ESTHER Switzerland was developed in the spirit of partnerships and equity. In line with the World Health Organization’s Twinning Partnerships for Improvement, the basis of ESTHER projects is partnership building. The first objective of an ESTHER project should therefore be strong bi-directional partnership building between health institutions. Building on this, effective interventions based on needs identified in a collaborative way at the service delivery level should be determined. Learning and experience should then be spread within the local and national health system and beyond, for example through input in policy-dialogue. These values are reflected in the Project Proposal Evaluation Criteria.
ESTHER Switzerland subscribes to the values of equality, integrity, sustainability, solidarity, and reciprocity formulated by the European ESTHER Alliance:
We foster mutual collaboration between partners, striving to work together on an equal basis
We aspire to earn the trust of our partners, clients, and other beneficiaries through transparent and ethical practices
We work to develop long-term institutional and individual capacity through peer-to peer learning, education, operational research, and skills transfer
We are united in working together in genuine partnership to address global health inequities
We learn from each other for mutual benefit and respect the different contributions partners make
Partnership quality and principles
ESTHER Switzerland’s main activity involves twinning Swiss hospitals, universities, laboratories, and research institutions with partners in the South. ESTHER Switzerland will support North-South partnerships to strengthen individual and institutional capacities, reduce North/South inequalities in health, and improve quality health care in low-income countries. Partnerships will be guided by the ESTHER Charter for Quality of Partnerships and characterized by:
- Adherence to national policies and strategies
- Developing formal agreements between twinned institutions
- Fostering equal involvement of partner institutions in project development and implementation
- Equal accountability for outcomes
- A commitment of both partners to sustainable interventions
- Equity and respect with no hierarchical relation between North and South institutions
- Transparency through declaration of conflicts of interest and regular narrative and financial reporting
- Adherence to ethical principles, including clearance of data collected for research purposes by the responsible Ethics Committees or Institutional Review Boards
Project Proposal Evaluation
The ESTHER Secretariat will do a formal check of the proposals. All eligible and complete (all sections in the application form must be completed according to the instructions) grant proposals will be sent to three independent, external reviewers who will assess them based on the following criteria:
- Partnership building is the baseline for the intervention activities. The project builds on existing links with institutional commitment.
- There is evidence of mutual accountability and transparency, reciprocity is clear.
- Partner capacity and experience is clear, institution involvement is well articulated.
- Stakeholders in the LMIC and Swiss health systems are equally involved in project design and management.
- The partnership has a clear understanding of other health partnerships and other health actors operating in the field and is taking opportunities for learning and collaboration
- The activities respect the ESTHER European Alliance Strategic Framework 2015-2020 (http://www.esther.eu/wp-content/uploads/2015-2020-EEA-Strategic-Framework.pdf ).
- The partnership has the capacity to deliver the project.
- The project is demand-driven, and needs based. The project and its approach are appropriate and relevant to the local context and based on a joint needs assessment.
- The project is country-owned and aligned with country partner priorities.
- The project has a clear goal that is achievable with the resources and time available with a health system strengthening perspective going beyond the project level. There is a strong potential for impact, and it is guided by sustainability.
- Objectives and activities are in line with the overall goal and responsibilities are clear.
- The theory of change is clearly explained.
- The project pays careful attention to equity.
- The project has clear benefits for all partners involved.
- The project has clear evaluation indicators for measuring success as well as resources allocated for monitoring and evaluation.
- The project demonstrates value for money.
- The project is based on recognised good practice.
- The project demonstrates critical reflection on previous work and builds on lessons learnt, as applicable.
Theory of Change
The SDGs are the conceptual and the operational framework in which all health cooperation interventions, including the ESTHER institutional health partnerships projects, operate. ESTHER partnership projects shall therefore explicitly formulate and show how their interventions are embedded into the global SDG framework and relate to broader health system strengthening thereby indicating the added-value ESTHER partnerships can generate. The request to show a clear theory of change spelling out how global health cooperation projects contribute to systemic changes has increased and has rightly become an important funding criterion. Thus, ESTHER partnership projects shall indicate systematically, from the inception phase onwards, how a given project impacts beyond the involved health institutions and how a project relates to broader health policies and system’s strengthening. The rational here is the increased need for sustainable solutions and the maximization of value for money. A single ESTHER projects may not have the capacity to strengthen an entire health system or directly achieve policy changes. However, it is important that the project can show that it goes beyond service delivery, contributing to governance aspects of UHC.