issues to governments, institutes and decision-making bodies. In addition, services to stakeholders and other donors in defining, monitoring and evaluating backstop development strategies and programmes has the potential to open up new channels for income generation.
The Strategic Planning Process, and ICDDR,B Strategic Plan 2020
13
page2 THE STRATEGIC PLANNING PROCESS
The process for developing the new strategic plan for ICDDR,B was divided into distinct phases.
An analysis was made of the Centre in light of its key focus and past achievements and the challenges and opportunities that were likely to arise. This was carried out by reviewing the emerging trends in health and healthcare research, taking into account the financial environment in both Bangladesh and globally. Discussion followed to redefine the Vision, Mission statement and Guiding Values of the Centre before developing the Strategic Plan 2020 to include specific objectives with associated initiatives and measures. Key enablers were identified who would make the plan operational, and the existing Monitoring and Evaluation Framework (MEF) was modified to ensure its ability to monitor progress in implementing the Strategic Plan on a periodic basis.
In order to ensure “buy-in” from all those involved with the Centre, a participative approach was adopted with more than 40 workshops being held throughout the Centre, involving around two- thirds of the employees from all levels. The initial workshops focused on gaining insights into core competencies, strengths, weaknesses and key trends in the external environment that would likely generate challenges to and/or opportunities for ICDDR,B. Subsequently, specific strategic and operational objectives, together with their associated initiatives, were discussed in smaller working groups. The process also included participation by external stakeholders, including the Centre’s Core Donors Group (CDG), development partners, GoB agencies, collaborators, alumni and selected members of the local population.
The Strategic Plan considered all the information generated by this process in order to create a clearly articulated and achievable plan that could be measured and evaluated.
The strategic planning process
14
page ICDDR,B Strategic Plan 20203 ICDDR,B STRATEGIC PLAN 2020
The following Strategic Objectives were identified as being key for achieving the stated Mission of ICDDR,B:
a) Contribute to the improvement in health of the Bangladeshi population through effective translation of knowledge and research at a national level
b) Achieve excellence in the priority areas of research
c) Provide services that support the Mission statement by leveraging research and the generation of knowledge
d) Develop organizational capacity to achieve identified objectives
a) Contribute to the improvement in health of the Bangladeshi population through effective translation of knowledge and research at a national level
In order to be an effective partner in improving the health of the Bangladeshi population, ICDDR,B will increase its engagement and working partnership with the government and other stakeholders.
More specifically, the Centre will develop and implement joint research projects with the GoB, development partners and other institutions, such as BRAC, in order to fill the gaps that exist and strengthen the health delivery mechanisms that exist. In conjunction with this, ICDDR,B will actively participate in building the capacity of public health officials both independently through its own programmes and in collaboration with different government institutes. It is clear that effective monitoring and evaluation needs to be incorporated into these plans and to this end ICDDR,B with develop initiatives that are responsive to the needs of the government and other stakeholders.
The Centre counts on professional expertise in numerous healthcare areas, which will be
channelled so that ICDDR,B becomes an active participant in the formulation of policy and
programme design in the area of public health. This will be achieved by engaging in policy review
committees, creating a suitable platform for sharing knowledge including key research findings with
the government and other key stakeholders, and by establishing a suitable framework to assess the
efficacy of translational research undertaken by the Centre.
15
pageSuccess indicators will provide quick and accurate information as to the effectiveness of these
programmes and the relative importance of ICDDR,B’s input. These will include, but are not limited to, the number of health systems and policy research protocols and activities initiated in a given year, the number of healthcare professionals and/or officials trained by the Centre by type of training, the number of joint programmes initiated with the GoB and other development partners and stakeholders, the number of citations in health system policy guidelines, systematic reviews and assessments, the inclusion of new knowledge generated by the Centre in national policies, and the number and type of programmes initiated by the government and other institutions both at home and abroad to which ICDDR,B staff are invited to participate.
