Compañeros en Salud (Fall 2023)

Project Background

Partners In Health (PIH) is an international health organization relentlessly committed to improving the health of the poor and marginalized. PIH partners with local governments to build local capacity and works closely with impoverished communities to deliver high-quality health care, address the root causes of illness, train providers, advance research, and advocate for global policy change.

The organization originally developed as a community health project in Haiti in the 1980s and has since expanded to several countries around the world, including Mexico. Since 2011, Compañeros En Salud (CES), Partners In Health in Mexico, has operated as a non-governmental organization that collaborates with the local Ministry of Health to strengthen healthcare delivery. Over the last decade, CES has developed and implemented numerous healthcare delivery innovations with remarkable outcomes.

Definition of Opportunity

The primary objective of this project is to create a comprehensive inventory of healthcare delivery innovations implemented by CES in Mexico. The inventory will not only highlight CES's achievements but also provide a global context by identifying and comparing similar innovations worldwide. To achieve this, the project will involve a meticulous scope review, thorough publication analysis, interviews with knowledgeable CES personnel, and contextualization with global examples.

Definition of Success

Success for this project entails producing a comprehensive report that showcases CES’ healthcare delivery innovations in an organized manner. The report will vividly describe each healthcare innovation, outlining its key implementation elements, highlighting the significant outcomes achieved, and offering insightful global comparisons. The document will be a valuable resource that not only demonstrates CES's contributions to healthcare delivery but also serves as a source of inspiration and learning for donors, local organizations, and government officials in Mexico. This success will be measured by the report's ability to effectively communicate CES's innovative approaches, engage stakeholders, and foster meaningful collaborations toward advancing healthcare practices and outcomes within Mexico's healthcare landscape.

Meet the Team

Compañeros en Salud (Fall 2022)

Project Background

Partners In Health (PIH) is an international health organization relentlessly committed to improving the health of the poor and marginalized. PIH partners with local governments to build local capacity and works closely with impoverished communities to deliver high-quality health care, address the root causes of illness, train providers, advance research, and advocate for global policy change.

The organization originally developed as a community health project in Haiti and has since expanded to several countries around the world, including Mexico. Since 2011, Compañeros En Salud (CES), Partners In Health in Mexico, has operated as a non-governmental organization that collaborates with the local Ministry of Health to strengthen healthcare delivery. To achieve comprehensive healthcare delivery, CES provides follow-up care for non-communicable diseases and maternal health patients with community health workers, known locally as Acompañantes.

Definition of Opportunity

Acompañantes care for members of their own community who have complex medical and social situations; the impact of their work on their own mental health – both its emotional burden and its therapeutic role – was highlighted in a CES quality improvement project to inform the creation of a comprehensive mental health pathway to care for the acompañantes. Programmatic changes suggestions done by current Acompañantes are being taken into consideration to allow wellness and professional growth opportunities for the whole team.

The Acompañantes program coordinators at CES are looking to develop a curricula through the fall of 2022 to later be implemented in 2023 - 2024 with the Acompañantes and Acompañantes supervisors to improve the personal and collective wellbeing of the current teams through techniques such as mindfulness and relaxation, gratefulness, purpose, creativity; as well as reinforce adequate team dynamics and communication that will allow for each CHW to feel as supported by CES as they care for their patients. Because supportive supervision plays a critical role in ensuring CHWs feel well-prepared to do their work, it is also important to expand training of CHW supervisors to enhance their current activities by gaining more knowledge on 1) other CHW programs, 2) popular education techniques and 3) practical use of Microsoft Office package; as well as developing more leadership skills such as team building and group dynamics, assertive communication, opportune feedback, etc.

Definition of Success

Development and creation of training materials and a work plan on the proposed subjects that can be delivered to the 9 groups of Acompañantes and 3 Acompañantes supervisors during the period of July 2023 – June 2024.

