PHM-Exch> Call for 'expression of interest' - Evaluation of the People's Health Movement

[Claudio Schuftan]

From: PHM Global Secretariat <globalsecretariat at phmovement.org>




The Steering Council of the People’s Health Movement (PHM) calls for
‘expressions of interest’ for a team

leader to lead an evaluation team and for members of that team to undertake
a comprehensive evaluation of

PHM activities.

Context and Background

The PHM is a global network bringing together grassroots health activists,
civil society organizations and

academic institutions from around the world, particularly from low and
middle-income countries. PHM

currently has presence in around 70 countries that include both individuals
and well-established circles with

their own governance structures.

The PHM strives for the revitalization of Primary Health Care (PHC), as
described in the Alma-Ata

Declaration of 1978 which includes addressing the social determinants of
health, in particular, the growing

inequity within and between nations mostly due to the unfair economic
structures which lock so many people

into poverty and poor health. For more information about vision, mission,
strategic objectives, governance

structures, and currently active programs, please refer to Annex 1: PHM
biography.

An evaluation in 2004 mostly focused on the internal governance of the PHM
and its global visibility. The

report is available for sharing as background material for the 2010
evaluation team.

Since 2004 PHM has grown significantly and gained more global recognition.
Key aims in the past five years

have been to enhance inclusiveness and functionality of the movement;
strengthen PHM presence at the

grassroots; strengthen internal management system and financial control;
become more gender sensitive

and ensure revitalization of the movement’s leadership

Objectives

The over all goal of the 2010evaluation is to enable sharper impact of the
PHM as a global actor for change.

This would be achieved partially through assessing current gaps and
informing more effective strategies.

The evaluation is expected to address the following questions:

_ Do the current strategic objectives of the ‘organizational component’ of
the movement adequately

respond to the movement’s mission articulated by the People’s Charter for
Health and other strategic

documents?

_ To which extent have the current PHM global programs, thematic circles,
and other activities achieved the

strategic objectives (see Annex 1) and respond to the PHM mission? This
includes assessment for the

capacities, achievement, performance and organization of each program and
thematic circles and

provision of clear recommendation for needed changes. Internal and external
communication system and

tools (electronic and non-electronic) should be included in the assessment.

_ To which extent has the current governance structure (including the
management system and financial

controls) enabled the movement to achieve reasonable levels of inclusiveness
and transparency? Current

initiatives to enhance the governance structure and the management and
financial policies should be

taken into consideration. The progress PHM has made towards gender
mainstreaming should be

addressed.

_ How effective is the current PHM strategies for managing the
sustainability of human and financial

resources?

_ Is the current geographical spread pertinent to carrying out the PHM
mission? The assessment should

provide clear strategies to enhance the PHM geographical spread and linkage
with grassroots initiatives.

_ To which extent is the PHM recognized as a global actor for change?

Those objectives and questions are subjected to be refined through further
discussions between he PHM

global structures and the evaluation team.

Methodology

The evaluation will be conducted by a team. The detailed methodology is to
be developed by the evaluation

team; however we expect that the following methods and tools will be
essential:

_ Intensive review of the PHM main documents.

_ Collective and individual meetings with the PHM global structures
(governing and executive bodies)

including staff and volunteers.

_ Visits to some of the countries in which PHM has presence in (the sample
of countries should be

selected to represent different regions/realities as well as different level
of development of the PHM

circles). During these visits, quantitative and qualitative techniques may
be used including short

questionnaires, rapid participatory assessment, focus group discussions, and
interviews.

_ Online questionnaires and teleconferences to reach wider range of targets
and to reduce the costs.

The PHM global secretariat should be able to provide the evaluation team
with the needed materials in

addition to assist the development of the electronic and non-electronic
tools when needed.

Evaluation team

PHM is seeking to appoint an evaluation team leader and three members of the
team. PHM expects that the

team will have gender balance, include members from the global south and all
members will have evaluation

experience. The evaluation team is expected to have the following criteria:

_ Reasonable Knowledge of the PHM – excluding those who are currently
members in the PHM global

structures.

_ Sympathy with the goals and visions of the PHM as expressed in the
People’s Charter for Health.

_ Experience with social movement and civil society networks – previous
involvement in activities related

to movement/network building and management would be an asset.

