We are thrilled to release the Partners In Health Program Management Guide.

Based on PIH’s experiences, the Program Management Guide offers an approach to starting, revamping, or expanding a program in the field. Its aim is to help program managers solve challenges commonly faced in resource-poor settings. Our goal in releasing the guide is to share our approach, solicit feedback, and spark conversations that will help all of us improve global health delivery.

Please take a moment to read the "Note to the Reader" below or jump straight to the guide overview:


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Note to the Reader

As PIH enters the 25th year of providing a preferential option for the poor in health care, we reflect on how much we have evolved since the organization’s inception. What started as a small, grassroots health project in a community of internally displaced people in Cange, Haiti, has grown to an effort that, as of 2011, serves 2.4 million patients in more than 76 health facilities in 12 countries, and compensates close to 15,000 staff.

PIH has progressively built on its approach to ensure health as a human right through community engagement and strengthening of the public sector. Poor communities all over the world (in rich and poor countries) cope with a high disease burden and gross inequities in the social determinants of disease, while being strapped for infrastructure and health workers.

PIH’s track record in building systems that address these complex synergies has gained traction with communities, grassroots nongovernmental organizations, and governments. Given PIH’s experience, we have been increasingly asked to articulate the architecture of this work.


A practical “how-to” manual

To this end, we are pleased and proud to share this guide, a collective effort of PIH leadership from around the world to capture the elements of how our work is designed, implemented, and evaluated.

Meant as a practical “how-to” manual, there’s a storyline that’s familiar even though the settings—and people—change. The opening scene: a team organizes with a local community and public sector workers to improve health services in a catchment area that has been chronically understaffed, under-equipped, under-trained, and under-resourced for years.

The team works around the clock to identify and treat patients while also trying to get medicines and supplies through customs, manage finances, secure clean water for the site, set up power and an Internet connection, hire clinic-based and community staff, locate an ambulance and driver, identify potential partners—and the list goes on. A program manager’s extensive “to-do” list inevitably gets longer as more challenges arise.


Sharing what worked for us, not a set of answers

Partners In Health is founded and named on the belief that health inequalities are best addressed through a movement for social justice involving a multitude of partners working on behalf of the destitute sick. Every day, we are inspired by the work of other like-minded organizations, and buoyed by the sharing of knowledge within this community.

We're acutely aware and grateful that we’re not alone in this work. We wrote this guide not to provide set answers, but rather to share what we’ve done and how we’ve done it over the past 25 years. To get this right, we undertook extensive background research, sifted through stacks of documents, carried out over a hundred interviews with staff in Boston and at PIH-supported sites, and had long discussions about how we tackled many difficult situations.


The beginning of a conversation

Documenting PIH’s experience in implementing programs with as much internal candor as possible is one way to preserve institutional memory, but it’s more than simply an introspective exercise. We believe that detailed analysis and self-reflection is necessary for us to continue to improve the quality of our programs and services.

In this way, the guide serves as a roadmap for the organization as we continue to strengthen services in the countries where we work. But we also wrote the guide for those who are beginning health programs in resource-poor settings: those who seek ideas and suggestions on how to manage the myriad challenges in this work.

Above all, we see this guide as the beginning of a conversation with all those whose work champions the needs of the world’s poor. We look forward to refining all of our best practices as other practitioners—seasoned in this struggle or new to it—engage in a pragmatic discussion.


The importance of listening to the poor

Staying true to our mission of providing health care in solidarity with the poor is a difficult, ongoing process. It demands taking a hard look at the challenges that we’ve confronted, mistakes that we’ve made, and hard lessons we’ve learned from Haiti to Peru, Boston, Rwanda, Malawi, and the mountains of Lesotho. During the process, we’ve realized the importance of the many, often mundane, details on which the success of our work depends.

If there is a common thread that runs through all the units of this guide, it’s the importance of listening to the poor, and with them, designing programs and services that address their needs.

Ted Constan
Chief Operating Officer, Partners In Health

Joia Mukherjee
Chief Medical Officer, Partners In Health