Meet the Team

Final Deliverable

ITESM (Spring 2021)

Project Background:

Since its founding in 1943, Monterrey Tech has quickly become one of the most prestigious universities in Latin America.  With 36 campuses in Mexico, the Tech has stood out for training leaders through quality education, research and innovative educational models. In August 2019, as an initiative by the School of Medicine and Health Sciences, and the School of Government and Public Transformation, the Initiative for the Institute of Global Health Equity (IESG in Spanish) emerged. As the first global health institute in Mexico, it seeks to be a leader in training and education of change agents, through research, innovation and knowledge translation, addressing the health inequities in Mexico and the world, based on the belief that health is a fundamental human right.

The Institute of Global Health Equity aspires to partner and work with leading local, national,and global organizations, including Partners In Health (PIH) and its sister organization in Mexico, Compañeros en Salud (CES).  PIH has created an organization to work with community members and university students called PIH Engage to help build a global movement for the right to health,  as well as recruit, train, and equip dedicated teams of volunteer community leaders who mobilize their communities in the fight for health equity. 

The IGHE is launching the first PIH Engage community outside of the United States, and already 15-20 Monterrey Tech students (most medical school students) from Guadalajara, Monterrey and Mexico City have indicated an interest in working together with PIH and CES as “CES Embajadores” (CES Ambassadors) in community building, fundraising, and advocacy on issues of health equity and social justice.

Opportunity:

IGHE is interested in partnering with this DAT and CES Embajadores to explore building new skills and capacities for advocacy on critical health care issues in Mexico. While PIH has built out PIH Engage Advocacy Resources resources in the US, there is nothing similar in Mexico. Our hope is to build these advocacy resources and capacity, sensitive to and adapted for the Mexican context.

 

Definition of Success:

Create and expand significantly the capacity of a student-led force for positively influencing health and equity policy in meaningful ways in Mexico. At the end of this collaboration we would like to have a solid and replicable framework for the rest of the teams that will emerge in the future, with strategies designed and adapted to the Mexican context.

Meet the Team:

Final Deliverables:

Advocacy Manuel

Fundraising Guide

Vía Educación (Spring 2021)

Project Background:

Vía Educación is a non-profit organization in Mexico seeking to improve people’s quality of life by promoting sustainable social development through education. The organization believes that every person is capable of improving their opportunities in life as well as those of their communities. The organization’s main objective is to implement best practices and share knowledge related to quality education and social transformation from an interdisciplinary and systemic perspective. It has a professional team of more than 40 collaborators in seven cities of the country, committed to equal opportunities for quality education, the development of communities and families, human rights, respect for the dignity of people and confidence in their transformation potential.  Since its beginnings, the organization has placed a strong focus on research and the evaluation of its programs. This year, the Monitoring, Learning & Evaluation team is transitioning and expanding into a laboratory of social innovation. Among other things, the lab will focus on designing innovations and generating evidence to inform and address social and educational challenges. 

Opportunity:

 Vía Educación seeks to collaborate with the DAT Team in carrying out a comparative study of the educational context and indicators in the two Mexican states of Nuevo León and Yucatán. Some of the questions to explore are:  (1) What are the challenges that the education systems in these states are facing/will face because of the school closures to prevent the spread of COVID-19? and (2) What are some actions and innovations that may help overcome these challenges? Thus, Vía Educación would like the DAT team to contribute to these by providing initial inputs to deepen the understanding of the context in such states and to have a basis to design innovations that respond to their educational needs.

 

Definition of Success:

Working with the Notre Dame DAT, Vía hopes to be inspired to design and implement new responses to the educational opportunities of the five targeted states by having a first analysis of each state and some initial ideas of forward-thinking practices worth exploring.

Meet the Team:

Final Deliverables:

Final Presentation

One-Pager

Letter Writing Guidelines

Deportes de Comunidades

Vía Educación (Fall 2020)

Project Background:

Vía Educación is a non-profit organization in Mexico seeking to improve people’s quality of life by promoting sustainable social development through education. The organization believes that every person is capable of improving their opportunities in life as well as those of their communities. Vía Educación implements Learning Communities, a project whose model is founded on 30+ years of research and practice by the Community of Research on Excellence for All (“CREA”) at the University of Barcelona. The model involves “implementing ‘Successful Educational Actions’ (SEAs) characterized by reorganizing the available resources in the school and the community to support all pupils’ academic achievement” (Flecha, Soler, 2013).  The model is implemented internationally through different implementing partners in countries such as Mexico, Colombia, Ecuador, Spain, Perú, among others. Vía Educación is the implementing partner in Mexico, working with nearly 200 public elementary and middle schools across 8 states in Mexico as of July 2019.