_ Good experience in gender mainstreaming and gender-based analysis.

_ An experience in coordinating and facilitating strategic and operational
planning.

_ Background of implementing research and coordinate knowledge generation
project.

Evaluation report and other outputs

The evaluation team is requested to provide:

1. Evaluation report (limited to 50 pages / 25,000 words). The report should
include description for:

o The used methodologies (the tools should be also attached as annexes)

o The evaluation findings (in response to the evaluation questions included
in this TOR)

o Discussion and recommendations (specific recommendations for addressing
each question in

addition to general ones).

2. Executive summary for the evaluation report focusing on the major
findings and recommendations with

hints on the methodology (5 pages / 2,500 words).

3. Strategy paper that act as a concept note to inform proper operational
plan responding to the evaluation

results.

Time Frame and time allocation

_ The evaluation process, including the development of the detailed
methodology and submitting the

evaluation report, is expected to last in SIX months (September 2010 –
February 2011).

_ A detailed time plan and time allocation of each member of the evaluation
team will be developed jointly

with the evaluation team.

Budget

_ The available budget is quite limited, accordingly, we expect that the
evaluation team will consider a

portion of their time as voluntary work and they will also accept activist’s
rate.

_ The detailed budget will be developed in negotiation with the evaluation
team but is likely within a range

of USD 5,000 – 6,000 as a total for each evaluation team member for an
average of 30 working days.

Expression of interests and process of recruitment

_ The expression of interest (EOI) should be submitted by individual
evaluators before 31st August 2010 by

e-mail to PHM Global Secretariat [globalsecretariat at phmovement.org]

_ The EOI should include:

- Evidence on a past experience in leading / engaging evaluation projects
(short CV should be

attached)

- Experience in light of the criteria listed above and indication of the
minimum acceptable rate per day

(considering our limited financial resources). We expect 20 working days
from each member of the

evaluation team which should be well-distributed on the time frame described
above.

- Indication of time availability to meet the time frame.

- Indication of readiness to travel (for the evaluation of the country
processes – we expect that the

travel tasks will be distributed on the team each may be responsible for
evaluating one country

model unless other agreements (different distribution of tasks) are reached
within the evaluation

team.

- All possible means of contacts; e-mail, telephone number and Skype ID.

_ The PHM global secretariat jointly with the chairpersons of the PHM
Steering Council will review the

received EOI and get back to the applicants by the 10th of September 2010.
Potential applicants are

encouraged to discuss the evaluation task with either the global
co-ordinator Bridget Lloyd

(globalsecretariat at phmovement.org), or the Co-Chairs of the Steering Council
Prem John

(prem_john at vsnl.net) or Fran Baum (fran.baum at flinders.edu.au)

Annex 1

*People’s Health Movement in Brief*

People’s Health Movement (PHM) is a global network bringing together
grassroots health activists, civil

society organizations and academic institutions from around the world,
particularly from low and middle-income

countries. PHM currently has presence in around 70 countries that include
both individual health

activists and well-established circles with their own governance structures.

PHM works to revitalize the comprehensive Primary Health Care (PHC), as
articulated in the Alma-Ata

Declaration of 1978 as well as to address the social determinants of health,
in particular, the growing inequity

within and between nations mostly due to the unfair economic structures
which lock so many people into

poverty and poor health.

PHM organizes a People’s Health Assembly (PHA) every five years that draws
people from across the globe.

The First PHA was organized in Dhaka (Bangladesh, 2000) and the Second in
Cuenca (Ecuador, 2005). The

Third Assembly is planned to be organized in Cape Town (South Africa) around
mid 2011.

The PHM governance structure includes the ‘Steering Council’ as the
principal decision-making body, the

‘Coordinating Commission’ as an extended executive body and the ‘Global
Secretariat’ as the main

executive body. The PHM Secretariat rotates every three years. Dhaka
(Bangladesh, 2001-2002), Bangalore

(India, 2003-2006) and Cairo (Egypt, 2006-2009) have hosted the Secretariat
earlier. The main ‘Global

Secretariat’ office is currently based in Cape Town (South Africa) hosted by
PHM-South Africa and assisted

by other two offices based in Cairo (Egypt) and Delhi (India).