b) Achieve excellence in the priority areas of research
In an attempt to be more flexible in the nature and type of research, ICDDR,B will manage research programmes across broader research themes. As detailed below, the themes will cross all current and future research programmes providing greater opportunity for more extensive and multidisciplinary studies.
i) Healthy Life Course
Research undertaken along this theme will focus on factors that affect the health and well- being of the population from birth to old age. Such factors would include individual and population characteristics, genomics, lifestyle, the physical and social environment, and the interactions that occur between each of these.
ii) Mitigating Risks and Vulnerability
This broad theme encompasses research that identifies and modifies the factors and choices, which influence health and quality of life.
iii) Combating Priority Diseases
Research in this thematic category will focus on disease burden and develop strategies for preventing and treating diseases with a high public health priority.
iv) Equitable Health Systems
This thematic area will include research relating to the development and evaluation of systems that provide access to quality services, information, medical interventions and technologies for
ICDDR,B Strategic Plan 2020
16
pageall sectors of the population. It will also encompass the development of systematic reviews on specific issues that can guide the creation of appropriate interventions. In addition, research will look at the means to ensure the appropriate and sustainable levels of staffing, financing and governance, and the methods to monitor and improve them.
Within these thematic areas, research will be categorised according to one of four types within what is known as the “4D Framework”, which will be used to assess the focus of ongoing and future research in the Centre. The four types of research will be:
Discovery
i) – research that defines the nature and causes of a problem/issue
Development
ii) – research that develops solutions or a response to a problem/issue
Delivery
iii) – research that delivers these solutions Delivery Evaluation
iv) – research that evaluates whether the delivery of the solutions is having the anticipated impact, in other words, “Did the solution work?”
According to the 4D Framework, in the past five years the Centre has focused on the Discovery and Development types of research with 80% of protocols by number and 72% by budget falling into these two research types. While the Centre will continue to work in these areas of strength, it will strive to develop a more balanced portfolio with efforts to increase activities in the Delivery and Delivery Evaluation types of research. This transition will follow a steady path with the
objective of reaching 65% Discovery and Development research and 35% Delivery and Delivery Evaluation research by 2020.
The specific research programmes that will be followed within the thematic themes and 4D Framework will be:
Reproductive Health
Child Health and Development Nutrition
Infectious Diseases and Vaccine Sciences Health Systems
Population Sciences Poverty and Health HIV/AIDS, TB, Malaria
Environmental Health, Urbanisation and Climate Change Non-Communicable Diseases
Gender, Health & Human rights
ICDDR,B Strategic Plan 2020
17
pageReturn on investment and donor agency restrictions have made assessing the impact of research
a necessity in order to maintain future fund flow. To this end, ICDDR,B will put into practice the following framework to measure the impact of health research by individual protocol (Figure 1).
The main tools by which measures will be made include bibliometric analysis, literature and archival document review, and interviews with leading experts in a given field.
Figure 1
Knowledge Production
Research Targeting and Capability Development
Informing Policy
Health and Health Sector Benefits
Economic Benefits
To be measured through an analysis of contributions to scientific literature Number of papers published in peer reviewed journals
Number of papers which received citations
Research targeting will try to define how the outputs of specific research programmes inform subsequent research agendas. A key measure will be:
Number of new research questions/practices developed which contribute to the incremental process of knowledge production
Capability development will be measured by the following:
Number of PhD and MSc graduates per research area
% of PhD graduates applying for postdoctoral fellowship or research associate positions Number of trainees and areas of research by protocol
Number of public policies influenced by generated knowledge Number of clinical practice guidelines developed by disease area
Number of published papers cited in national and international clinical guidelines, high level reviews and task group reports
Number of interventions/solutions developed to foster equitable access to health services
Number of studies conducted to develop solutions to reduce mortality and morbidity for specific diseases
Number of innovations contributing to health promotion and disease prevention
Savings in healthcare related expenses due to the availability of new solutions/
intervention measures/treatments
Life years saved due to the availability of new solutions/intervention measure/
treatments
Contribution to the economy through a healthier workforce Categories to Measure the Impact of Health Research by Individual Protocol
ICDDR,B Strategic Plan 2020
18
page19
pagec) Provide services that support the Mission statement by leveraging research and the
generation of knowledge and its effective application
During the Strategic Planning process, it was decided to redefine the term “services” to denote any activity or series of activities provided as a solution to an external recipient. The services that ICDDR,B will offer fall into three main categories:
i) Services that translate the research expertise of the Centre into income-generating activities ii) Humanitarian services in response to emergencies, both within and outside Bangladesh iii) Support services that are not linked to research but which have the potential to generate
income
i) Services that translate the research expertise of the Centre into income-generating activities
Services in this category will be related to the four thematic research areas with the aim of generating evidence-based knowledge, which can be used to improve public health practices in Bangladesh, the region and elsewhere.