Opportunity:

Via is interested in expanding its work in citizenship education, and would like the team to review mechanisms for citizenship education in non-formal spaces around the world.  We are developing a collaboration with a local Mexican organization focused on civic participation in neighborhoods to broaden the reach of our community programs. It would be great to have a review of what other organizations are doing, their theory of change, a comparison among the different initiatives, innovatives and high-impact practices and implementations, and some insights on how it could be adapted to Mexico. DAT students will have support from Via not only in providing information and responding to questions, but also in connecting the team with stakeholders for interviews and surveys, etc.

Definition of Success:

Working with the Notre Dame DAT, VIA hopes to be inspired to expand its work on citizen education, identifying best practices both globally and in Mexico in citizenship education as well as presenting the ideas in ways that are engaging with and attractive to policymakers and administrators.

Meet the Team:

Final Deliverable

Final Deliverable - VIA F2020 by DAT on Scribd

Vía Educación (Spring 2020)

Project Background:

Vía Educación is a non-profit organization in Mexico seeking to improve people’s quality of life by promoting sustainable social development through education. The organization believes that every person is capable of improving their opportunities in life as well as those of their communities. Vía Educación implements Learning Communities, a project whose model is founded on 30+ years of research and practice by the Community of Research on Excellence for All (“CREA”) at the University of Barcelona. The model involves “implementing ‘Successful Educational Actions’ (SEAs) characterized by reorganizing the available resources in the school and the community to support all pupils’ academic achievement” (Flecha, Soler, 2013).  The model is implemented internationally through different implementing partners in countries such as Mexico, Colombia, Ecuador, Spain, Perú, among others. Vía Educación is the implementing partner in Mexico, working with nearly 200 public elementary and middle schools across 8 states in Mexico as of July 2019.

Definition of Opportunity:

The Monitoring, Evaluation and Learning (MEL) team at Vía Educación would like to understand the link between these programs and academic achievement. Are the schools involved in this program scoring higher on standardized test scores than they did before they were implementing the program? While the model’s theoretical background asserts that schools implementing SEAs improve their academic achievement, we would like to explore this relationship in practice. An important thing to keep in mind is that the implementation in the 200 schools in Mexico is not homogenous across all schools - rather, schools choose which of the 7 SEAs they want to incorporate into their school. 

What does success look like? 

Success for us would look like a clearer picture of the relationship (with evidence) between the program and academic achievement, that we could use to support the theoretical arguments behind this program. This project is an opportunity to collaborate with a successful educational program as well as an opportunity to put in practice your data analysis abilities (mostly quantitative) to empirically demonstrate the relationship between the program and academic achievement.

Meet the Team:

Instituto Tecnológico y de Estudios Superiores de Monterrey (Spring 2020)

Project Background:

The ​Tecnológico de Monterrey​ ​and its network of campuses throughout Mexico is committed to providing quality education, world-class research, and building innovative models for the benefit of society. With the leadership of ​ITESM’s School of Medicine and the School of Government​, the University is building a new interdisciplinary institute for global health training and research with strong links to practice. The fall 2018 DAT helped develop some of the foundational ideas for the new Institute for Global Health Equity (IESG).

The IESG aims to be a global center of excellence that generates health through training, research, innovation and knowledge translation, addressing in an interdisciplinary way the existing inequities in Mexico and the world, based on health as a human right. The IESG aspires to lead in training, research, implementation and public policy development in Global Health and Social Medicine in Latin America, through the creation of integral solutions to address social factors and strengthen health systems with an intersectoral approach, with a preferential option for poor and vulnerable populations.

