Table 2 T-HOPE framework: descriptive fields with examples

A. Program Profile:

Description of several operational aspects of the program.

Example: Marie Stopes International (MSI) Bolivia.

1. Summary (100 word overview): MSI Bolivia approaches the subjects of sexual and reproductive health in men and women through the provision of established and mobile services, aiding in the financing of services for low-income families, social marketing, and participative, inclusive education.

2. Implementing organization: Marie Stopes International.

3. Health focus: Family Planning & Reproductive Health.

4. Type of product/service: Reproductive service delivery at medical centers and mobile clinics; a call center to provide info and make referrals; social marketing about new contraceptive products; and education in regards to sexual and reproductive rights, as well as sexual violence.

5. Client type: Young adults (13–24); men; women; general population.

6. Program type: Country office of an international organization.

7. Country registered and legal status: Bolivia, private (not-for-profit).

8. Country of Operation: Bolivia.

9. Geographic location (within the country): La Paz, Santa Cruz, Cochabamba, Potosi, Chuquisaca, Oruro, Beni. Operates in 4 of 9 states, and reaches more than 110 municipalities with 5 mobile units.

10. Stage: Existing/expansion stage.

11. Year launched: 1995.

12. Number of facilities: 11 (6 established health centers, 5 mobile clinics).

13. Number of employees: 50–99; MSI Bolivia manages a staff of 70 professionals, including doctors, drivers, health promoters and social marketing experts.

14. Target population: Approximately 800,000 people.

15. Operational and technical partners: None.

B. Problem:

Brief description of the problem that the program is trying to address, including the rationale and/or justification for the program.

Example: MotoMedics (Vietnam).

In a city like Hanoi where traffic is a critical problem, traditional ambulance vans struggle to reach patients within 30 or 45 minutes after the call for assistance is made. By then, the chance to provide life-saving medication or procedures significantly decreases. The introduction of a medical first responder program using motorbikes would improve response times and could significantly increase medial emergency survival rates as well as lower the costs of medical care for the patient.

C. Goal:

Description of the program’s theory of change or what the program aims to achieve through its interventions.

Example: Ziqitza - Dial 1298 for Ambulance (India)

Dial 1298 for Ambulance, delivered by Ziqitza Health Care Limited (ZHL), strives to deliver a nationwide network of Life Support Ambulance Services accessible to anyone, anytime and anywhere through an easy to remember four-digit telephone number. The program is committed to meeting international quality standards in emergency medical services and aims to extend the availability of emergency transportation and care to lower-income populations.

D. Process:

Description of how the program achieves its goals. This field should outline the processes and steps that are used to deliver the program’s products and/or services and the relationships between them.

Example: Piramal E-Swasthya (India).

1. Local literate women are recruited to undergo a rigorous training program in which they are trained to collect simple diagnostic information, and to provide preventive medicine, first-aid and customer service.

2. These women are given a medical kit, marketing material and a mobile phone. They are then assisted in setting up a tele-clinic (Piramal e-Swasthya Center) at their own homes.

3. Villagers who feel ill come to the Piramal e-Swasthya Center or are given a home visit. After talking to and examining the patient, the health care worker communicates this diagnostic data through a cell-phone to a centralized call center.

4. A call center paramedic enters the information provided into a simple e-diagnosis system, which generates an automated response with the recommended prescription and treatment. Doctors manning the call center also validate this.

5. If the ailment appears serious, the call center recommends that the patient visit a secondary or tertiary health care facility immediately.

6. The health care worker also conducts preventive health workshops, which generate awareness about issues such as sanitation, nutrition, and first aid.

E. Challenges/Opportunities:

Description of the obstacles the program faces in delivering its products or services, and/or any opportunities the program has discovered and plans to leverage.

Example: Aceh Besar Midwives with Mobile Phones (Indonesia).

This 2006 World Vision project leveraged mobile phone communication technology in Indonesia by distributing cell phones and developing an SMS data collection system, which helped to facilitate patient data collection by midwives and voice communication between midwives and obstetrician-gynecologists. Challenges faced in the use of these technologies included high cost of adoption, inadequate health care facilities, and poor infrastructural support.

F. Strategic Planning:

Description of how the program sets its plans for identifying and achieving future goals including scaling-up or plans for growth. This section should include plans for engaging in activities to obtain resources and assigning responsibilities to attain these goals. This section should also provide information on the future plans of the program.

Example: LifeNet International (Burundi, East Africa).

Through their efficient social franchising model, which involves medical training, management training, pharmaceutical supply, and growth financing for existing clinics, LifeNet plans to double the quality of care received in 10 million patient visits to 1,000 partner clinics in 10 East African countries by 2020.

G. Innovative Practices:

Description of innovative practices used by the program to meet its goals.

Example: APOPO (Tanzania and Mozambique).

Using process reengineering, APOPO trains African giant pouched rats in Tanzania and Mozambique to provide second-line screening of TB samples from collaborating TB diagnostic centers.