Our Approach
Lasting change in a health system takes time.
It is built step by step through trusted, long-standing partnerships with government entities and communities that will own and maintain it long after One Heart Worldwide has stepped out.
Every district where OHW works follows a six-year pathway to local ownership. We begin by strengthening the foundations of the health system, work alongside local governments to build capacity and systems, and strategically transition financial and operational responsibility based on demonstrated progress, ensuring that local ownership is built on readiness, performance, and sustainability
The three phases below describe how that journey unfolds.
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Before any program activities begin, we take the time to build strong foundations. This means establishing formal partnerships with local municipal government representatives and local NGOs, conducting baseline surveys and needs and capacity assessments to understand the current state of maternal and newborn health services in the district. We then work with local stakeholders to customize our model and co-create solutions adapted to the specific context, needs, and priorities of each community.
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Once solid foundations are in place, the implementation phase starts. This is where the core work of building a stronger health system begins. Health facilities are upgraded and equipped, healthcare providers are trained, community outreach activities are launched, and quality improvement programs are established.
Throughout this phase, we work side by side with municipal governments and community partners, building their capacity to manage and sustain these programs independently, while municipal cost-sharing commitments ensure local ownership is financial as well as programmatic from the start.
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The transition phase marks the beginning of the handover. Municipal governments assume full administrative and financial ownership of the programs implemented, conduct quality improvement assessments independently, manage essential medicine and equipment stocks at birthing centers, and budget for maternal and newborn health from their own municipal funds. One Heart Worldwide remains available throughout this phase to provide follow-up support and technical assistance as needed, while the government retains day-to-day management, decision-making, and operational leadership.
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A district reaches completed status when the transfer of full ownership is confirmed and sustained. We continue to assess our completed districts by reviewing secondary data and conducting integrated monitoring onsite visits. In our completed districts, 97% of local governments prioritize maternal and newborn health in their municipal budgets, and our program impact is reflected by an average 58% increase in births attended by a trained healthcare provider. These numbers are the measure of a model that works.