Definition of Opportunity:

In August 2019, ITESM’s IESG created a partnership with Partner In Health’s sister organization, ​Compañeros en Salud​ in Chiapas, Mexico and the International Center for Social Innovation of Tec de Monterrey (Centro Internacional de Inovación Social, CIIS in Spanish) to generate collaborative projects. Compañeros en Salud works in rural Chiapas Mexico to provide quality health care to underserved communities and hopes to serve as an inspiring model to train and accompany health professionals and community health workers, and to deliver quality health care in low resource settings in Mexico and elsewhere. ​The International Center for Social Innovation (CIIS) is a world-class center that offers an ecosystem apt for social innovation. The CIIS focuses on research and the generation and validation of innovative solutions to social problems. Located in San Cristóbal de Las Casas, Chiapas, every year, during the summer and winter,  the CIIS receives dozens of students from various Tec campuses to work on the resolution of social problems in Chiapas communities. For a 5-week period, the students take various classes and work to generate solutions to social problems in a community. CIIS follows up on the work until the best solutions get implemented. IESG and PIH​ have deep ties to Notre Dame, and both IESG and PIH have served as clients on DAT projects in the past. 

In late November-early December 2019, IESG, CIIS, and CES offered the first-ever immersive global health course in rural Chiapas to Tec students from any discipline at any campus. The five-weeks course was aimed to initiate long-term partnerships with local communities where CES worked and collaboratively address local social issues while training Tec students in the philosophies of accompaniment, program implementation, and global health. Professors, administrators, and communities were excited to see this program unfold. After three weeks of advertising, however, the course offer had to be withdrawn due to lack of interest expressed -- only three students registered to the course.

What does success look like? 

1. That IESG, CIIS, and CES are able to use the lessons and recommendations by the Development Advisory Team to successfully attract talented students interested both in learning about global health and in making contributions to the 2020 summer immersive course in global health. 

2. That after using the partnership framework during the immersive experience in rural communities in Chiapas, a diverse group of stakeholders is satisfied by the experience and work and we can replicate and expand the model in the future. Such stakeholders include people in the villages, CES staff, students, CIIS and IESG administrators, and Tec professors.

Meet the Team:

- VIA Educacion (Fall 2019)

Project Background:

 Vía Educación is a non-profit organization in Mexico seeking to improve people’s quality of life by promoting sustainable social development through education. The organization believes that every person is capable of improving their opportunities in life as well as those of their communities. 

Vía Educación developed a methodology for social transformation based on building problem-solving capacities on communities of youth and adults. The methodology aims to increase individual and collective self-efficacy among community members; develop civic competencies through solving relevant community needs; and strengthen social capital. This methodology is the backbone of the organization and is applied in a variety of programs and settings in Mexico. 

Definition of Opportunity:

With that in mind, the Investigation and Evaluation team at Vía Educación would like to explore the link between these acquired skills (teamwork, democratic and citizenship participation, conflict resolution, assertive communication, collective organization skills, among others) and mobility (social, educational, economic). An emerging body of literature suggests that civic engagement may affect peoples’ wellbeing. Are our participants expanding their opportunities in life? The team would like to further learn about this, and even possibly incorporate a tool we could apply with our alumni network and current participants to test this potential relationship. 

What does success look like? 

Success for us would look like a clearer picture of the relationship between civic participation skills and mobility (e.g. a couple of pages concisely stating what literature has to say about this relationship as well as the mechanisms behind it – that is, if there is a positive relationship, how do civic participation skills contribute to expanding an individual’s opportunities in life?). We also would appreciate a concrete tool that we could use to test in the field to measure this relationship in a variety of settings (e.g. urban, indigenous, marginalized, rural communities, etc.) and populations (from students in high school to teachers and authorities in Mexico’s public school system as well as neighborhood community members).

Meet the Team:

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Best Global Practices for Tobacco Control - National Institute for Respiratory Diseases, Mexico (Fall 2019)

National Institute for Respiratory Diseases, Mexico

Project Background:

The Tobacco Clinic (TC) at the National Institute of Respiratory Diseases (INER) aims to provide support to all smoking patients so that they can quit such a habit in Mexico. Currently, TC provides care to more than 300 patients with an 85% success rate once treatment is finished, 50% at 6 months and 35% at one year after treatment. Through a multidisciplinary team of medicine, psychology, nursing, and nutrition, the Clinic has a cognitive-behavioral program made of 10 group or individual sessions for 5 weeks. This program also includes medical consultation along with pharmacologic treatment to improve therapy outcomes. The whole Clinic’s program is available to the general population: any patient can enter the program. The cost of the sessions is decided according to a socioeconomic level study which varies between $20 and $200 USD. In case pharmacologic treatment is required, the patient will probably spend between $40 and $400 USD depending on his or her needs.