Healthy Life Course – the research programmes linked to the services in this thematic area include reproductive health, child health, nutrition, and development and nutrition. The services will range from counselling and advisory services on child nutrition, micronutrient deficiencies, lipid disorders, and obesity, to providing comprehensive obstetric care. Central to these services will be the continued promotion that the well-being of newborns, infants and children is interrelated to the well-being of their mothers, in addition to advocating the benefits of exclusive breastfeeding and appropriate complementary feeding.
Mitigating Risks and Vulnerability – Bangladesh is a country considered to be at high risk for emerging and re-emerging infectious diseases. With this in mind, ICDDR,B will research and gather information and data that could be used to provide equitable health solutions that will reduce the associated risks of such infections and provide tangible benefit to the poor of Bangladesh and other developing countries. Key services to be offered include clinical trial facilities and related services, testing of water and food samples, performing assays of environmental samples for arsenic and other contaminants, and providing access to the demographic surveillance system and data. Promotion of the Centre’s voluntary counselling and testing (VCT) centres will continue to minimise the transmission of HIV/AIDS and other sexually transmitted diseases.
Combating Priority Diseases – it is envisaged that by 2020, non-communicable diseases will account for 41% of total disease burden in Bangladesh, with communicable diseases making up 46%. ICDDR,B will face this challenge by offering specialised care services for patients suffering from acute respiratory illnesses, as well as services against gastrointestinal disorders including acute infections and persistent diarrhoea. As mentioned in the Mitigating Risks and Vulnerability section, clinical trials’ facilities will be offered to leading research institutes and the pharmaceutical industry as a source of renewable revenue, as well as a means to generate all- important data and information on new and existing treatments that can benefit everyone.
ICDDR,B Strategic Plan 2020
20
pageEquitable Health Systems – services in this category will involve external training and capacity building of health professionals and public health officials from both Bangladesh and abroad.
The Centre will address the gaps that exist in the knowledge and practice of healthcare professionals, which act as a major obstacle in providing essential life-saving health services to millions of people who lack access to such services in Bangladesh, the region and other developing countries. Programmes will be developed through existing associations with the James P. Grant School of Public Health, BRAC University and other collaborators.
ii) Humanitarian services in response to emergencies, both within and outside Bangladesh As an organisation with decades of expertise in the treatment of cholera and dysentery and the management of large epidemic outbreaks, ICDDR,B has always supported other nations facing these problems. Researchers and support staff from ICDDR,B have helped local authorities to manage cholera outbreaks in Bahrain, Ecuador, Iraq, Mozambique, Peru, Zaire, and more recently in Nepal, Papua New Guinea and Zimbabwe. This help will continue in the form of rapid response teams comprising of experts who manage cholera and severe diarrhoea in the field, both in Bangladesh and abroad. ICDDR,B supplements this practical support with capacity building services to health professionals in affected countries. In addition, the Centre will offer the services of its biosafety levels 2 & 3 laboratories to type, process and store pathogens from humans and animals sent by partners and obtained by its own scientists, as well as for the training of professionals in the region in the use of these types of facilities.