*Background*

*HEALTH FOR ALL - INTERNATIONAL DENIAL*

In 1978, at the PHC Conference in Alma-Ata, 134 countries in association
with

the World Health Organization (WHO) and UNICEF called for “Health for All

by the Year 2000” and selected PHC as the best tool to achieve it.

Unfortunately, that dream never came true. The health status of third world

populations has not improved, and in many cases has deteriorated further.

We are facing a global health crisis characterized by growing inequalities

within and between countries. New threats to health are continually
emerging.

This is compounded by negative forces of globalization which prevent the

equitable distribution of resources necessary for people's health,
particularly the poor’s.

Within the health sector, failure to implement the principles of PHC has

significantly aggravated the global health crisis. Governments and the

international community are fully responsible for this failure. By the end
of

the year 2000, in response to the intentional denial of “Health for All”,

several international organizations, civil society movements, NGOs and

women's groups decided to work together towards the denied yet possible

dream of “Health for All”. Along with others committed to the principles of

PHC and people's needs, they organized the PHA from the 4th to the 8th of

December, 2000 in the People's Health Centre at Gonoshasthaya Kendra

(GK), in Savar, Bangladesh.

1453 participants from 92 countries came to the Assembly after a culmination
of 18 months

of preparatory action around the globe, which included thousands of village
meetings, district

level workshops and national gatherings. At the Assembly, they reviewed
their problems and

difficulties, shared their experiences and plans, formulated and endorsed
the People's

Charter for Health. In their Charter, people considered equity,
ecologically-sustainable

development and peace the heart of their vision of a better world – a world
in which a healthy

life for all is a reality; a world that respects, appreciates and celebrates
all life and diversity; a

world that enables the flowering of people's talents and abilities to enrich
each other; a world

in which people's voices guide the decisions that shape our lives. We
believe that there are

more than enough resources to achieve this vision.

The People’s Charter for Health defines health as a social, economic,
political issue, and above all, a

fundamental human right. It considers inequality, poverty, exploitation,
violence and injustice the root of ill health

and deaths of poor and marginalized people. Accordingly, “Health for All”
means that powerful

interests have to be challenged, that globalization has to be opposed, and
that political and economic

priorities have to be drastically changed.

The Charter is now the common tool of a worldwide citizens movement
committed to making the Alma-Ata

dream a reality. It has been translated and published in more than 36
languages till present. The Charter and

its two updates, the Mumbai Declaration of January 2004 and the Cuenca
Declaration of July 2005 articulate

PHM’s vision.

*Strategic objectives*

Key objectives of the PHM, as elaborated in its key documents, include:

_ *Challenge *powerful interests and *political and economic priorities of
globalisation*.

_ Encourage *people to develop their own solutions.*

_ Hold accountable local authorities, national governments, international
organizations and corporations.

_ Demand that governments and international organizations reformulate,
implement and enforce policies

and practices which respect the *right to health*.

_ Build broad-based *popular movements *to pressure governments to
incorporate *health and human*

*rights *into national constitutions and legislation.

_ Demand *transformation of the World Trade Organisation *and the global
trading system so that it

ceases to violate social, environmental, economic and health rights of
people and begins to discriminate

positively in favour of countries of the South.

_ Pressure governments to introduce and enforce legislation to protect and
promote the physical, mental

and spiritual health and human rights of *marginalized groups*.

_ Demand that *education and health *are placed at the top of the political
agenda. This calls for free and

compulsory quality education for all children and adults, particularly girl
children and women, and for

quality early childhood education and care.

_ Hold *transnational and national corporations, public institutions and the
military accountable *for

their destructive and hazardous activities that impact on the environment
and people’s health.

_ Develop people-centered, *community-based indicators *of environmental and
social progress, and to

press for the development and adoption of regular audits that measure
environmental degradation and

the health status of the population.

_ Support actions and campaigns for the *prevention of natural disasters *and
the reduction of

subsequent human suffering.

_ *Oppose *international and national *politics that privatize health care *and
turn it into a commodity.

_ Demand that governments promote, finance and *provide comprehensive
Primary Health Care *as the

most effective way of addressing health problems and organizing public
health services so as to ensure

free and universal access.

