Evaluation of the contribution of the NHS South Central 'Improving Global Health through Leadership Development' scheme towards the improvement in health and healthcare in Cambodia: a policy report

Background In 2008 NHS South Central launched a new initiative entitled ‘Improving Global Health through Leadership Development’, aiming to provide both leadership development for NHS staff, and improve health in developing countries. This policy report both reviews the literature on the effectiveness and evaluation of similar ‘health links’, and evaluates the partnership with the Maddox-Jolie Pitt (MJP) Foundation in Cambodia with regards to its development aim; reviewing the schemes contribution towards improvement in health and healthcare, drawing examples from the family planning workstream. Methods Literature was viewed on the effectiveness and evaluation of UK ‘health links’ with developing countries. A process and outcome orientated evaluation was conducted using qualitative research methods and a review of monitoring data. Interviews were conducted with Cambodian stakeholders with a focus on the family planning workstream. The evaluation did not specifically address cost-effectiveness, or issues of sustainability and equity. Key findings and conclusions The findings from this evaluation suggest that ‘Improving Global Health through Leadership Development’ has contributed towards the improvement in health and healthcare within MJP’s target area in Cambodia. There was evidence of changes in health services, and practices of Cambodian healthcare workers, attributable to the work of the scheme. The Cambodian experience of the process has been generally positive, but a number of challenges were identified, similar to those identified with other health links. The findings from this report add to the body of evidence on the effectiveness of health links, and their associated good practice. Recommendations Recommendations are proposed around five themes: 1. Review and clarify the development objectives of the scheme 2. Improve alignment with Cambodian Ministry of Health policy 3. Enhance mutual learning by considering a minimum placement length of four months and reciprocal visits to the UK for developing country partner health workers 4. Promote local ownership of the workstreams that are led and driven by developing country partners 5. Consider further evaluation of links in order to contribute to the literature on best practice