iii) Support services that are not linked to research but which have potential to generate income
ICDDR,B will offer a full range of clinical and diagnostic services and will promote the services of its Traveller’s Clinic and laboratories for routine diagnostic examinations, vaccinations, pathological tests, mammographies, ultrasonographies, bronchoscopies, and upper and lower gastrointestinal endoscopies. ICDDR,B will also open a blood bank and ensure continual monitoring of laboratory equipment and techniques to maintain and offer suitable services at the cutting edge of development.
d) Develop organisational capacity to achieve identified objectives
In many organisations, the main asset is their staff and ICDDR,B is no exception to this. The expertise and experience of the physicians, scientists, technicians and support staff will continue to ensure that objectives are met and the Strategic Plan 2020 is followed and achieved. ICDDR,B is committed to building a world class culture for attracting, retaining and nurturing the right talent though a number of key initiatives.
i) Organisational Structure and Practices
ICDDR,B will create an organisational structure that is aligned to the strategic objectives of the Centre and conducive to growth opportunities for talented individuals. Reviews will be undertaken before establishing appropriate processes and practices for recruiting and retaining talent, as well as recognising and rewarding performance. In order to attract the best talent from around the world, ICDDR,B is committed to implementing the required processes and practices, and providing the facilities and equipment associated with a Centre of Excellence.
ICDDR,B Strategic Plan 2020
21
pageii) Capacity Building and Strengthening
ICDDR,B has conducted an extensive training needs analysis that included more than 70% of its employees at different hierarchical levels. Some of the key needs that were identified during the analysis include the preparation of grant applications, research methodologies for scientific staff, computer operating skills, and English language skills.
A structured Training Programme and calendar is being developed covering both technical and behavioural competencies, with courses in key technical competencies in research ethics, research methodologies, development of research protocols, grant applications, data management, analysis and data interpretation, scientific writing, dissemination of research findings, and influencing policies and practices.
Scientific staff will also be encouraged to attend selected external training programmes in their respective fields in order to enable skills development and provide valuable opportunities for networking and collaboration. In addition, the Centre will continue to sponsor groups of selected employees for advanced studies to enhance their qualifications and skills.
ICDDR,B will also promote training programmes that focus on behavioural and management issues including communication, team building, project management, finance for non-finance managers, management, mentoring, and leadership.
iii) Gender and Environmental Policies
In 2003, ICDDR,B adopted a new Gender Policy, which promotes gender equality within the Centre. The Strategic Plan 2020 includes additional initiatives to enhance and expand the existing policy as it moves forward into the second decade of the century. Following an evaluation of the existing gender goals, diversity will be included in the gender mandate. This will be implemented after conducting an organisational diversity diagnosis, and developing gender and diversity indicators before they are mainstreamed into the key activities of the Centre.
Environmental responsibility has also been a major policy of the Centre and ICDDR,B is committed to promoting sustainability and environmental awareness at all levels of decision- making. The Strategic Plan 2020 includes requisite safeguards to ensure that the Centre reduces energy consumption, purchases renewable, reusable, recyclable and recycled materials to the maximum extent possible, minimises the generation of solid and hazardous waste, conducts environmentally significant research, employs non-toxic materials for research purposes, and avoids research and activities that may have a detrimental impact on the environment.
ICDDR,B Strategic Plan 2020
22
page4 MAKING THE PLAN WORK
In order for any plan to work, the organisation needs to ensure that the plan has “buy-in” and that its infrastructure and codes of conduct and practices are aligned to support the initiatives outlined in the plan. ICDDR,B has identified key support activities, which will enable the Strategic Plan 2020 to be implemented and achieved.
i) Human resources and organisational development
ICDDR,B is developing a new gender sensitive, competence-based human resources strategy, which will include a monitoring and evaluation framework for gender-related objectives. In addition, an “Excellence” competency framework will be created with identified competencies for all key positions. The Centre will follow an objective performance management system based on well defined indicators, which will be closely linked to promotion and compensation policies. Succession planning and mentoring programmes will be enhanced along with the continued development of a market and performance related compensation policy.