_ Demand a *radical transformation of the World Health Organization (WHO) *so
that it responds to

health challenges in a manner which benefits the poor, avoids vertical
approaches, ensures intersectoral

work, involves people’s organizations in the World Health Assembly, and
ensures independence from

corporate interests.

_ Promote, support and engage in actions that encourage *people’s power and
control in decision-making*

*in health *at all levels, including patient and consumer rights.

_ Demand that *research in health, *including genetic research and the
development of medicines and

reproductive technologies, is *carried out in a participatory, needs-based
manner by accountable*

*institutions*.

_ Build and strengthen *people’s organizations *to create a basis for
analysis and action. Promote, support

and engage in actions that encourage people’s involvement in decision-making
in public services at all

levels.

_ Demand that *people’s organizations be represented in local, national and
international fora *that

are relevant to health.

_ *Support local initiatives *towards participatory democracy through the
establishment of people-centred

solidarity networks across the world”.

*Key Programs*

The PHM has *three globally coordinated programs *and numerous other
activities across the globe. The

globally coordinated activities are:

*1. Global Health Watch: An Alternative World Health Report (**
www.ghwatch.org**)*

At the WHA in May 2003, the PHM, together with Global Equity Gauge

Alliance (GEGA) and Medact discussed the need for civil society to produce

its own alternative World Health Report. It was felt that the WHO reports

including the annual ‘World Health Report’ were inadequate; that there was
no

report monitoring the performance of global health institutions; and that
the

dominant neo-liberal discourse in public health policy needed to be
challenged

by a more people-centred approach that highlights social justice. The idea
of

an alternative report soon developed into an initiative called the 'Global
Health

Watch' (GHW) with the first report launched in July 2005, during the PHA-2
in

Ecuador. The second edition, GHW2, was launched in October 2008. Each
edition of the Watch had

approximately 150 contributors, representing people’s organizations, civil
society organizations, academic

institutions, and each was launched in over 20 countries around the globe.
The development of GHW3 is

coordinated by Delhi office of the PHM global secretariat.

*2. International People's Health University (IPHU) **
www.phmovement.org/iphu*

The IPHU aims to contribute to 'health for all' by strengthening people's
health

movements around the globe, by organising and resourcing learning, sharing

and planning opportunities for people's health activists, particularly from
Third

World countries. The IPHU’s principal activities are:

_ To organise regular short course opportunities for health activists from
around the world but particularly

from Third World countries;

_ Present a range of learning opportunities; a growing collection of
resource materials; and a wider network

of resource people to progressively enhance its programs;

_ Sponsors research into the barriers to Health for All and strategies to
support the people's struggle for

health.

The IPHU was launched in July 2005 just prior to the PHA-2 (Cuenca,
Ecuador). Since when it has

conducted 16 short courses ‘Struggle for Health’ in 1) Cuenca, Ecuador, July
2005; 2) Bhopal, India, March

2007; 3) Vancouver, Canada, June 2007; 4) Atlanta, USA, June 2007; 5) Savar,
Bangladesh, November

2007; 6) Cairo, Egypt, March 2008; 7) Jaipur, India, March 2008; 8) Porto
Alegre, Brazil, September 2008; 9)

London, UK, April 2009; 10) Thessaloniki, Greece, May 2009; 11) Bangalore,
India, September 2009; 12)

Havana, Cuba, November 2009; 13) London, UK, April 2010; 14) Chimaltenango,
Guatemala, April 2010;

15) Kisumu, Kenya, April 2010; 16) Colombo, Sri Lanka, August 2010.

*3. Global Right to Health and Health Care Campaign (RTHHC)*

PHM has embarked on a global RTHHC campaign which involves

coordinated national and international level action. The overall idea of

the campaign is to change the international approach to health and

development, and, via a ‘Global Action Plan on the Right to Health

Care,’ convincingly show how quality essential health care services

(based upon the Alma Ata PHC model) could be made available

NOW to every human being on earth, provided certain key

reallocation of priorities and resources. PHM uses a consultative

process in about 40 countries to involve thousands of people in

making this demand.