Furthermore, there is a monthly support session for ex-smokers to strengthen addiction cessation through three objectives: 1) Continuous professional interaction with patients so that follow up can be completed; 2) Connection with people ranging on different stages of the smoking cessation process; 3) Provide information regarding the impact tobacco has on patients’ health so that abstinence can be reinforced.

Besides its welfare component, the Clinic has a very important clinical research component, trying to associate different consumption patterns with genetic and functional variations, symptoms and patient prognosis. The TC is currently including dual users (patients that smoke both tobacco and marijuana) in its research and care groups. Moreover, the Clinic is nowadays the headquarters for the Interinstitutional Committee for Tobacco Control, a working group that gathers key stakeholders in private, public and hospital Institutions around Tobacco Control policies.

Definition of Opportunity:

Despite its 30 years of experience, the TC has not compared its model to other successful models for tobacco cessation. Nor has it expanded its influence through e-health. The TC has a limited impact mostly because its population comes almost exclusively from the patient population from inside INER. This limits most of its focus on patients older than 50 years with an already existent pulmonary and/or chronic disease. Thus, there is a need to attract younger populations. Moreover, there is a wide gap of knowledge regarding a patient who has drug addictions that can affect the lung such as inhaled polymers, cocaine and others. For this, the Clinic is currently trying to launch an app that can provide support for patients who want to quit smoking and at the same time feed the TC with data useful for research. Additionally, our Interinstitutional Committee has important and yet unused talent due to a lack of social communication and PR strategies.

Initial ideas:

Comparative work from what the TC does, compared with what other evidence-based centers are doing is extremely useful. Moreover, being able to compare what differences exist between developing and developed countries can help the Clinic find the middle ground that could scale its impact. Specifically exploring the following topics:

• Best examples of Tobacco Cessation Group Session strategies

• Tobacco Cessation Center’s outcome tracking and impact measurement

• Use of e-health strategies to scale the Clinic’s impact

• Successful Strategies for Tobacco Control Committees.

What does success look like:

Specific deliverables regarding the four areas shown above would help the Clinic greatly. Any further development of each one of these comparative tasks into an actual application to the TC would be most welcome. For example, if based on a comparative table of other Tobacco Center’s main impact measures, the team could aid the Clinic in creating its own or our joint project would really make a lasting difference.

Meet the Team:

View fullsize

Final Deliverable

Building a new university-based, interdisciplinary center for global health - ITESM, Mexico (Fall 2018)

Client Profile

The Tecnológico de Monterrey and its network of campuses throughout Mexico is committed to providing quality education, world-class research, and building innovative models for the benefit of society. With the leadership of ITESM’s School of Medicine and the School of Government, the University is looking to build a new interdisciplinary center for global health training and research with strong links to practice.

The DGHSM aims to be a global center of excellence that generates health through training, research, innovation and knowledge translation, addressing in a profound and interdisciplinary way the existing inequities in Mexico and the world, based on health as a human right.  The DGHSM aspires to lead in training, research, implementation and public policy development in Global Health and Social Medicine in Latin America, through the creation of integral solutions to address social factors and strengthen health systems with a preferential option for vulnerable populations.

Definition of Opportunity

ITESM’s DGHSM is currently exploring the possibility of partnerships with the Program on Global Surgery and Social Change (PGSSC) and the Partner In Health’s sister organization, Compañeros en Salud in Chiapas, Mexico.  The Program on Global Surgery and Social Change (PGSSC) is a collaborative effort between the Harvard teaching hospitals, Harvard Medical School/ Department of Global Health and Social Medicine, Boston Children’s Hospital (BCH) and Partners In Health (PIH).  This organization emerges out of work of the Lancet Commission on Global Surgery, tled by Dr. John Meara at Harvard Medical School (a 1986 ND graduate).  PGSSC’s objective is to advocate for Universal access to safe, affordable surgical and anesthesia care when needed. Compañeros en Salud is affiliated with Partners In Health and works in rural Chiapas Mexico to provide quality health care to underserved communities and hopes to serve as an inspiring model to train and accompany health professionals and community health workers, and to deliver quality health care in low resource settings in Mexico and elsewhere. Both PGSSC and PIH have deep ties to Notre Dame, and have served as clients on DAT projects over multiple semesters.