To expand and thrive, the Centre needs to expand its critical mass of internationally
recognized independent scientists who can secure funding for these efforts and lead a robust and innovative scientific program. To create an environment that is conducive to attracting, developing and retaining the best scientific talent, the Centre will implement a separate personnel assessment system and compensation plan for its scientific staff.
A new organizational framework by Centres of Excellence will be created as part of a new structure of the Centre. A Centre of Excellence is an organizational unit lead by a senior independent scientist designed to create an intellectually stimulating environment that supports multidisciplinary thematic scientific processes to engage in innovative translational research and facilitates work at the interface of different disciplines.
ii) Financial management
ICDDR,B has identified that sustained growth in funding will occur by diversifying the base of development partners. A fund raising strategy will be developed that will match the Centre’s funding requirements in terms of both restricted and unrestricted funding. Funding sources will also be reviewed and targeted to increase the Centre’s funding portfolio to include multilateral and bilateral agencies, endowment funds, infrastructure development funding sources, and corporate social responsibility sources. Subsequently, responsibilities will be allocated for engaging with potential financial partners.
ICDDR,B is committed to minimise its expenses and overheads through efficient management and execution of research protocols and activities, resource deployment and the sharing and streamlining of support functions and processes.
Expanding revenue sources is a prime objective of the Strategic Plan 2020. ICDDR,B has already identified a number of key services that will be offered to generate additional income including a wide range of clinical and diagnostic services, as well as offering capacity building programmes for health professionals from Bangladesh and beyond.
Making the plan work
23
pageiii) Infrastructure and organisational services
The objective for ICDDR,B is to develop and upgrade its facilities and infrastructure with particular focus on augmenting and modernising the existing infrastructure to address the needs and activities outlined in the Strategic Plan 2020. In addition, the Centre will prepare a maintenance plan for capital assets and implement a business continuity plan with specific focus on disaster recovery systems.
The Centre will also make strategic information technology (IT) investments in conjunction with the development of IT policies and standard operating procedures. As part of the support services offered to all areas of the Centre, a steering committee will be formed to oversee the implementation of the initiatives identified in the IT strategy.
iv) Key risks to implementation
The Centre has considered the risks it is likely to face during the implementation of the new strategy and has developed a set of actions to mitigate these as part of a risk management framework. The risks have been divided into strategic and operational. The key elements of the framework are risk policy, root causes, mitigating factors, key performance indicators, and risk management. Specific focus was placed on those risks that have the potential to prevent the implementation of the new plan’s strategic objectives.
Table 1: Potential risks and proposed reduction measures
Risks Mitigation
Changes in the external environment may raise questions on the relevance of the strategy
The new Strategy will be a “living” plan. ICDDR,B will continuously monitor the external environment and will revisit the strategy periodically to ensure that it remains relevant in the context of the health sector in Bangladesh and the priorities of other stakeholders
Majority of ICDDR,B’s staff unable to identify Centre’s Mission and strategic objectives
The process of developing the Strategic Plan has been highly participative but that is only “half the battle”. It will be crucial to replicate the same level of participation from all levels of Centre staff during strategy implementation. The Executive Director will play the steward’s role to ensure maximum participation Implementation of the strategy would
not be effective to achieve the planned objectives
The Board of Trustees would review the progress of implementation of the Strategic Plan 2020 every two years leveraging the monitoring framework outlined below. They would be supported in this initiative by the Executive Director and the Scientific Council
5 MONITORING AND EVALUATION
In 2007, ICDDR,B developed a Monitoring and Evaluation (M&E) Framework as part of an agreement with its development partners who provide multi-year and unrestricted funding to the Centre. The objectives of the framework are to reduce transaction costs, which are incurred when dealing individually with multiple development partners, and to provide regular reports to development partners against measurable indicators that specify the use of pooled funds.
Since its inception, the M&E Framework has performed a key role in providing information
regarding the Centre’s progress in achieving specified objectives. The same framework will be used
Monitoring and evaluation