The campaign involves the production of rights-based evaluations of national
health policies in countries with

PHM circles. The global coordinating group has developed *The Assessment of
the Right to Health at the*

*Country Level: A People's Health Movement Guide *for national PHM circles
to use to produce consistent

reports using human rights law. The process generates lobbying/activist
strategies to use on the national and

international level. Key strategic allies within international organizations
are also enlisted.

*Other Activities of the PHM include:*

1. *Evolving an advocacy strategy to bring WHO back to Health for All
*perspective
and goals and to

focus action on health determinants.

In 2003: a campaign to influence the resolution on PHC. The campaign
succeeded to put a pressure on

some member states to change the direction of the resolution from
‘celebrating the anniversary of Alma

Ata declaration’ to ‘revitalize the PHC approach’

In 2006: a campaign to influence the elections of the WHO’s Director General
(DG). The campaign

strategy included publishing articles about the role of the WHO and PHM
expectations from the coming

DG. One of these articles was published in the Lancet just before the
elections. In addition, PHM

developed a list of key questions that was sent to the potential candidates
for the DG position and

responses were widely published (PHM list of questions and the responses of
the candidates including

the current WHO DG; Dr. Margaret Chan are published on the PHM website).

One of the biggest achievements of this circle was pushing the WHO to launch
a Commission on Social,

Economic and Political Dimensions of Health which is resulted in the
creation of the Commission on

Social Determinants of Health (CSDH). PHM pushed to be formally represented
in the CSDH and we

believe that PHM was influential to the final report of the Commission. In
addition, the PHM has used the

opportunity of the CSDH for an intensive mobilization process in different
regions. This process resulted

in an independent civil society report on the social determinants of health.
The full report was published

by the PHM while its summary was published by the WHO.

In 2009: a campaign to influence the resolutions on PHC and SDH. PHM jointly
with several civil society

partners has organized a civil society workshop (Equity, Justice and Health)
in Geneva prior to the 62nd

WHA. The workshop came out with a single civil society voice (statement)
that was read during the

assembly.

2. *Building country circles *around community and national needs,
challenges and opportunities.

Strong country circles exist today in over 30 countries, including
Bangladesh, India, Sri Lanka,

Philippines, South Africa, Zimbabwe, USA, Australia and many countries of
Central and South America

such as Ecuador, Brazil, Guatemala, Argentina, Mexico, El Salvador etc. Over
40 countries are in the

process of developing country circles.

3. *Facilitating PHM representation and building global solidarity;
*participation
in local, national,

regional an international fora and meetings. This has ensured the PHM’s
regular involvement and

participation in the World Social Forum, Global Forum for Health Research,
and WHO’s World Health

Assembly.

4. *Disaster and Humanitarian Responses *The PHM’s War, Disaster and
Humanitarian Circle has been

active raising issues and promoting collective initiatives during the build
up to the Iraq war, and during

the Tsunami (South Asia), earthquake (Iran) and some Latin America
disasters.

*Get involved*

· Read and discuss the Alma Ata Declaration, the People's Charter for
Health, the Mumbai

Declaration, the People's Charter of HIV/AIDS and the Cuenca Declaration.

· Endorse the People's Charter for Health.

· Organize a convention of Primary Health Care workers and community level
PHC volunteers. Listen

to their experiences. Endorse their work.

· Organize street theatre or folk culture events that express solidarity
with the themes of the People's

Health Movement through skits, songs and other forms of cultural expression.

· Organize a small exhibition of Alma Ata Declaration principles and the
action points of the People's

Charter for Health.

· Write a letter from your PHM Regional Circle to the Government (to the
President, Prime Minister,

Health Ministry and other related ministries such as Rural Development,
Urban Development, Social

Justice and Empowerment, Labour and Employment, Environment and Forests) and
share your

concerns about Primary Health Care and the concerns of the People's Charter
for Health.

· Write articles in the newspaper or in magazines, journals or your local
newsletter on the need for

Primary Health Care, the Health for All Now Movement and other PHM themes.

· Translate the People's Charter for Health and other PHM documents into
your local language and

distribute them freely to the community and local health officials.

· Launch a PHM circle in your institution/ local area/ district/ state.

· Register to the PHM website to contribute to its content and health
library.

More at http://www.phmovement.org/en/activists

*Contacts*

*Website: **www.phmovement.org*

*Email: **globalsecretariat at phmovement.org*
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