Initial Ideas

The ITESM Department of Global Health & Social Medicine is looking for models of university-based, interdisciplinary centers that work in the international context in close partnership with health service providers and policy makers.

●      ITESM is interesting in exploring different models of partnership that have been established for developing, first-rate, interdisciplinary global health centers that have strong links to practice, that highlight different institutional structures, incentives, and potential partnerships.

●      ITESM hopes to explore and expand partnerships with international development and health organizations, such as Compañeros en Salud, the Harvard Medical School and the University of Notre Dame, consistent with its strategic objectives.

●      ITESM is interested in implementing a framework to develop international partnerships.

Definition of Success

That ITESM uses the systematic examination of different examples and models for building an interdisciplinary, university based Center for Global Health with a strong link to practice in ways that it might serve as a roadmap for a path forward.

Recommendations

Healthcare Delivery Expansion in Rural Mexico - Partners in Health (Fall 2015)

Client Profile

Partners in Health (PIH) is a global healthcare NGO founded in 1987 to provide a preferential option for the poor in healthcare. The organization originally developed as a community health project in Haiti and has since expanded to several countries around the world—Mexico being one of the most recent in 2012.  In Mexico, PIH operates through its sister organization, Compañeros en Salud (CES).  CES partners directly with the Mexican government to strengthen healthcare delivery in the rural state of Chiapas (the southernmost and poorest state in Mexico) by providing mentorship to recently graduated Mexican medical students serving in primary health clinics, training community health workers to support chronic diseases patients, and accompanying patients requiring higher level care as they navigate the health system.  

Definition of Problem

A young organization, CES is still working to develop new programs and expand its existing services in order to better deliver care to rural communities in Chiapas.  Beginning in 2012 with clinics in just two communities, the organization now operates clinics in ten communities and supports community health workers in six.  For many years, it was nearly impossible to find medical doctors to serve the rural clinics in Chiapas. Today, CES’s global health education model attracts medical students from top medical schools throughout all of Mexico.  Through its “Right to Health” reference program, CES is able to assist patients requiring more specialized attention beyond just primary care coverage.  Given the diversity of these operations, there are many paths for CES to pursue in the future, and it is still uncertain where the organization should best invest its resources to maximize impact.  CES would like to work with a Development Advisory Team to investigate and evaluate different strategic options for the organization’s future.

 Initial Ideas and Options

• Explore the costs and the benefits of options such as:
  • Expanding the number of clinics supported in Chiapas
  • Expanding the types of health coverage provided
  • Expanding services to another state in Mexico
  • Increasing focus on the policy level
  • Increasing focus on medical education
• Work closely with CES staff to understand the organization and its current operations.
• Identify organizations that have faced similar dilemmas in expansion and development.  Write short case studies that draw lessons from those experiences.

Definition of Success

 A systematic report exploring options for CES’s future activities, based on evaluation of each of the above potential options and comparative analysis of similar organizations, that helps us to understand how each strategy would increase our impact, and provide the basis for dialogue within the organization to consider these strategic options.

Recommendation 

Presentation

Report

From Aid to Accompaniment - Partners in Health (Spring 2014)

Client Profile

Partners in Health (PIH) was founded in 1987 to bring quality medical care to rural Haiti.  Since then, PIH has expanded to several countries around the world including Rwanda, Lesotho, Malawi, Russia, Peru, and Navajo Nation in the United States.  PIH also partners with several sister organizations to increase its ability to further its mission.  In 2012, PIH launched its newest project in the Chiapas region of Mexico.  PIH draws on the world’s best medical institutions to provide a preferential option for the poor in health care.  According to PIH’s mission statement, its mission is both medical and moral, and it is based on solidarity rather than charity alone.

See all Development Advisory Team projects with Partners in Health

Recommendation

Development Advisory Team Biographies